World Malaria Day - News & Features
24 April 2017
For World Malaria Day, WHO are calling for an accelerated scale-up of efforts to prevent malaria and save lives.
In sub-Saharan Africa, which carries 90% of the global malaria burden, more than 663 million cases have been averted since 2001. Insecticide-treated nets have been the biggest boon, clocking up an estimated 69% of cases prevented through control tools.
Together with diagnosis and treatment, WHO recommends a package of proven prevention approaches, including insecticide treated nets, spraying indoor walls with insecticides, and preventive medicines for the most vulnerable: pregnant women, under-fives and infants.
Three African countries have been chosen to test the world's first malaria vaccine, the World Health Organization announced Monday. Ghana, Kenya and Malawi will begin piloting the injectable vaccine next year with young children, who have been at highest risk of death.
Voice of a vaccine
Those who were lucky enough to attend SfAM’s Vaccines and Synthetic Biology meeting would have heard Professor Brian Greenwood of Clinical Tropical Medicine at London School of Hygiene & Tropical Medicine discuss his work with the RTS,S/AS01 vaccine.
"Despite the falling efficacy over time, there is still a clear benefit from RTS,S/AS01," he said.
"An average 1,363 cases of clinical malaria were prevented over four years of follow-up for every 1,000 children vaccinated, and 1,774 cases in those who also received a booster shot. Over three years of follow-up, an average 558 cases were averted for every 1,000 infants vaccinated, and 983 cases in those also given a booster dose."
“Given that there were an estimated 198 million malaria cases in 2013, this level of efficacy potentially translates into millions of cases of malaria in children being prevented.”
Bring it on
Despite the vaccine’s partial effectiveness, it still has the potential to save tens of thousands of lives if used with existing measures, the WHO regional director for Africa, Dr. Matshidiso Moeti, said in a statement. The challenge is whether developing countries can deliver the required four doses of the vaccine for each child.
The malaria vaccine has been developed by pharmaceutical company GlaxoSmithKline. The $49 million for the first phase of the pilot is being funded by the global vaccine alliance GAVI, UNITAID and Global Fund to Fight AIDS, Tuberculosis and Malaria.
Kenya, Ghana and Malawi were selected for the vaccine pilot because all have solid prevention and vaccination programs but endure high numbers of malaria cases. The countries will deliver the vaccine through their existing vaccination programs.
Neglected tropical diseases
WHO also reported more good news earlier this week with regards to tackling neglected tropical diseases (NTDs). An estimated 1 billion people received treatment in 2015 alone. Once widely prevalent, these diseases are now mainly restricted to tropical and sub-tropical regions with unsafe water, inadequate hygiene and sanitation, and poor housing conditions.
“WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and elephantiasis to their knees,” said WHO Director-General, Dr Margaret Chan. “Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health”.
Elephantiasis begins with a mosquito bite. In some parts of the world, the insect might transmit the larvae of worms which cause the disease (also called lymphatic filariasis). The larvae grow into thin microscopic worms which invade the host’s lymphatic system, where they grow into adult worms.
During a seven-year life span these worms damage the lymphatic system, and cause infections that lead to blockages, swelling and fevers. Male patients can develop scrotums so large that they can hang to the knees. Their enlarged limbs can emit rancid odours, as they become prone to infections. Adding to the misery, patients may be shunned by their communities and often believe their condition is a ‘punishment’ for some past ‘sins’.
WHO have published a roll-call of shudder inducing conditions that’s worth a read if you’re moaning about hangnail or an unsightly blemish and need perspective. Mycetoma, for example (named because of the tumour-like mass it forms) is a chronic granulomatous disease characterised by localised infection of subcutaneous tissues by actinomycetes or fungi. There are more than 30 species of bacteria and fungi that can cause mycetoma.
The battle against NTDs is largely dependent on the governments that fund much drug distribution, chief among them America and Britain, but will this continue? This week the British government said it would double spending on NTDs over the next five years, to £360m ($460m). However, there’s a rising trend for rich countries to question foreign aid contributions. British newspapers have become noisily hostile towards it with many tabloids frequently using their front pages to question foreign aid. The Daily Mail is currently campaigning for Britain’s government to abandon a pledge, passed into law in 2015, to earmark 0.7% of GDP for foreign aid.
It seems that while in many ways, we’re winning the battle, the fight is not nearly over.