Officials in areas of Kenya, Tanzania, and Uganda highly susceptable to malaria outbreaks have reported ranges of 86 to 100 accuracy in their models designed to factor the temperature and rainfall of the regions into their calculations. The models have been tested over the past nine years and correctly identified hundreds of locations where outbreaks later occured.
The project was funded by the Climate Change Adaptation in Africa program, Canada’s International Development Research Centre and Britain’s Department for International Development, and was implemented by the Kenya Medical Research Institute (KEMRI).
Local health officials and government officials are confident that with the continued cooperation of local weathermen to predict accurate rainfall and temperature variations they can budget for and prepare resources more effectively for outbreaks.
By identifying areas at greater risk to a malarial outbreak, scientists hope to reduce spraying for mosquitos during critical times and places to reduce chances that the mosquitos develop a resistance to the insecticides.
The highlands of East Africa where the studies were conducted are seen as critical areas in combatting malaria epidemics. The residents of the highland areas are at greater risk to malaria sickness because they exposed less frequently and are less immune to the sickness than residents of lower regions. Accurate prediction and preperation for possible oubreaks in regions that have been incresingly exposed to the disease could go a long way to educating residents about malaria and helping to eliminat it altogether.
A study to be published Thursday reports that some Malarial Drugs supplied by international donors are being stolen and are turning up on commercial markets. The report confirms what many experts have long believed to be the case involving drugs donated by international donors. Many of the millions of free drugs destined for government clinics and hospitals, are being resold instead in private pharmacies across Africa.
Overall, the study found that 6.5 percent of the medicine intended for hospitals and clinics was being found on store shelves in retail outlets. Almost 30 percent of artemesinin combination drugs, the best malaria medicine available on the market, was being resold commercially. This number is nearly double the 15% of malaria drugs reported stolen in 2007.
Research and Reports in Tropical Medicine recieved funding for the study from the Legatum Institute, a U.S. philanthropic group with no ties to drug makers. The study was conducted in 11 African cities and included 894 random samples of which 58 were found to be stolen.
Both the authors and outside experts have weighed in on the study’s findings.
The researchers admit that their sample size was small and could create an exaggerated view of the problem. Due to corruption and the inability to track drugs from their origin to their destination, it is difficult to know exactly how severe the problem is.
Outside experts, however, confirmed that the findings of the study were credible and help to publicize what they maintain is a serious problem in the fight to eliminate malaria in Africa. Disappearances of donated drugs are common according to these experts. These experts also agree that the study helps to raise awareness of the issue surrounding stolen malaria drugs in Africa.
Across the continent, more than 30 percent of malaria medicines are estimated to be fake, and many look identical to the real thing.
Soon, Africans will be able to text message a code to a project called mPedigree that allows individuals to verify whether or not their drugs are genuine. The system is free for consumers and is paid for by pharmaceutical companies and governments.
Health officials say the innovative system could help Africa curb the tide of fake drugs and potentially save hundreds of thousands of lives. Experts think about 700,000 people die from malaria or tuberculosis every year after taking counterfeit drugs, with some containing little more than sawdust, baby powder and water. In addition, fake medicines speed up drug resistance. If a drug contains some but not enough of the active ingredient, it won’t kill the disease’s virus or bacteria, but gives it a chance to mutate into a deadlier form instead.
Authorities have seized 20,000 pounds of counterfeit medicine and arrested 80 people suspected of illegal trafficking in six East African nations. More than 300 premises were checked or raided in the two-month operation across Uganda, Burundi, Kenya, Rwanda, Tanzania and Zanzibar.
Counterfeit drugs are more than theft from the people who need medicine most. In fact, substandard drugs can increase drug resistance and counterfeit drugs can lead to death in those who believe they are taking the proper medicines when they are not.
For this reason, ensuring that these substandard and fake drugs are kept out of the market is key to maintaining drug efficiency as well as protecting individuals.
Technology Review recently had a conversation with Bill Gates about a myriad of topics, including his passion for global health.
One of the most fascinating points that Mr. Gates touches on is the fact that there used to be no market and no incentive for investment in malaria. In response, The Gates Foundation simply created one by investing massive amounts of capital in malaria and the results have been astounding.
The interview is excerpted below.
The Gates Foundation has invested in solutions to big problems like infectious diseases in poor countries. Providing clean energy for the nine billion people the planet will hold in 2050 is a problem that’s equally civilizational in scale. What can philanthropy contribute to energy research?
Well, basically not much. The energy market is an absolutely gigantic market, and the price of energy is a key determinant in improving lifestyles, whether for the rich, the middle-income, or the poorest. It seems slightly more intense for the poor: things like fertilizer and transport, or health care, are very expensive for them. You know, things like basic lighting are very expensive. But it’s a big enough market that if you come up with cheap ways of making electricity, then that should be done with typical big-firm risk taking, small-firm risk taking. On the other hand, the way capitalism works is that it systematically underfunds innovation, because the innovators can’t reap the full benefits. But there’s actually a net benefit to society being more R&D-oriented. And that’s why in health research, governments do fund R&D.
You are a member of the American Energy Innovation Council, the AEIC, which calls for a national energy policy that would increase U.S. investment in energy research every year from $5 billion to $16 billion.
Right.
I was stunned that the U.S. government invests so little.
Yeah, particularly when you look at the DOE budget, and it looks so big–but the biggest part of that by far is dealing with the legacy of nuclear weapons production at various sites around the country. I was stunned myself. You know, the National Institutes of Health invest a bit more than $30 billion.
The Gates Foundation is in that health area, and when we pick a disease to work on, we pick a disease where for some reason the market is not working. Like malaria: rich people don’t need a malaria vaccine. They are rarely in malarial areas, and when they are, they can take prophylactic drugs and not worry about it. And yet for the people who live there, over a million a year, mostly kids in Africa, die. When we did our first $50 million grant for malaria, about a decade ago, we more than doubled the amount of money going into malaria research at the time. It’s a horrific disease, but there’s not a market reward for coming up with a malaria vaccine.
So you made a market.
Yes, you can create a market where there’s no natural market. The biggest project, the one that’s furthest along, is where GlaxoSmithKline is doing a vaccine called R2SS, which is now in phase 3 [trials]. It’s not a perfect vaccine. It reduces mortality a bit more than 50 percent. And then we’re funding a lot of other things that aren’t as far along that–either by themselves or in combination–would get us a perfect vaccine. There are some very novel ideas in the early stages.
But to go back to your question, the reason we’re involved is because there’s not a market. And so our investment is mind-blowing compared to anything else. And you do have that in diseases of the poor world. You know, in the rich world, the percentage of people with AIDS is fairly small, and so the cost of treating people with drugs for a lifetime is affordable. It’s not perfect for those people, it’s not perfect financially, but the difficulties of coming up with a vaccine are such that there’s not a market incentive for it. So an AIDS vaccine is another one that is being funded by a combination of government budgets and philanthropy. The two biggest funders by far are our foundation and the U.S., the part of the NIH involved.
As 2015 draws closer, the Millennium Development Goals are becoming more attainable than ever before. One of the critical pieces of the Millennium Development Goals is the fight against malaria. Success in that fight has produced results across the board. Declining child mortality, decreased burden on health care facilities and increased economic productivity are all results of investing in malaria. The following video presents the myriad of successes that the world has seen from the tremendous efforts against malaria so far. While these statistics represent real lives that are being impacted by the progress in the fight against malaria, it must also be remembered that these results are not irreversible. The global community must push forward and advance these gains in order to end malaria deaths in Africa by 2015.
Although he will surely be seeing limited playing time in the upcoming season due to the 76ers’ acquisition of No. 2 NBA pick Evan Turner, nothing will humble veteran guard Willie Green more than his recent trip to Senegal. As part of Basketball without Borders Africa, Green traveled to Dakar, Senegal to instruct the top 60 young basketball players from the continent, on and off the court.
NBA coaches and players from Africa, including DeSagana Diop (Senegal), Luc Mbah a Moute (Cameroon) and Hasheem Thabeet (Tanzania), along with Dwight Howard and former Sixers Sam Dalembert and Dikembe Mutombo (Democratic Republic of Congo), participated in community outreach events through NBA Cares, the league’s social responsibility program. Partnering with the nonprofit organization Hoops 4 Hope the players and coaches led activities that focused on leadership, character development, and health, with particular emphasis on HIV/AIDS and malaria prevention.
The group also participated in the malaria bed-net distribution program in partnership with United Nations Foundation, USAID, and the Senegal Ministry of Health. Green described his experience delivering mosquito bed nets to homes in the community, a simple task that he could do to help the situation. He discussed how sad it is that most Americans know little about malaria, while it remains a serious killer of young children and mothers in Senegal, and kills nearly one million people every year worldwide. The trip was Green’s first visit to to Africa, and it struck him to his core.
“Seeing the kids here, their faces and eyes light up when they see players from the NBA… they are so happy to see us up close, to give us a handshake, to give us a hug. For the kids, it’s a great experience for them, something they will always remember. But it’s the same for us, maybe even more so.” Witnessing real despair, Green explains how he sees loosing a few minutes on the court with a new perspective.
“It is of particular significance that Basketball without Borders Africa is being held here in Dakar for the first time,” said Amadou Gallo Fall, vice president of development for the NBA in Africa and a Senegal native. “With the help of the current and former NBA and FIBA players, coaches and partners, Basketball without Borders is a perfect vehicle to draw attention to important social issues, while allowing us to coach and mentor the top youth basketball talent from across the African continent.”
Scientists and farmers face challenges as they attempt to supply enough artemisinin, the key ingredient of first-line antimalarial drugs, to meet the increasing demand of the compound triggered by a $343 million initiative that is battling malaria with hugely subsidized medicines.
The Nature News article describes the two-year trial run by Affordable Medicines Facility-Malaria initiative, a program within the Global Fund to Fight AIDS, Tuberculosis and Malaria, that is increasing the demand for artemisinin.
The AMFm initiative, operating in seven African countries and Cambodia, is hoping to ensure the sale of ACTs in the private sector at $0.20-0.50 per dose. They are already available at governmental public-health clinics for just $1 per dose, but patients more often than not opt for convenience and buy the medicines at local market stalls and private pharmacies at significantly higher prices.
This expense encourages people to buy cheap but ineffective chloroquine or the single artemisinin therapies which lead to drug resistance. Lowering the cost of ACTs in the private sector would be a major breakthrough in the fight against malaria and improve access to affordable and effective medicines that do not promote drug resistance.
However, artemisinin suppliers have experienced this bubble of high demand before. In 2005 the World Health Organization’s call to ramp up production lead to an oversupply of ACTs that dramatically reduced the price of the drugs, putting processing companies and farmers out of business while millions of people in sub-Saharan Africa still were not getting access to the ACTs.
While driving down the price of drugs is undeniably important, it doesn’t yield the intended results unless access to the medicines is also improved, hence the idea for the AMFm, and its attention to local businesses that sell treatments for malaria, hopefully at dramatically reduced prices in the near future.
Ellicot Dredges became interested in participating in the fight against malaria in Nigeria during their sand-dredging projects in the country. Malaria accounts for 11 percent of maternal deaths in Nigeria and contributes to poverty, school absenteeism, and low productivity in the country. “Women are the foundation of families throughout the world,” said Peter Bowe, President of Ellicot Dredges. “Their health is directly related to the nations health.”
