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Moving Mountains: The Evolution of USAID's Malaria Control Program  - Roger Bate, Richard Tren, Philip Coticelli
The President's Malaria Initiative and USAID both made progress in the fight against malaria in 2006. The true test of success moving forward will be how well African countries can sustain and build upon donor success.

World Bank Matrix (Malaria Booster Program) - Analysis for Africa Fighting Malaria  - Dr Roger Bate
The World Bank recently issued a malaria matrix, detailing spending on malaria control along with outcomes and targets. Roger Bate undertook an analysis of this matrix for AFM which critically analyzes the quality of the data and the logic of the World Bank undetaking this project.

Report on East and Southern Africa Malaria Conference  - Jasson Urbach
AFM's Jasson Urbach reports back on the recent East and Southern Africa Malaria Control Conference, held in Harare, Zimbabwe between 14 and 18 August.

DDT and neurodevelopment: results inconclusive to effect policy change  - Ameena E Goga
This reponse to Eskenazi et al.'s recent study on the link between DDT and childhood neurodevelopment argues that more data is needed to properly consider the implications for malaria control.

Tariffs, Corruption and Other Impediments to Medicinal Access in Developing Countries. Field Evidence  - Roger Bate, Lorraine Mooney, Richard Tren, Kathryn Boateng
AEI and AFM collaborate on a study investigating the incidcence of corruption and import tariffs on medicines and the impact on access to medicines in poor countries.

Government-Controlled Research and Development - A recipe for disaster  - Richard Tren & Roger Bate
The proposed research and development (R&D;) treaty being discussed at the World Health Assembly during the week of May 22 could end up harming those it aims to assist. Public-private partnerships, which are already delivering drugs and treatments and showing promise in vaccine development, offer a far better model to address diseases. Greater state and bureaucratic control of R&D; will not deliver results, especially given the need to deploy unique private-sector testing and development facilities. A range of market-friendly proposals to encourage research is likely to deliver practical solutions.


The World Bank: false financial and statistical accounts and medical malpractice in malaria treatment  - Amir Attaran et al
Amir Attaran & malaria experts & health policy commentators, including Africa Fighting Malaria's Roger Bate criticise the World Bank's failures in malaria control.

Still Taxed to Death: An Analysis of Taxes and Tariffs on Medicines, Vaccines and Medical Devices  - Roger Bate, Richard Tren & Jasson Urbach
Bate, Tren & Urbach update their working paper on taxes and tariffs on medicines and medical devices - published by the AEI-Brookings Joint Centre.

The WTO and Access to Essential Medicines: Recent Agreements , New Assignments  - Dr Roger Bate & Richard Tren
Roger Bate and Richard Tren discuss the recent WTO agreement on TRIPS and public health and recommend that the WTO now turn its attention towards removing import tariffs on medicines and medical devices, which have been shown to reduce access to medicines and medical care.

Brazil's AIDS Program - A Costly Success  - Richard Tren & Roger Bate
Richard Tren & Roger Bate comment on Brazil's AIDS Treatment program which has achieved some notable successes, but potentially reduces research into new AIDS medicines and could result in large long term costs down the line.

AFM testimony to the US Senate Committee on Environment & Public Works  - Roger Bate & Richard Tren
Download the testimony given by AFM's Roger Bate and Richard Tren to the US Senate's Committee on Environment and Public Works. The hearing, chaired by Sen. Inhofe (R, OK) was set up to look at the role of science and environmental policy - what better case study than DDT?

An Immesurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured  - Prof. Amir Attaran
Prof. Amir Attaran evaluates the Millennium Development Goals and criticises them for being unmeasurable and therefore largely meaningless. He also criticises the UN for failing to discuss the measurement of these goals at the September 2005 UN meeting on the MDGs.

State in Fear - Zimbabwe's Tragedy is Africa's Shame  - Archbishop Pius Ncube, Dr Roger Bate & Richard Tren
Catholic Archbishop of Bulawayo Pius Ncube, Dr Roger Bate and Richard Tren report on the horrific abuses of human rights by Mugabe's police and military. The authors call on the G8 leaders to exert pressure on African leaders, such as President Mbeki, to condemn Mugabe's regime and support the return of peace and democracy in Zimbabwe.

AFM's Comment on the WHA Malaria Resolution  - AFM
The World Health Assembly recently passed a resolution on malaria control. The WHO and UNICEF also recently published their World Malaria Report. AFM comments here on some aspects of the resolution and report.

Senate Hearings on USAID  -
The Senate Hearings on USAID's involvement in malaria control led to significant challenges to the agency's activities. Download the testimonies from USAID, Senator Sam Brownback, Professor Amir Attaran and AFM's Dr Roger Bate here.

Eliminate Neglected Diseases Act of 2005  -
Senator Sam Brownback's Eliminate Neglected Diseases Act of 2005 has been dropped in the US Senate. Read the Act and supporting documents here.

Taxed to Death  - Roger Bate, Richard Tren and Jasson Urbach
AFM publishes a working paper on the degree to which import tariffs, taxes and bureaucratic procedures block access to essential medicines in poor countries. See the latest version of this ongoing study here.

Despotism & Disease  - Richard Tren & Roger Bate
Africa Fighting Malaria report on the destruction of the Zimbabwean healthcare sector and the probable impacts on the entire region. Download the pdf version of this report here.

Ugandan Study Highlights Best Drug Combinations for Treating Malaria in Africa  - The Lancet
Results of a randomised trial from Uganda in this week’s issue of THE LANCET suggest that the drug combination of amodiaquine and sulfadoxine-pyrimethamine might offer the optimal treatment for malaria in terms of efficacy and cost-effectiveness in this region. The study also shows that the drug combination of chloroquine and sulfadoxine-pyrimethamine—the recommended first-line treatment in Uganda—is far less effective than other drug combinations.

Climate Change and Malaria  - Indur Goklany - with response from Sir David King
Indur Goklany offers some fascinating insights into climate change, malaria, poverty and development. Sir David King, the UK Government's chief scientific adviser gives a predicable response.

The Real Obstacles to Sound Treatment of AIDS in Poor Countries  - Roger Bate & Richard Tren
Writing for the American Enterprise Institute's Health Policy Outlook, Bate and Tren explore some of the reasons for low drug access in poor countries. Despite promises of cheap or free antiretroviral drugs, Bate and Tren argue that access to treatment in poor countries is abysmally low because of a lack of infrastructure, political indifference, excessive bureaucracy and taxes and tariffs.

South Africa's War Against Malaria - Lessons for the Developing World  - Richard Tren & Roger Bate
The Cato Institute published Richard Tren and Roger Bate's analysis of South Africa's recent history with malaria control. They argue that its policy on DDT use and Artemesinin based combination therapy provide excellent examples for other malarial countries.

SA's Leading Malaria Researchers Support DDT Use  -
South Africa’s leading malaria control experts, researchers and doctors support and endorse the use of the insecticide DDT to control malaria. Their statement is released in light of recent claims that DDT is harmful to human health and should be removed from South Africa’s malaria control programme.

South African Malaria Data  - SA Dept of Health
November 2003 - the malaria statistics show that malaria is still well under control in South Africa. A recent epidemic in the Limpopo Province was primarily caused by late spraying and poor case management.

South Africa Malaria Data  - SA Dept of Health
The latest data on malaria cases and deaths from South Africa show that the country's policy of indoor residual spraying with DDT (among other insecticides) and the use of artemesinin based combination therapy is working. KwaZulu Natal, traditionally the province with the worst malaria and the centre of the recent epidemic has only recorded 1 malaria death this year!

South Africa Malaria Statistics  - Dept of Health
The 11th Dept of Health Malaria Update shows the latest number of confirmed cases and deaths from malaria in the three malarial provinces of South Africa.

Saving Lives Today and Tomorrow  - Dr. Roger Bate
This paper analyses trends in drug development using data from the drug industry association, the Pharmaceutical Research and Manufacturers of America (PhRMA). Worryingly, the findings suggest that far fewer AIDS drugs are in development compared to several years ago, and at a time when drug development for other communicable diseases is increasing. There are several probable explanations for this phenomenon, but the least benign is the likelihood that continual pressure group and media attacks on the industry over pricing of drugs in Africa has reduced incentives for development of new AIDS medicines

South African Malaria Update  - SA Dept of Health
The latest malaria update from the Directorate of Communicable Diseases.

Africa Fighting Malaria’s Report on the East and Southern Africa Joint Annual Consultation and Planning Meeting

14-18 August, 2006.

Harare, Zimbabwe

 

Jasson Urbach, Africa Fighting Malaria, South Africa

 

Malaria continues to be the leading cause of death and morbidity on the African continent. It is estimated between 300 and 500 million people are infected with malaria each year and millions die from a disease that is entirely preventable and curable. What makes matters worse is that more than 90 per cent of the deaths occur in children under the age of five.  Every year, malaria robs Africa of potential leaders, scientists, and entrepreneurs – yet the disease is both preventable and entirely curable.

 

This year Zimbabwe hosted the east and southern African planning meeting. This year was also the first year that east African countries attended the proceedings. With the addition of the east African countries the number of countries attending increased to 14. In addition to the representatives from each of the countries a number of individuals from the private sector, ranging from pesticide representatives to pharmaceutical representatives, attended the conference. There was also a large body of representatives from the large multilateral donor agencies attending the proceedings. 

 

Many of the worst affected African countries, which are located in the East and Southern regions of the continent, are increasingly recognising the importance a well-run vector control programme, particularly with the use of indoor residual spraying. Furthermore, there is increasing recognition of the importance of treating malaria with artemisinin based combination therapies and many southern and east African countries have adopted these drugs as their first line treatment for malaria.

 

Most cases of malaria are diagnosed on the basis of clinical symptoms and treatment is presumptive, rather than based on laboratory confirmation. This is one of the major contributing factors to resistance build up. Indeed, resistance to chloroquine – the former treatment of choice – is widespread, with estimates of around 80% in countries where malaria continues to be a major killer. For this reason it is imperative to make the correct diagnosis of patients, based on scientific evidence, if wish to see the outstanding results we have observed thus far with artemisinin based combination therapies extend into the future.

 

Fortunately, many countries present at the meeting have recognised and adopted the relatively new rapid diagnostic tests. These tests are easy to administer and are cost a fraction of the traditional microscopy means of testing. The introduction of rapid diagnostic tests has also reduced the caseload on existing laboratory technicians and has enabled testing to be done in areas where previously it was impossible to do so.

 

Many southern and east African countries have recognised the importance of forming cross-border initiatives with neighbouring countries. One of the successful initiatives is the Lubombo Spatial Development Initiative (LSDI), which a cross-country collaboration between South Africa, Swaziland Mozambique and Zimbabwe. Due to the high level of human traffic in these areas it was important to establish an integrated vector control programme.  

To read on and get specific information on the country malaria control programs, please download Jasson Urbach's report (pdf document)