H5N1

Malaria eradication within a generation: Ambitious, achievable, and necessary

Via The Lancet, a major report: Malaria eradication within a generation: ambitious, achievable, and necessary. Excerpt from the executive summary:

50 years after a noble but flawed attempt to eradicate malaria in the mid-20th century, the global malaria community is once again seriously considering eradication. Momentum towards eradication has been building for decades, and more than half of the world's countries are now malaria free. 

Since 2000, a surge of global progress has occurred, facilitated by the roll-out of new technologies and the substantial growth in political and financial commitment by countries, regions, and their global partners. Annual domestic and international spending on malaria increased from roughly US$1·5 billion in 2000 to $4·3 billion in 2016. Simultaneously, the number of countries with endemic malaria dropped from 106 to 86, the worldwide annual incidence rate of malaria declined by 36%, and the annual death rate declined by 60%. 

Inspired by these outstanding achievements, and troubled by a stagnation in progress that saw 55 countries report an increase in cases between 2015 and 2017, the Lancet Commission on Malaria Eradication (the Commission) was convened to consider whether malaria eradication is feasible, affordable, and worthwhile. In this report of the Commission, we synthesise existing evidence and new epidemiological and financial analyses to show that malaria eradication by 2050 is a bold but attainable goal, and a necessary one given the never-ending struggle against drug and insecticide resistance and the social and economic costs associated with a failure to eradicate.

Global social, economic, and environmental trends are, in most places, reducing malaria. Our models show that these trends alone will lead to greatly reduced but still widespread malaria by 2050. When the effects of enhanced access to high-quality diagnosis, treatment, and vector control are factored in, the 2050 projections show a world largely free of malaria, but with pockets of low-level transmission persisting in a belt across Africa, from Senegal in the northwest to Mozambique in the southeast. 

In view of these projections, we explore the responses to the operational, biological, and financial challenges that are required to bend the curve (ie, to accelerate the decline in malaria cases and deaths) and achieve elimination everywhere outside of Africa by 2030 and worldwide eradication by 2050.

Far from Ebola, other diseases continue to kill in the DRC

Via mediacongo.net: Health: far from Ebola, other diseases continue to kill in the DRC. The Google translation:

The second largest epidemic in the history of Ebola is the one reported in eastern Democratic Republic of Congo since August 1, 2018. The National Multisectoral Response Committee reported 3,000 cases including 2000 dead since the beginning of the epidemic. 

This epidemic has caught the attention of the international community since the World Health Organization declared it "global emergency" to forget other diseases that, moreover continue to kill populations. 

Measles more deadly than Ebola and cholera combined 

Measles has killed more people in seven months than Ebola in one year, according to Médecins Sans Frontières (MSF). According to this organization, the measles epidemic has caused more than 2700 deaths in the DRC between January and early August. 

"The measles epidemic declared last June 10 is the deadliest that the DRC has known since 2011-2012," the organization wrote in a report in June, stating that it had infected more than 145,000 people. leading to being more deadly than Ebola and cholera combined. 

18,000 people died of malaria 

Malaria had killed more than 18,000 people in 18 million cases registered in 2018 according to a report by the national health ministry published on April 25, 2019. If the key intervention in the fight remains the distribution of long-lasting insecticide-treated mosquito nets, for the collective of civil society organizations for health and the fight against malaria, this is not enough.

Cholera killed 112 people in seven weeks  

In a report in February this year, the Congolese Ministry of Health said in a statement that the country had registered 4,716 cholera cases from January 1 to February 17, 2019 including 112 deaths.  

In 2018, this disease had made 900 deaths against 1190 for the year 2017 on 55,000 cases for that year. While the epidemic is rife in almost all provinces of the country, Upper Katanga, Upper Lomami, Tanganyika and South Kivu are the most affected provinces. 

Other diseases such as hepatitis B, HIV/AIDS, diabetes, cancer of the uterus and breast continue to kill in the country.  

From this table, it appears that the DRC is experiencing enormous health difficulties and that efforts in this area must be provided in order to clean up the environment in which the Congolese population lives.

DRC: António Guterres talks to Goma about measles, malaria, cholera and Ebola among the challenges

Via Actualite.cd: DRC: António Guterres talks to Goma about measles, malaria, cholera and Ebola among the challenges. The Google translation:

António Guterres, Secretary-General of the United Nations, arrived this Saturday in Goma. This is the first stage of a three-day visit that will also take him to Beni and Kinshasa. 

"There are major concerns about health. There is measles, malaria, cholera and now terrible drama of Ebola. We are fully on the side of the Congolese authorities and the Congolese people to try to meet all these challenges. I reaffirm that this visit is a solidarity visit to express my admiration to the Congolese people and especially to the people of North Kivu," he said in his brief communication arriving in Goma.  

Declared officially in the DRC last June, the current measles epidemic is the deadliest that the country has seen since 2011. More than 3,000 people have died since January 2019. The epidemic affects all 26 provinces of the country since the beginning of 2019 with more than 161,397 suspected cases, including 3,117 deaths (CFR: 1.9%). 

The other health challenge is Ebola. Since the beginning of the epidemic, the cumulative number of cases is 3,017, of which 2,912 are confirmed and 105 are probable. In total, there were 2,015 deaths (1,910 confirmed and 105 probable) and 902 people healed. Current efforts to find funding for the Fourth Strategic Ebola Response Plan (SRP4).  

In Goma, the UN chief will meet Ebola survivors and health workers engaged in the response to the virus. He will also visit an Ebola treatment center before traveling to Beni.

How mosquitos shaped humanity

The Tyee has published my review of Timothy C. Winegard's new book The Mosquito: A Human History of Our Deadliest Predator: How Mosquitos Shaped Humanity. Excerpt:

The mosquito, Timothy Winegard argues, has killed half of all humans who ever lived — 52 billion of us.  

Add all the other mammals and birds it preys upon, and it is clearly the planet’s apex predator. After millions of years in that role, however, the mosquito could be overthrown by its human victims’ ingenuity. 

Winegard’s research makes this an important book for anyone concerned with mosquito-borne diseases. As his subtitle suggests, he focuses on how mosquitos have shaped human history. And they have even shaped us genetically. Humans evolved in an Africa where mosquitos had prospered for millions of years. They preyed on our ancestral species, and by the time modern humans emerged we had even evolved sickle-cell anemia as a defensive measure against malaria.  

Modern humans who left Africa took malaria and other mosquito-borne diseases with them, infecting the mosquito populations they encountered. Migration and settlement must have come at a terrible price in deaths and sickness. The survivors, after repeated infections, might become “seasoned” — able to recover from malaria relatively easily. But if they moved into a new region, an unfamiliar strain of malaria might still finish them off.

'Malaria will not be eradicated in near future', warns WHO

Via The Guardian, health editor Sarah Boseley writes: 'Malaria will not be eradicated in near future', warns WHO. Excerpt and then a comment:

Malaria will not be eradicated in the foreseeable future even though it is achievable and would save millions of lives, according to World Health Organization (WHO) experts following a three-year review. 

The WHO remains committed to the “disappearance of every single malaria parasite from the face of the planet”, as it has been since the UN organisation was launched in 1948, said Dr Pedro Alonso, the director of its global malaria programme. 

But the experts warned in their review that there must not be a repeat of past disasters. The WHO’s first global malaria eradication programme that lasted from 1955 until 1969 rid several countries of the disease, but was not implemented in sub-Saharan Africa, the region most badly affected. 

“Falling short of eradication led to a sense of defeat, the neglect of malaria control efforts and abandonment of research into new tools and approaches,” the review stated. “Malaria came back with a vengeance; millions of deaths followed. It took decades for the world to be ready to fight back against malaria.” 

In 2007, support by the Bill and Melinda Gates Foundation led to the distribution of millions of insecticide-impregnated bednets, new drugs and a vaccine. Alonso said that, though these tools substantially reduced the numbers of malaria cases and deaths, they are not enough to rid the world of the disease that disproportionately kills small children and pregnant women.  

The review was commissioned in 2016 to investigate how eradication could be achieved. It found that there are no biological or environmental barriers to eradication and that global development will probably mean less malaria in the future. 

“However, even with our most optimistic scenarios and projections, we face an unavoidable fact. Using current tools, we will still have 11 million cases of malaria in Africa in 2050,” said the review. “In these circumstances, it is impossible to either set a target date for malaria eradication, formulate a reliable operational plan for malaria eradication or to give it a price tag.”

Meanwhile, WHO AFRO promises to fight vector-borne diseases including malaria. But as of Thursday evening, 8:00 pm Pacific Daylight Time, Worldometers tells me over 628,000 people have died of malaria so far this year, 90% of them in Africa.

MSF: Urgent humanitarian response needed to unprecedented crises in northeast DR Congo

MSF.org has published Urgent humanitarian response needed to unprecedented crises in northeast Democratic Republic of Congo.

KISANGANI/GENEVA – Multiple humanitarian crises are unfolding in Ituri province, northeastern Democratic Republic of Congo, and hundreds of thousands of people are in urgent need of humanitarian assistance, according to Médecins Sans Frontières (MSF). 

The recent upsurge in violence across the regions of Djugu, Mahagi and Irumu have forced thousands to flee their homes. Despite MSF’s repeated calls on international aid organisations to scale up humanitarian aid, the majority of the displaced still haven’t received even the most basic assistance.

“Unfortunately, this is not the first time there are important humanitarian needs in the country,” explains Dr Moussa Ousman, MSF Head of Mission in the Democratic Republic of Congo. “This time we are seeing not only mass displacement due to violence but also a rapidly spreading measles outbreak and an Ebola epidemic that shows no signs of slowing down, all at the same time. This is unprecedented.”

Intercommunal violence has been increasing in Ituri since December 2017, and the large majority of people displaced as a result have been in urgent need of humanitarian assistance, some for more than a year. Since October 2018, MSF has conducted three mortality surveys in the locations of Drodro, Nizi and Angumu. All showed that the mortality rates in these communities were far above emergency levels. 

“Our surveys show that people are mainly dying from preventable diseases such as malaria, measles and diarrhoea,” says Dr Ousman. “That is very worrying. Especially as it has not yet been possible to vaccinate against measles because of the ongoing Ebola outbreak, and the fear of Ebola further spreading. Together with the ministry of health, we are looking at what innovative strategies we can implement given the circumstances, but more help is urgently needed here to prevent more deaths.”

MSF is supporting the local ministry of health to provide medical care and respond to the most acute needs of the displaced in Drodro, Nizi and Bunia. Our teams are also providing clean water, distributing relief items and constructing showers and latrines. Nevertheless, the most urgent needs of thousands of families remain unmet. 

MSF urges for an immediate scale up of long-term humanitarian assistance, to prevent the loss of more lives and to ensure decent living conditions for all those who have been forced to flee.

Kenya: Ebola scare in Karatina as two patients isolated

Thanks to Craig Wilson for catching my mistake; I first posted this as a Uganda story. Via The Standard: Ebola scare in Karatina as two patients isolated.

A suspected Ebola case has caused scare at Karatina Hospital in Nyeri County after two patients exhibited Ebola related symptoms. 

The two male patients are said to have presented haemorrhagic fever and were admitted in the isolation unit. 

According to a community health worker at the hospital who declined to be mentioned over sensitivity of the matter told The Standard that the two patients were admitted on Tuesday. 

“The two were bleeding from the ears and nose. They have been isolated in one ward and no one is allowed to be go near them. The ward has been sprayed and any items they use remain in that ward,” said the officer.

Nyeri health Chief Officer Newton Wambugu confirmed that the two were admitted to the hospital but he did not reveal report that blood samples were taken to Kenya Medical Research Institute (Kemri) laboratory in Nairobi for further testing. 

The chief officer however said the two tested positive for malaria. 

The two businessmen from Mathira are said to had traveled through Uganda from Democratic Republic of Congo for a business trip. 

A week ago a patient suspected to have had Ebola virus in Kericho tested negative after blood samples were taken to Kemri laboratory.

DR Congo: A doctor researcher pleads for the cultivation of Artemisia

Via mediacongo.net, a report from The Tropical Storm: Malaria: A doctor researcher pleads for the cultivation of the plant "Artemisia". The Google translation: 

On April 25, humanity celebrated World Malaria Day under the theme: "Zero Malaria! I'm in ". In the Democratic Republic of Congo, at least 15 million people affected by this disease have been registered, especially among children, in 2017. This was stated by the doctor researcher, Dr. Pika Longila, citing as source the Organization World Health Organization (WHO).  

In the face of the challenge of malaria, Dr. Longila pleads for the cultivation of the plant "Artemisia", which is a credible alternative for the developing country. "Even people who are in remote areas can grow at home at home for treatment," he told the newspaper The Storm of the Tropics. This natural remedy against malaria plays a dual role: preventive and curative. 

"We want to give every family the opportunity to have a garden of Artemisia, but people must first be trained in culture," said the representative of Artemisia House in Kinshasa.  

Integrate Artemisia into the pharmacopoeia 

According to this researcher, Artemisia is effective, inexpensive and accessible to everyone. Favoring the Artemisia herbal tea in the case of simple malaria allows patients to escape the influx of fake drugs. This allows those living in remote areas to have this molecule allowing, these days, to overcome many malaria situations around the world. Especially that access to health care and treatment for malaria, including the distribution of insecticide-treated mosquito nets are difficult for many people living in these lost areas. 

According to him, it is necessary to work for the promotion of the tea Artemisia in order to integrate it in the pharmacopoeia and the care of the malaria in the DRC. Dr. Longila supports this approach following comparative scientific research conducted on a sample of 1,000 people in the country, and the results have demonstrated the effectiveness of this plant in the management of malaria with a success of 98%. Thanks to these studies conducted at the University of Paris, some African countries are interested in this plant, including Nigeria, Senegal, Niger, Cameroon, Chad, Burundi, Rwanda, Congo-Brazza and Madagascar. 

No adverse effects  

Generally, this product has no adverse effects except in some patients who do not support its bitter taste, informs the doctor. This product helps post-consumer patients to destroy female Anopheles cells and to fight severe malaria. 

Also, it was pointed out that the scientific studies conducted on this plant distinguish them from charlatans, the case of traditional practitioners. Thus the researchers on this plant sensitize the community in the churches, schools, companies ... through the projection of films in order to favor its appropriation. 

It is since 2015 that the house Artemisia works in the DRC, but very active in the provinces of South Kivu, North Kivu and Kongo-Central. There is also a representation in Kinshasa, in Lubumbashi as well as in other cities of the country. 

As a reminder, the latest report of the World Health Organization (WHO), the number of deaths caused by malaria in 2017, is estimated at 435,000, a figure virtually unchanged from the previous year. This is why the urgency of WHO is to relaunch the global action against malaria, before asking the countries most affected by this disease to appropriate this challenge.

DR Congo: Over 18,000 persons died of malaria in 2018

Via mediacongo.net: WMD 2019: Over 18,000 dead of malaria in 2018. Excerpt from the Google translation:

On the occasion of the commemoration of the 12th JMP 2019, the Minister of Public Health announced that the DRC has recorded more than 18 million cases of malaria in 2018, of which more than 16 million cases of simple malaria and 1.8 million cases of severe malaria. Of this number, 18 thousand people died. 

Placed this year under the theme "Zero Malaria. I commit myself ", the 12th World Malaria Day (JMP 2019) was celebrated yesterday Thursday, April 25th by the international community. In Kinshasa, the Minister of Public Health and the actors of the fight against malaria met on the campus of the Academy of Fine Arts (ABA), in Kinshasa / Gombe, to commemorate and prepare the state of play against the scourge of malaria in the DRC. On this occasion, the Minister of Public Health declared that the celebration of this 12th JMP reminds the suffering conveyed by malaria with its cohort of expenses and deaths unacceptable, because avoidable.  

Malaria, he said, is the leading cause of morbidity, hospitalization and mortality in the country. Thus, this pathology killed silently during the year 2018, more than 18 thousand people in the DRC on more than 18 million cases of malaria, including 16 million cases of simple malaria and more than 1.8 million severe malaria, or nearly 10%. These figures are staggering and must appeal to the national community. 

It is therefore in this sense that we must inscribe the manifestation of the day that encourages awareness and urgent action. It is precisely because of the need to act against this pathology that the Government of the Republic has committed, through the Ministry of Health, to guarantee universal access to key interventions in the fight against malaria for all inhabitants. from the country.

WHO: Malaria vaccine pilot launched in Malawi

A WHO news release: Malaria vaccine pilot launched in Malawi. Excerpt:

WHO welcomes the Government of Malawi’s launch of the world’s first malaria vaccine today in a landmark pilot programme. The country is the first of three in Africa in which the vaccine, known as RTS,S, will be made available to children up to 2 years of age; Ghana and Kenya will introduce the vaccine in the coming weeks. 

Malaria remains one of the world’s leading killers, claiming the life of one child every two minutes. Most of these deaths are in Africa, where more than 250 000 children die from the disease every year. Children under 5 are at greatest risk of its life-threatening complications. Worldwide, malaria kills 435 000 people a year, most of them children.  

“We have seen tremendous gains from bed nets and other measures to control malaria in the last 15 years, but progress has stalled and even reversed in some areas. We need new solutions to get the malaria response back on track, and this vaccine gives us a promising tool to get there,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The malaria vaccine has the potential to save tens of thousands of children’s lives.”  

An innovation milestone, three decades in development 

Thirty years in the making, RTS,S is the first, and to date the only, vaccine that has demonstrated it can significantly reduce malaria in children. In clinical trials, the vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threatening severe malaria  

“Malaria is a constant threat in the African communities where this vaccine will be given. The poorest children suffer the most and are at highest risk of death,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We know the power of vaccines to prevent killer diseases and reach children, including those who may not have immediate access to the doctors, nurses and health facilities they need to save them when severe illness comes.” 

“This is a day to celebrate as we begin to learn more about what this tool can do to change the trajectory of malaria through childhood vaccination,” she added.  

The pilot programme is designed to generate evidence and experience to inform WHO policy recommendations on the broader use of the RTS,S malaria vaccine. It will look at reductions in child deaths; vaccine uptake, including whether parents bring their children on time for the four required doses; and vaccine safety in the context of routine use.  

The vaccine is a complementary malaria control tool – to be added to the core package of WHO-recommended measures for malaria prevention, including the routine use of insecticide-treated bed nets, indoor spraying with insecticides, and the timely use of malaria testing and treatment.