World focus back on malaria
Secretary-General Ban Ki-moon will announce a global initiative Friday that steps up the fight against malaria — seeking to eventually wipe out a tropical scourge blamed for killing a million people a year.
In a video message for a World Malaria Day event at UN headquarters, Ban said the initiative would offer indoor spraying and bed nets treated with long-lasting insecticide "to all people at risk, especially women and children in Africa." It will also ensure that public health facilities have access to effective malaria treatment and diagnosis, that health workers are trained to deal with the disease, and that research into its eradication is encouraged, Ban said. Ban said he wants these measures in place in just a few years. "The aim is to put a stop to malaria deaths by ensuring universal coverage by the end of 2010." The secretary-general said that several African countries "have made dramatic strides in malaria control, but the most affected nations remain off track to reach the goal of halting and reversing the incidence of the disease." "That is why today, together with the Roll Back Malaria Partnership, I am putting forward a bold but achievable vision," Ban said. The Roll Back Malaria initiative The Roll Back Malaria initiative was launched in 1998 by the World Health Organisation and its partners with the goal of reducing malaria deaths by half by 2010. At the midway point, when they assessed their accomplishments, it turned out that there were more malaria cases than when they had started. Some of the key interventions included distributing bed nets and using more insecticides — but the programme never really got wide coverage. Only about 2% of African children sleep under insecticide-treated bed nets. Ban and the partnership decided that they want to tackle the problem on a larger scale. "Malaria still kills more than one million people every year," he said. "The toll it is taking is unacceptable — all the more so because malaria is preventable and treatable." American philanthropist Ray Chambers, who was appointed in February as the secretary-general's special envoy for malaria, said he is optimistic the goal of eventually eliminating malaria deaths. "He (Ban) is able to call for that because we have the best technology — the long-lasting, insecticide-treated bed nets last approximately five years — and we have significantly more funding available than ever before in history," Chambers said in an interview. Ban is calling for bet net coverage for an additional 500 million people — which will require 250 million bed nets. "That's four-to-five times what we've done in the past, so that's a real ratcheting up," Chambers said. Chambers said the Global Fund, World Bank, Bill and Melinda Gates Foundation and other groups trying to fight malaria are assembling a team to provide supervision of the campaign. "We have to address everywhere, but 90% of the deaths occur in sub-Saharan Africa, so the initial concentration will be in the most endemic countries," he said. "We have the resources and the know-how," Ban said in his message. "But we have less than 1,000 days before the end of 2010." Chambers stressed, however, that the campaign won't be over. Ultimately, he said, the goal is eradication. "We're not likely to eradicate malaria without an effective vaccine, and that might be quite a few years away," Chambers said. Malaria spreading to new regions in India Despite all campaigns and programmes to eradicate malaria, the disease not only continues to persist but is scaling new heights, literally. For the first time, scientists have documented three malaria cases near Nainital. Scientists attribute this to climate change, which is causing temperatures to rise at high altitudes. The National Institute of Malaria Research (NIMR) has reported the cases from villages near Bhimtal in Uttarakhand. A total of 30 samples were tested for malaria in the first week of April. These are areas which had never experienced malaria before. “An increase in temperature impacts survival of malaria parasite borne by mosquitoes. While a temperature of 24 degrees Celsius is optimum for breeding of malaria parasite, it requires a minimum temperature of 14 degrees Celsius,” said Dr A.P. Dash, director, NIMR. Officials at the National Vector Borne Disease Control Programme said India reports around two million malaria cases annually. The national programme of malaria control earlier aimed at eradicating malaria, but now the government has shifted its goal to reducing morbidity and mortality due to the disease. After 1947 At the time of independence, an estimated 75 million malaria cases were reported every year in India while the disease was responsible for 0.8 million deaths annually. The cases sharply declined after the launch of the National Malaria Control Programme in 1953. There are nine species of mosquitoes, which cause malaria. Each specie has many subspecies, which have different behaviour such as biting, eating and resting habits. “So, the mantra is to ‘ think globally, act locally’,” Dash said. An analysis of malaria outbreaks in the country has revealed that the main reasons for the spread were inadequate surveillance, immigration of labour, mosquitoes developing resistance to insecticides and heavy rainfall. Industrialisation, drug resistance in the malaria parasite, floods, droughts and population mobility are the main challenges for malaria control. For example, mosquito-genic conditions were created during construction of the Indira Gandhi Canal in 1994 when Rajasthan reported a major outbreak, which killed about 432 people. Officials said though the total number of cases now remain about two million annually, a disturbing observation has been the increasing share of the more deadly falciparum malaria. Cases of falciparum malaria, caused by plasmodium falciparum have been reported from Delhi also. Officials said this was happening because of migration of people from areas where falciparum malaria is widespread. Before 1976, only 11-15% of total malaria cases were caused by falciparum parasite. But it has gone up to 50% now. “We have not been able to control falciparum parasite. Its proportion has increased,” officials said. Falciparum malaria is transmitted by mosquitoes which have long survival rate. Besides, there are human carriers of falciparum parasite which may spread the disease. One of the preventive strategies could be a vaccine against malaria. Two centres in the country are being prepared for phase II clinical trials of two malaria vaccines. An Indian vaccine prepared by the International Centre for Genetic Engineering and Biotechnology would undergo clinical trials at a site in Orissa while a vaccine prepared by the Centres for Disease Control in Atlanta, US, will undergo clinical trials in Madhya Pradesh, Dash said. NIMR is working on different drug combinations to treat drug resistant falciparum malaria. Currently, a revised drug policy under which artesunate is used in combination with sulpha pyrimethamine is being used in 20 states where the parasite has become resistant to chloroquine. Source: Associated Press and Mail Today |
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