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Malaria is a leading cause of death in Sub-Saharan Africa. In 2018, among 228 million cases of malaria globally, there were 405,000 deaths, 94% of which were in Sub-Saharan Africa. Although treatment has gotten much better in recent years and deaths due to malaria have begun to decline globally, in the time of the COVID-19 pandemic worries have arisen that those who receive treatment for malaria will be unable to continue to do so. (https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/maintain-essential-services-malaria.html)Recent results from the Global Fund’s biweekly survey of HIV, TB, and malaria treatment programs found that 73% of malaria programs reported disruption to service delivery, with 19% reporting high and very high disruptions. Activities within the programs are being canceled due to lockdowns, restrictions on the size of gatherings, transport stoppages, COVID-related stigma, and clients not seeking health services as usual. With these disruptions to important malaria treatment services, such as insecticide-treated net campaigns and antimalarial medicine administration, the World Health Organization predicts that deaths from malaria in Sub-saharan Africa could double. (https://www.theglobalfight.org/covid-aids-tb-malaria/) These deaths would return countries' malaria mortality levels from the year 2000, regressing on the progress that malaria treatment has reached in the past 18 years. It has never been more vital than now that countries continue to mitigate malaria treatment in their communities and sustain essential services that have helped save so many lives of those affected by malaria. (https://www.who.int/news-room/detail/23-04-2020-who-urges-countries-to-move-quickly-to-save-lives-from-malaria-in-sub-saharan-africa) The Global Fund is a partnership designed to help eradicate HIV, TB, and malaria epidemics. It raises and invests more than $4 billion a year to support local programs for these epidemics. They partner with local experts in countries, as well as governments, faith-based organizations, technical agencies, the private sector, and those affected by these diseases to raise money, invest it, and implement strategies to give aid. (https://www.theglobalfund.org/en/overview/) The Global Fund has created an urgent mitigation plan to curb the effect of COVID-19 on delivering essential health services, such as malaria relief, as well as making $1 billion available to other countries as part of their response. They plan to adapt malaria programs to mitigate the impact of COVID-19, protect frontline workers with protective equipment and training, reinforce supply chains, laboratory networks, and community-led response systems, and fight COVID-19 by supporting testing, tracing, isolation, and treatment. The Global Fund is seeking an additional $5 billion to mitigate the impact of COVID-19 on countries receiving treatment for malaria, TB, and HIV. (https://www.theglobalfund.org/en/covid-19-plan/) Along with the Global Fund and the WHO, the CDC has also created a set of key considerations for continuing essential malaria prevention, while safeguarding against the COVID-19 pandemic. In addition to recommending that a representative from the National Malaria Control Program should be considered for membership on the country’s National COVID-19 Incident Management Team, the CDC recommends continued access to Insecticide-Treated Nets for populations at risk, physical distancing during spray treatments, and the continuance of essential routine entomological monitoring activities while abiding by social distancing and wearing protective gear. The CDC also recommends that countries monitor their supply chain and adapt their malaria treatment programs if needed, due to higher costs or less resources. Countries should continue to collect data on COVID-19 and malaria illness in the population. It is important that countries communicate their continuation of malaria treatment to their citizens and educate them on how to seek treatment while also protecting themselves from COVID. (https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/maintain-essential-services-malaria.html)
The leading cause of death in Sub-Saharan Africa is malaria. There were 228 million cases of malaria globally in 2018. Additionally, there were 405,000 deaths, 94% of which were in Sub-Saharan Africa. The treatment improves in recent years and malaria has begun to decline globally. However, concerns about receiving treatment for malaria occurs during the COVID-19 pandemic. Recent results from the Global Fund’s biweekly survey of HIV, TB and malaria treatment programs found that 73% of malaria programs reported disruption to service delivery. Around 19% reports high and very high disruptions.

Lockdowns canceled activities within the programs. There are restrictions on the size of gatherings, transport stoppages, COVID-related stigma and patients are not seeking health services as usual. The World Health Organization predicts that deaths from malaria in Sub-saharan Africa could double due to disruptions to important malaria treatment services. For example, insecticide-treated net campaigns and antimalarial medicine administration. It is extremely vital that countries continue to mitigate malaria treatment in their communities. Additionally, the countries should sustain essential services that have helped save many lives affected by malaria.

The Global Fund

The Global Fund is a partnership that helps eradicate HIV, TB and malaria epidemics. It raises and invests more than $4 billion a year to support local programs for these epidemics. The organization partner with local experts in countries, governments, organizations, the private sector and those affected by these diseases. The aim of the partnership is to raise and invest money and implement strategies to give aid.

Furthermore, The Global Fund created an urgent mitigation plan to curb the effect of COVID-19 on delivering essential health services. The plan includes making $1 billion malaria relief available to other countries as part of their response. In addition, The Global Fund plans to adapt malaria programs to mitigate the impact of COVID-19 and protect frontline workers with protective equipment and training. It also reinforce supply chains, laboratory networks and community-led response systems. The Global Fund fights COVID-19 by supporting testing, tracing, isolation, and treatment. It seeks an additional $5 billion to mitigate the impact of COVID-19 on countries receiving treatment for malaria, TB and HIV.

Centers for Disease Control and Prevention (CDC)

The CDC created a set of key considerations for continuing essential malaria prevention while safeguarding against the COVID-19 pandemic. The CDC gives four recommendations during the COVID-19 pandemic. First, a representative from the National Malaria Control Program should be considered for membership on the country’s National COVID-19 Incident Management Team. Second, continued access for Insecticide-Treated Nets for populations at risk should be put in place. Third, physical distancing during spray treatments should be imposed. Lastly, the continuance of essential routine entomological monitoring activities while abiding by social distancing and wearing protective gear.

For countries that impacted by malaria, the CDC advises the countries to monitor their supply chain and adapt their malaria treatment programs. Countries should continue to collect data on COVID-19 and malaria illness in the population. It is important that countries communicate their continuation of malaria treatment to their citizens and educate them on how to seek treatment while also protecting themselves from COVID-19.

Giulia Silver
Photo: Flickr

Malaria treatment

At the young age of six years old, YouTube and comedy star Kacaman (aka Darcy Irakoze) just became the latest victim of malaria in Burundi. He was one of the biggest names in Burundi’s comedy scene and had thousands of views on YouTube. His videos, featuring the rural dirt floors and rusty villages of Burundi, were lighthearted and melodramatic skits starring himself and other comedians/actors. Darcy Irakoze is just one example of the need to improve malaria treatment in Burundi.

A Silent Crisis

Kacaman’s death brings to light an often-unspoken crisis: Burundi’s malaria epidemic. Nearly half of the country’s population has been affected by malaria this year. Of that number, 1800 have died from the disease. This staggering amount actually rivals the number of deaths from Ebola in the neighboring Democratic Republic of the Congo.

Poor preventative measures have been the driving factors behind the epidemic. These include a lack of mosquito nets, the movement of the population with low immunity to malaria from mountain areas to city areas and various changes in climate. The crisis has received some attention from the World Health Organization and the United Nations, but it remains remarkably untouched as a result of the current leadership. Afraid of admitting weakness in health policies, President Nkurunziza is hesitant to admit he needs help increasing malaria treatment.

An Epidemic of the Poor

The brutal reality that a six-year-old boy in Burundi can access the internet and YouTube but not malaria treatment presents a serious call for action. Often referred to as the “epidemic of the poor,” malaria disproportionately affects poverty-stricken areas like Burundi because of the expense required to purchase preventative measures and medical treatment.

The disease presents many ramifications for family members of the sick. They deal with psychological pain, the strain on already tight budgets and job loss. Additionally, malaria damages the economic wellbeing of countries as it decreases the chances of tourism and foreign investment. This keeps poor countries in a vicious cycle because they are unable to provide enough funds for malaria treatments or to improve other aspects of their country.

What Is Being Done?

Innovations like the Kite patch offer promising improvement for malaria prevention. The patch works by making humans virtually invisible to mosquitoes for up to 6 hours, stopping any bites. The company is working to distribute the patch around the world through the Kite-Malaria-Free Campaign, but it still needs more funding. The World Health Organization has launched the “high burden high impact” campaign as a response to countries facing extremely large epidemics. This entails a more aggressive approach to preventing and treating malaria by working with national governments in each of the countries to create an organized and strategic approach.

Increasing prevention is still vital in the fight against malaria. Widespread distribution of mosquito nets and insecticide in areas where these items are inaccessible or too expensive could yield massive results. More effective antimalarial treatments are also needed to fight malaria. The problem of the developing resistance to antimalarials in certain populations needs to be addressed to increase the efficacy of the drugs. Finally, a successful malaria vaccination needs to be more accessible. A semi-effective vaccine has been developed, but the technology still requires some fine-tuning.

It is likely at least one child will have died from malaria in the last minute. Kacaman was one of those children. His death should inspire a revitalized passion and determination to conquer malaria. While some incredible advances have been made, more is needed. Hopefully, these efforts can make this world one where malaria treatment and prevention is just as viral as YouTube.

Hannah Stewart
Photo: Flickr

anti-malaria_drug
An international group of medical scientists and vaccination experts have announced the discovery of a new class of antimalarial compounds capable of killing malaria parasites in an alternative method than currently observed in other medications. The team of researchers has expressed hopes that the discovery of the compounds will someday lead to a single dose cure or preventative vaccine for malaria that would cost as little as $1.00 US.

Dr. Ian Gilbert and his team of colleagues of the University of Dundee in the UK, in collaboration of the Medicines for Malaria Venture, discovered that the compound now named DDD107498 is capable of killing Plasmodium Falciparum, the species of the Malaria parasite considered most deadly, through targeting a molecule considered essential for protein synthesis.

In an interview regarding the discovery of the new compound, Dr. Gilbert eagerly reported, “This is an exciting new compound. It works against multiple life-cycle stages and has the potential to be an important medicine in the battle against malaria.”

With over 198 million cases of malaria worldwide recorded in 2013 and nearly 600,000 lives lost, mostly children who lived within sub-Saharan Africa, the race to discover a “miracle” malaria medication is tireless. Many scientists are exciting about the discovery of a compound that can fight Plasmodium Falciparum, as this form of malaria is especially dangerous due to its innate ability to develop resistances to various anti-Malaria drugs. The new anti-Malaria drug will be stronger against the parasite.

Through the analysis of over 4,700 compounds, the scientists learned that DDD107498 held the capabilities to fight malaria. Dr. Akhil Vaidya, a malaria research scientist at the Drexel University College of Medicine, reported that, “’The drug DDD107498 appears to have excellent pharmacological properties that would make it possible to devise a single dose cure for malaria, as well as to prevent malaria. It is also important that the drug works against various stages of the parasite, thereby making it possible to be used as a transmission blocking drug.”

The team of scientists hopes to determine an effective partner drug for DDD107498, as this compound is considered a relatively slow-paced killer of the Malaria parasite. Dr. Vaidya believes that combining the compound with a fast-killing drug would be the most suitable solution.

The pharmaceutical company Merck Serono has now adopted the development of the compound, which is currently undergoing critical stages of safety testing. Dr. Gilbert hopes that the first human clinical trials will begin within a year, and the drug will be available for consumer medical treatments within five to six years.

Dr. Michael Chew of the Wellcome Trust, a funder of the research being conducted, has claimed, “The need for new antimalarial drugs is more urgent than ever before, with emerging strains of the parasite now showing resistance against the best available drugs. The discovery of this new antimalarial agent, which has shown remarkable potency against multiple stages of the malaria lifecycle, is an exciting prospect in the hunt for viable new treatments.”

James Thornton

Sources: Humanosphere, Royal Society of Chemistry
Photo: The Scotsman

Five-Things-You-Didn't-Know-About-Malaria
Malaria is a disease caused by Plasmodium parasites, which are carried by Anopheles mosquitos. The mosquitos thrive in high temperatures, making malaria more common in tropical and subtropical regions. According to the Center for Disease Control, common symptoms include fever and flu-like illness, along with other issues, depending on the strain. The disease can also cause anemia and jaundice. Without treatment, malaria can lead to more severe issues and can be fatal. The following are some lesser known facts about the disease.

1. The United States was not considered free of malaria until 1951.

While many picture malaria being concentrated in more tropical areas, malaria was once prevalent across the globe. Malaria has been eliminated from several mild-weathered developed countries. In order to be considered officially free of a disease, a country needs to have no new cases of the disease for three years. The United States did not completely eliminate malaria until 1951, according to the Gates Foundation.

2. There are five species of Plasmodium parasites that cause malaria in humans.

P. falciparum, the deadliest of the species, can be found in tropical and subtropical areas around the world and is especially predominant in sub-Saharan Africa.

Another species, P. vivax, is the most prevalent of the five species and is found mostly throughout Asia, Latin America and some parts of Africa. Meanwhile, P. ovale is found predominantly in West Africa. P. vivax and P. ovale are both dormant for several months or years before they activate within an infected human being.

While these three species have a two-day replication cycle, P. malariae has a three-day cycle. Without treatment, this species can create a chronic infection that can last throughout one’s lifetime.

Finally, P. knowlesi is a species found in Southeast Asia that was recently shown to be a cause of zoonotic malaria. This species has a one-day replication cycle.

3. Malaria can either be categorized as uncomplicated or severe.

Uncomplicated malaria attacks tend to last between 6-10 hours and generally involve a cold stage, a hot stage and a sweating stage. Meanwhile, severe malaria is much more likely to be fatal. It involves infections of organs or the blood and can lead to abnormal neurological behavior, kidney failure, severe anemia, seizures or other effects.

4. The treatment used in the 17th Century is still used widely today.

In the early 17th century, indigenous tribes in Peru taught Jesuit missionaries about the cinchona tree’s medicinal bark and its effectiveness in treating fevers. The medicine from the bark is known as quinine, which has been seen as one of the most effective drugs in treating malaria. It is still one of the major antimalarial drugs used to treat the disease today.

5. There is a positive correlation between malaria and poverty.

While it is argued that both conditions feed into one another, it is clear that poor countries, who are most severely affected, have the least access to effective treatment and services for malaria. Malaria does not only affect both the physical and economic health of individuals, but it also affects the health of nations who need to deal with malaria systematically. According to the World Health Organization, Africa spends roughly $12 million annually addressing problems related to malaria, and economic growth in malarious African nations is therefore slowed by up to 1.3 percent annually.

– Arin Kerstein

Sources: CDC, Earth Institute, Gates Foundation, World Health Organization 1, World Health Organization 2
Photo: Centers for Disease Control and Prevention