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Africa: Progress on Malaria
AfricaFocus Bulletin
Apr 27, 2009 (090427)
(Reposted from sources cited below)
Editor's Note
"A new phase in the fight against malaria has begun. Data
presented here show that the malaria community has accelerated
efforts to deliver critical interventions, while also reducing
bottlenecks in their production, procurement and distribution.
Countries have been quicker to adopt more effective strategies
that would have been out of reach with less funding available ...
[there are] substantial increases in coverage of
insecticide-treated nets, with 19 of 22 sub-Saharan African
countries with trend data showing at least a threefold increase in
insecticide-treated net use among children since around 2000." -
UNICEF
For the first time, there seems to be growing optimism that
the campaign against malaria may scale up quickly enough to made
world-wide eradication feasible. That might appear to be wishful
thinking, but the new Global Malaria Action Plan takes on the goal
of reducing preventable deaths from their current level of some one
million a year to near zero by the year 2015. Is it doable? If the
current momentum continues, it may just be possible, say a growing
number of those engaged in this effort.
This AfricaFocus Bulletins contains excerpts from two World Malaria
Day articles on recent initiatives against malaria, one by Sue
Mbaya, Africa Advocacy Coordinator for World Vision, based in
Nairobi and one by UNICEF on Children & Malaria. And, from
http://allafrica.com, an article about the UN Foundation's "Nothing
but Nets" initiative to mobilize individual contributors for
supplying bednets.
For previous AfricaFocus Bulletins on health issues, visit
http://www.africafocus.org/healthexp.php On malaria in particular,
see http://www.africafocus.org/docs08/mal0809.php and
http://www.africafocus.org/docs08/mal0802.php
For current news coverage on malaria, see
http://allafrica.com/malaria
Other sites with a wealth of additional background information
include
WHO World Malaria Program
http://www.who.int/malaria
Global Malaria Action Plan
http://www.rbm.who.int/gmap
World Malaria Day 2009
http://www.rbm.who.int/worldmalariaday
World Vision's End Malaria Campaign
http://www.endmalaria.org
Center for Interfaith Action on Global Poverty
"One World against Malaria" Summit, Washington, DC
http://www.centerforinterfaithaction.org
including keynote address by Susan Rice, U.S. Ambassador to the UN
http://www.state.gov/p/io/rls/rm/2009/122183.htm
++++++++++++++++++++++end editor's note+++++++++++++++++++++++
World Malaria Day: Here in Africa Mosquitoes Still Kill
By Sue Mbaya, World Vision, April 24, 2009
The Huffington Post
http://www.huffingtonpost.com
Sue Mbaya is World Vision's Advocacy Director for Africa
[Excerpts only. For full story, visit http://tinyurl.com/dnynwn]
Today is World Malaria Day. and more than sixty years ago some
Americans might have marked the day by being sick -- perhaps very
sick. Malaria causes high fevers, sweating and chills, and even
brain damage and death. But malaria was eradicated in North America
by 1950. So instead, U.S. communities are welcoming warmer weather
now with little more than bottles of bug spray and a vague
annoyance at the buzzing sounds of mosquitoes that come out at
dusk.
Here in Africa, it's quite a different story. Our mosquitoes still
kill.
More than nine out of ten malaria-related deaths happen in the
region of the world where I live, sub-Saharan Africa. Malaria takes
nearly one million lives a year, 85 percent of which are children.
Mosquitoes and their deadly bites deliver a steady blow to millions
of already struggling families, sapping their productivity and
income, and snuffing out the next generation.
Even as many African countries continue to make hard-earned
economic progress, the financial toll of malaria remains a
roadblock to these economies reaching their full potential. And
with the global economic crisis already threatening to cut into
Africa's gains, the effects of malaria should serve as a wake-up
call to the international community.
All told, malaria costs Africa an estimated $12 billion in lost
economic productivity each year, while consuming some 40 percent of
government health expenditures in countries where it is endemic,
according to UN and World Health Organization assessments.
The exhausting, debilitating symptoms of malaria keep hundreds of
millions of adults from completing a full day's work, sometimes for
weeks on end. Infected children often miss school and too many are
burdened with long-lasting complications of anemia or brain damage,
diminishing physical and mental productivity for years. For many,
death is the ultimate outcome.
...
Yet there's still good news on this World Malaria Day. This killer
disease is preventable and treatable for a fraction of the $12
billion it robs from Africa's economic potential. A new report from
World Vision this week confirms that the solution is simple--yet
also shows that the solution must be rooted in the affected
communities themselves.
Here is what it takes, according to experts: First, the
all-important bed nets, combined with indoor spraying of
insecticides, anti-malaria drugs and preventive medicine for
pregnant women. The world community is making commendable progress
on this front, with bold commitments to provide universal access to
these items in endemic African countries by the end of 2010.
The second key to ending malaria is less dramatic, but no less
important: In vulnerable areas, the local community has to be
equipped to train and reinforce prevention practices and proper bed
net use at the household level, as well as ensure availability of
nets to the entire community. In fact, research has shown that bed
nets need to cover everyone in a vulnerable community, not just the
most vulnerable to malaria--children and pregnant women, for
example. It's 80 percent or more coverage of everyone in one
village that stops the deadly cycle of malaria.
...
For more information on how you can get involved in the fight to
help end malaria around the world, go to http://www.endmalaria.org.
Malaria & children
Progress in intervention coverage
Summary update 2009
United Nations Children's Fund
[Excerpts only. For full text, including figures and footnotes, see
http://www.unicef.org/media/files/WMD_optimized_reprint.pdf]
The fight against malaria
On World Malaria Day in 2009, just over 600 days remain until 31
December 2010, UN Secretary- General Ban Ki-moon's deadline for all
endemic countries to achieve universal coverage with essential
malaria control interventions. Data presented here highlight major
signs of progress across Africa toward this goal.
The World Health Organization (WHO) has estimated that between 190
and 330 million malaria episodes occurred in 2006, resulting in
nearly 1 million deaths. About 90 per cent of all malaria deaths
occur in sub-Saharan Africa, most among children under age five.
Some 50 million pregnant women are exposed to malaria each year,
with malaria in pregnancy contributing to nearly 20 per cent of
low birthweight babies in endemic areas. Malaria in pregnancy can
also lead to stillbirth and maternal deaths.
Malaria control is a major development priority. Ambitious new
global goals, laid out in The Global Malaria Action Plan (Roll
Back Malaria 2008), are challenging countries to implement bold
plans for universal coverage. Malaria has also been included
among major global development targets, notably the Millennium
Development Goals. One of the eight goals relates specifically to
malaria, AIDS and other infectious diseases, and many of the other
goals, including those for child mortality and maternal health,
will be difficult to achieve in malaria-endemic areas without
substantially reducing the malaria burden.
...
Since 2007, and building on the recent momentum in the fight
against malaria, the UN Secretary-General, the African Union and
others have called for a bolder, long-term goal of eliminating
malaria as a global public health problem. To realize this vision,
the Roll Back Malaria Partnership revised its goals and targets,
as set out in its 2008 Global Malaria Action Plan.
Roll Back Malaria Partnership goals and targets [now include]:
- Achieve universal coverage for all populations at risk using
locally appropriate interventions for prevention and case
management by 2010 and sustain universal coverage until local
field research suggests that coverage can gradually be targeted to
high-risk areas and seasons only, without the threat of a
generalized resurgence.
- Halve the malaria burden between 2000 and .... 2010 and reduce by
2015 the number of cases by three-quarters and the number of
preventable deaths to near zero.
...
Global funding for malaria control has risen significantly in
recent years. The Roll Back Malaria Partnership estimates that
international funding has grown from $250 million in 2004 to $700
million in 2007, with funding expected to have reached $1.1
billion in 2008 alone, due largely to the Global Fund to Fight
AIDS, Tuberculosis and Malaria; the World Bank; the U.S.
President's Malaria Initiative and others. Many African countries
recently achieved unprecedented success in obtaining Global Fund
resources in the latest round of malaria grant applications (box
2). And in 2008, world leaders committed billions more towards
malaria control.
Indeed, a new phase in the fight against malaria has begun. Data
presented here show that the malaria community has accelerated
efforts to deliver critical interventions, while also reducing
bottlenecks in their production, procurement and distribution.
Countries have been quicker to adopt more effective strategies
that would have been out of reach with less funding available,
such as changing national drug policies to more effective--but
more expensive-- treatment courses and expanding diagnostics to
better target treatment. A focus on behavior change communication
programmes is also improving the effective use of malaria
interventions. Roll Back Malaria partners, including UNICEF, are
supporting efforts to integrate malaria control activities into
other maternal and child health services as they accelerate
delivery of these essential interventions. And new actors, such as
individual contributors and faith-based organizations, are
becoming increasingly involved in the fight against malaria.
We are witnessing substantial increases in coverage of key
interventions, notably insecticide-treated nets, with 19 of 22
sub-Saharan African countries with trend data showing at least a
threefold increase in insecticide-treated net use among children
since around 2000--17 of them with at least a fivefold increase.
Most of these nets have been distributed through maternal and
child health services such as antenatal care and immunization.
However, while antimalarial treatment is moderately high across
Africa, many children are still using less effective medicines
and many countries have shown little or no efforts to scale up
programs.
Insecticide-treated mosquito nets are one of the most effective
ways to prevent malaria transmission. Studies show that high
coverage and regular use can reduce all-cause mortality rates in
children under age five by nearly 20 per cent in malaria-endemic
areas. Since 2004 the number of insecticide-treated nets produced
worldwide has more than tripled--from 30 million to 100 million
in 2008--leading to a rapid rise in the number of nets procured
and distributed. The number of nets procured by UNICEF--the
largest global net procurer--is 20 times greater today than in
2000. Programs supported by the Global Fund to Fight AIDS,
Tuberculosis and Malaria distributed 70 million nets by the end of
2008. Most nets are distributed through integrated maternal and
child health services, such as in Madagascar (box 4). Many
countries are now working to develop monthly distribution plans to
help ensure distribution by the 31 December 2010 deadline to
achieve universal coverage.
...
Together with regular use of insecticide-treated nets,
intermittent preventive treatment during pregnancy is critical for
preventing malaria among pregnant women in stable malarious
areas. The treatment consists of at least two doses of an
effective antimalarial drug during the second and third trimesters
of pregnancy. This intervention is highly effective in reducing
the proportion of women with anemia and placental malaria
infection at delivery. Sulfadoxinepyrimethamine is a safe and
appropriate drug for intermittent preventive treatment for
pregnant women.
Most countries have only recently adopted intermittent preventive
treatment as a recommended regimen for pregnant women. The next
round of surveys is expected to show higher coverage. Some
countries have already achieved relatively high levels, including
Zambia (60 per cent in 2008) and Senegal (49 per cent in 2006;
figure 11). The higher coverage is due largely to early adoption
and implementation of intermittent preventive treatment as a key
part of national reproductive health and malaria control
activities. Indeed, many countries with more recent data show
higher values, and better coverage is expected in the next round
of surveys.
Africa: How a Sports Writer Unleashed a New Wave of Philanthropy
Elizabeth Gore
24 April 2009
http://allafrica.com/malaria
Opinion
Elizabeth McKee Gore is director of Nothing But Nets, one of the
most successful campaigns to distribute insecticide-treated bed
nets to malaria-endemic countries. The global Roll Back Malaria
Partnership estimates that 700 million insecticide-treated bed nets
will have to be distributed by 2010 to remain on target for the
goal of nearly eliminating malaria by 2015. More than half of those
nets must be distributed in Africa, where most malaria deaths
occur.
Nothing But Nets, based in the United States, uses an integrated
approach to distribution, relying on existing networks, such as
inoculation campaigns, non-governmental organizations, faith-based
communities, health workers and others to ensure nets are delivered
to even the most remote villages and that they are consistently and
properly used. So far, Nothing But Nets has distributed nearly 2.5
million bed nets. Gore recently talked to AllAfrica about how
Nothing But Nets came about.
About five years ago what we really needed was larger U.S.
government funding for malaria and we needed the rest of the world
to start paying attention. The Aids community in the United States
is amazing in terms of advocacy and ensuring proper funding but
there's no malaria community.
So we started thinking at the United Nations Foundation that we've
got to build a public campaign for malaria so people will start
supporting it. Nets seemed like a really interesting entry point
and a hook for the public to get behind. And it's such a small
price for an American - to think of a 10-dollar donation as
literally saving someone's life.
So we decided to start fundraising for the nets publicly and we
were hoping to leverage that into bigger U.S. dollars and start
building this constituency. It was going along okay, not great, but
then we got a phone call from Rick Reilly, a writer for Sports
Illustrated magazine, who has a huge following. He called and said,
"I just saw this documentary on malaria and I am blown away by it.
In sports we have nothing but nets - even a sports fan can figure
it out." So, we asked him to write a column about it.
He had not been to Africa. He just really liked the solution around
the net. So he wrote a column called "Nothing But Nets." Nothing
but net is a basketball term when you swish a basketball. It was
also used in a McDonald's commercial. [With the column] he did what
the entire UN probably couldn't have done and pulled a huge issue
down to a 30-second sound bite, down to 800 words in a column.
He said, if you've ever scored a goal in soccer, if you've ever
dunked in a basketball net, if you like cheerleaders in fishnets,
donate 10 dollars, do it now. And 1.2 million dollars were raised
in four weeks from that article. It almost crashed our server. We
had to hire temps to man the phones. The amount of mail that came
in was just unbelievable. And the bigger thing was 18,000 people
responded, which in a community, on an issue where you don't have
a following, is pretty huge.
It evolved into the Nothing But Nets campaign and Rick said why not
get the sports groups involved. NBA [National Basketball
Association] Cares were immediately in. They just loved it. But
then we really needed an organizational partner.
We had already been talking to the Methodists a little bit about
malaria and so I approached them again. They came on board, which
was huge for us because if you think there are 12 million
Methodists worldwide and they agreed to communicate this, suddenly
we have this enormous audience.
So those were the pinnacle partners that got us kicked off. We had
the public launch in January 2007 and we took Rick to Nigeria to
see where his nets had gone. And instead of asking the public again
we thanked the public. So he published this article "Nothing But
Thanks," which garnered double the amount of donations and that's
how we broadened out the campaign.
We boiled this whole issue down to Malaria Kills, Send a Net, Save
a Life. Donate 10 dollars. The UN Foundation pays the cost of the
campaign so that 10 dollars is the full contribution. There's no
overhead taken out, which is important to people at that price
point. Then we just kept bringing in new partners. Major League
Soccer came on board, the WNBA [Women's National Basketball
Association] Cares came on board, the Lutherans, the Union for
Reform Judaism.
These partnerships are what created the now 100,000 registered
people involved in malaria. Who would have thought? We couldn't get
three people in a room to talk about malaria and now we have
100,000 registered people. We think that through all of our
partners that Nothing But Nets touches about 25 million people.
We take the marketing very seriously but we also take the
distribution very seriously. We continue to follow this money all
the way to the ground. We go as often as we can to communicate back
to the donors: this is how your money is being used, this is what's
happening, this is how the mortality rates have dropped. So half of
our job is reporting back, which I think people love because you're
not just contributing to malaria, you're learning about Africa,
you're learning about the UN, you're learning about these awesome
kids that we're working with.
The youth have become the power of this campaign, which was not the
original goal. We have an eight-year-old in Pennsylvania who just
hit 100 thousand dollars. They're just amazing, they're our
celebrities and they surprise us every day. These kids are
educating us on the new wave of philanthropy and a new way of
getting involved. It's not just raising money. While that's
important, it's the whole awareness around this issue.
We need everybody and most of all we need our peers in Africa to
lead this and they are. We are supporting them and they are leading
the way. These nets only go where they say they should go and I
think this has been incredibly effective because they're our
partners.
We are encouraging everyone to go out and do their own Nothing But
Nets campaign, whether they're hosting a bake sale or a basketball
tournament, or just educating the public through their own press
release in their local town or at their school to get involved.
They can actually populate our Google map on http://nothingbutnets.net and show the rest of the world what
they're doing in honor of World Malaria Day.
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with
a particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.
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