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HEALTH: Final Push to Control Malaria by 2015

Ali Gharib

WASHINGTON, Apr 24 2009 (IPS) - About one million people die every year from malaria, including a child every 30 seconds. Half a billion people are infected annually. Africa alone, according to studies, loses 12 billion dollars in productivity and to treating the disease. And almost all of it is easily preventable.

But resources have been scarce and attention to the killer mosquito-borne disease relatively low, in large part because the disease burden rests almost exclusively in the poorest countries.

On the eve of World Malaria Day on Apr. 25, leaders of international agencies, activists, and U.S. President Barack Obama, among a host of others, are set on changing this situation.

“The United States stands with our global partners and people around the world to reaffirm our commitment to make the U.S. a leader in ending deaths from malaria by 2015,” Obama said Friday in a statement. “It is time to redouble our efforts to rid the world of a disease that does not have to take lives.”

Billions of dollars in prevention and treatment programmes have been launched in the last half decade, with advances in drug treatments and even progress on a long-awaited malaria vaccine.

Dedicating new resources, both for international donors as well as the mostly tropical and developing nations affected by malaria, is not an easy task in the midst of a global economic downturn. However, many public health experts say the costs of doing nothing far outweigh the spending that can do so much.

“With Africa’s economic growth slowing, reducing the growth penalty imposed by malaria is more important than ever,” said a press release from the World Bank announcing a two-fold increase in money for Nigeria – an additional 300 million dollars in loans for prevention and treatment. Nigeria accounts for a quarter of malaria cases in Africa.

An opinion piece in the Wall Street Journal Friday by Peter Chernin hailed both the “human” and “economic” returns of malaria treatment. Chernin, in addition to being the chairman of Malaria No More and on the board of the Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, is the chief operating officer of News Corporation, which publishes the Journal and is owned by media mogul Rupert Murdoch.

Fitting for the crowd reading the Journal, a business-oriented newspaper, Chernin rests his pitch on an economic cost-benefit analysis of malaria, as well as how the Global Fund to Fight AIDS, Tuberculosis and Malaria runs as “any good business should.”

Something all the supporters of combating malaria have agreed upon, in their various op-eds, reports, and speeches to mark World Malaria Day, is that one of the most important aspects of both the past and future success of the anti-malaria campaign is the patchwork coalition of different actors.

They fill varied but equally critical roles, from funding, to purchasing the bed nets that keep mosquitoes from biting their victims at night and transmitting the malaria parasite, to civil society groups drumming up grassroots support for the effort.

The U.N. children’s agency UNICEF has a rightful place of importance in the fight against malaria – some 85 percent of malaria deaths are children under the age of five, and some 50 million pregnant women contract the disease every year, according to a new report from the agency. Because of that position, UNICEF is the largest purchaser of insecticide-treated bed nets, said the group’s executive director, Ann Veneman, at a One World Against Malaria press conference.

One of the advances pointed out by Veneman, as well as U.S. ambassador to the U.N., Susan Rice, is that faith-based groups have played an important role in battling malaria.

“Religious leaders and faith-based groups play a vital role in the fight against malaria by distributing nets and providing information about their importance and correct use,” Veneman said.

In the continent where 90 percent of all malaria deaths occur, Africa, the work of faith-based groups is particularly important because of their wide reach.

“We have learned over the past few years that faith-based organisations have some distinct advantages that make them exceptional partners in the struggle to end malaria,” Rice told a crowd of heady leaders in the anti-malaria campaign. “They have nearly universal reach: many rural areas lack health clinics, but they almost always have a mosque or a church.”

She noted that religious groups “draw from a deep well of community trust”, “can mobilise persuasive volunteers”, and have “proved to be fine record keepers, helping governments track the rates of infection and death.”

At the One World Against Malaria summit here, the president of the United Methodist Council of Bishops, Bishop Gregory Palmer, announced that the United Methodist Church would participate in the distribution of anti-malarial bed nets – one of the cheapest, simplest and easiest ways to prevent the spread of malaria – in Sierra Leone.

A release said that the Christian group will ask members to forgo eating lunch out for one day in order to donate the purchase of one net – a striking image of how cheap bed nets can be, at about 10 dollars apiece for both purchase and distribution.

Marking last year’s World Malaria Day, U.N. Secretary General Ban Ki Moon announced a goal to give malaria protection to all those who need by the end of 2010.

A new front also being explored in the fight against malaria is the notion of using vaccines to immunise children against the disease.

In Africa, the RTS,S vaccine will be given to 14,000 children, making it the first malaria vaccine to enter the final phase of clinical trials. The RTS,S vaccine is perhaps the best funded of the experimental vaccines being developed – one of the reasons it has entered the expensive third phase of trails.

“But academic and industry researches are working on dozens of other candidate vaccines in earlier stages of development, which may be more effective than RTS,S at preventing infection by plasmodium parasites [malaria],” wrote Clive Cookson in a special section of today’s Financial Times dedicated to malaria.

One such potentially more effective vaccine is being developed by the U.S.-based Sanaria company with support from the PATH Malaria Vaccine Initiative (MVI). The researches are currently looking for adults to test the safety of the vaccine on.

What makes the Sanaria vaccine special is that it uses the whole plasmodium parasite to create the vaccine. Many vaccines use dead or weakened portions of disease cells to help the body build up immunity to the disease. Other malaria vaccines use only portions of the parasite.

“The first clinical trial of Sanaria’s candidate malaria vaccine is a watershed event,” said Michael Good, the director of the Queensland Institute of Medical Research, in a release announcing the start of the trial, set to begin inoculation in May.

“It is the culmination of a remarkable translational research effort by Sanaria directed at realising the dream of a practical malaria vaccine preparation based upon whole parasites,” he noted.