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Africa: Ending Malaria in Sight?

Africa: Ending Malaria in Sight?

AfricaFocus Bulletin, Nov 27, 2009

Editor's Note

On the Comoran island of Moheli, with a population of 36,000, malaria has been eliminated with the aid of a comprehensive Chinese-assisted treatment campaign. And at the 5th Pan-African malaria conference, held in Nairobi in early November, Kenya's minister of public health, Beth Mugo, announced that her country had set the goal of eliminating the disease by 2017.

This AfricaFocus Bulletin contains several short reports and article excerpts related to recent developments in the fight against malaria, including reports on the Comoros, Kenya, and Rwanda, on the multilateral initiative to reduce the prices of treatment, on the potential for new medications based on African plants, and the threat of new resistance to the current first-line treatment, Artemesinin-based combination therapies.

For more information on the 5th Pan African MIM Malaria conference, and links to a wide variety of related news and scientific reports,see

Previous AfricaFocus Bulletins on malaria include:

Africa: Progress on Malaria, Apr 27, 2009

Africa: Malaria Control Up, Majority Not Covered, Sep 19, 2008

Africa: Dramatic Anti-Malaria Results Feb 5, 2008

Africa: Africanizing Malaria Research, Nov 20, 2005

Africa: Rolling Back Malaria? May 4, 2005

Latest in AfricaFocus FYI

Nov 25, 2009 - President Barack Obama, " Remarks at Presentation
of Human Rights Award ", (Nov 24, 2009)

The full text of remarks by President Barack Obama at the presentation to Magodonga Mahlangu and Jenni Williams of Women of Zimbabwe Arise (Woza) of the 2009 Robert F. Kennedy Human Rights Award at a ceremony in the East Room of the White House on November 23, 2009. Links to remarks by Mahlangu and Williams as well.

Kenya: Govt Hopeful It Can Eliminate Malaria

David Njagi, SciDev.Net (London) 9 November 2009

Nairobi - Kenya hopes to eliminate malaria by 2017, a malaria conference heard last week.

The disease has been in decline in the country in recent years and scientists say they are optimistic that it can be eliminated by then.

The goal was announced by Beth Mugo, minister of public health and sanitation, at the opening of last week's 5th MIM Pan African Malaria conference in Nairobi. Implementation will be steered by a National Malaria Strategy (NMS), which the government launched at a separate event.

"We are at a point of moving towards a malaria-free Kenya in 2017," said Willis Akhwale, head of the country's Department of Disease Control and Prevention.

"Health systems strengthening, the development of effective medicines, human resources capacity building and more will be necessary to achieve this," said Mugo.

"Eliminating malaria in 2017 is possible based on current technologies and adequate funding," said Elizabeth Juma, head of the Division of Malaria Control.

The timeline is based on the findings of a 2007 Malaria Indicator Survey, which demonstrated that transmission is declining in most parts of the country - although seasonal transmission in arid and semi-arid areas is still at worrying levels.

"We plan to change the strategy of intervention in the arid and semi-arid areas and launch a mass drug administration campaign in areas where the disease is endemic," said Akhwale. Experts told the MIM meeting that elimination was not possible without mass drug administration. Elimination occurs when malaria prevalence drops to zero in a region, while eradication achieves the same on a global scale.

Some 13 per cent of pregnant women in Kenya now use insecticide treated nets (ITNs) in all malaria endemic areas, according to the 2007 survey. The number of children aged five and under using ITNs rose from under five per cent in 2003 to more than half in 2006.

Robert Newman, director of the WHO's Global Malaria Programme, said he was confident that Kenya would meet the 2017 target but he added that success depended on improved political will as well as the development of new tools to improve disease surveillance.

It was also essential for communities to realise that they are "not just recipients of drugs but they play an important part in the fight against malaria", he said.

Akhwale said Kenya would need US$100 million if it were to meet the target. NMS plans to decentralise control and to prioritise monitoring and evaluation.

The Affordable Medicines Facility-Malaria to begin delivering subsidized ACTs within two weeks

November 6th, 2009

The Affordable Medicines Facility: malaria (AMFm) program, hosted and managed by the Global Fund, will deliver subsidized artemisinin-based combination therapies (ACTs) to select countries within two weeks time. As a result of negotiations and larger, direct payments to manufacturers, malaria drug prices will be reduced from$6 to 40 cents per dose through AMFm. Countries selected to participate in the program, originally announced in April, are: Benin, Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Rwanda, Senegal, Tanzania and Uganda.

The announcement came from the 5th Pan-African MIM Conference in Nairobi on Monday. Experts hailed the drug-delivery decision as key to eradicating malaria in sub-Saharan Africa.

Drug Resistance Threatens Anti-Malaria Drive:Artemisinin,
Malaria "Miracle" Drug, Could Lose Its Potency

by Cathy Sunshine Nov 18, 2009

Artemisinin compounds are highly effective against malaria, but they're too expensive for most people. Use of cheap substitutes is leading to dangerous drug resistance.

Malaria kills nearly a million people each year, most of them young children in Africa. The vast majority of deaths are due to Plasmodium falciparum, a vicious malaria strain that has become resistant to all but one of the malaria drugs on the market.

That one drug is artemisinin, a derivative of Artemisia annua, the sweet wormwood plant. When taken in combination with another drug, artemisinin can knock out a lethal malaria infection swiftly and completely.

Now, as an indirect result of the drug's high cost, malaria parasites resistant to artemisinin have emerged along the Thai-Cambodian border and are threatening to spread.

Treating Malaria with Artemisinin Combination Therapies

Since 2004, the World Health Organization (WHO) has recommended
artemisinin-based combination therapies as the frontline treatment for malaria. The drug cocktails combine fast-acting artemisinin with a longer-acting, older antimalarial, delivering a one-two punch to the parasite.

It is crucial that artemisinin not be administered alone, a method known as monotherapy. Without a companion drug, some parasites linger in the body and can become resistant to artemisinin.

For this reason, the WHO in 2006 called for artemisinin monotherapies to be pulled from the market, except in special cases. But many manufacturers and countries are failing to comply.

Ineffective monotherapies still dominate the private market in large countries such as Nigeria and Congo, which together account for 30 percent of malaria cases in sub-Saharan Africa.

For full article, see

Remaining sections include: "High Cost of Artemisinin Leads to Underuse"

"Malaria Eradication Efforts Threatened"

China adopts "malaria diplomacy" as part of Africa push

Nov. 6, 2009]

By Tan Ee Lyn

Hong Kong, Nov 6 (Reuters) - In a laboratory in China's southern city of Guangzhou, scientists are trying to enhance the rare sweet wormwood shrub, from which artemisinin -- the best drug to fight malaria -- is derived.

China hopes to improve and use the drug as a uniquely Chinese weapon to fight malaria not on its own soil, where the deadly disease has been sharply pruned back, but in Africa, where it still kills one child every 30 seconds.

Already, a Chinese-backed eradication programme on a small island off Africa has proven a huge success.

Successful Trial

Tanzania, Kenya and Nigeria have begun farming hybrids of the sweet wormwood shrub with Chinese and Vietnamese ancestry, said Li Guoqiao at the Tropical Medicine Institute.

"I inspected the plantations and the plants are growing well," Li told Reuters in an interview.

Asked if China would export the high-yielding Artemisia annua to Africa, Li said: "We want to grow them in China and whatever we export depends on bilateral relationships."

Li is spearheading a project on the tiny African island of Moheli, which belongs to the Comoros group of islands at the northern mouth of the Mozambique Channel.

In mid-November 2007, he launched a "mass drug administration" exercise on the island. Its entire population of 36,000 had to take two courses of anti-malarial drugs to flush the parasite from their bodies -- on day one and day 40.

The rationale was that while mosquitoes pass the parasite from person to person, they are merely "vectors" and not hosts. The real reservoir of the disease is people, and many carry the parasite in their bodies without even showing symptoms.

"The key is to eradicate the source, which is in people. Without the source, the vectors are harmless," he said.

The results were startling. While the parasite carrier rate in Moheli ranged from 5 to 94 percent from village to village before the exercise, that fell to 1 percent or less from January 2008 and has stayed around that figure since.

"Before, 70 to 80 percent of hospital patients were there for malaria. After that, you hardly find any," Li said.

Comoros now bars anyone from entering Moheli unless they take a course of antimalarial drugs -- a mix of artemisinin, primaquine and pyrimethamine that China provides for free.

Its government has asked Beijing to roll out the same programme in two of its larger islands, Grande Comore and Anjouan, with a total population of 760,000. Li said Beijing supported the idea in principle and that funding was being worked out.

Kenya: Locally-Growing Moringa Tree Key in Fight Against Malaria

The Nation (Nairobi)Gatonye Gathura and Isaiah Esipisu, 3 November 2009

[Excerpts: full article at:]

Nairobi: A malaria treatment derived from a locally-growing shrub is one of only a few herbal cures being presented at the ongoing international conference in Nairobi.

The tree, moringa oleifera, commonly known as horseradish or mlonge in Kiswahili, is competing alongside malaria medicines developed by some of the world's best scientists with the backing of global pharmaceutical giants.

According to a presentation at the Pan-African Malaria Conference, moringa extract, in combination with other herbs, has been seen to cure even drug-resistant malaria.

Unfortunately for Kenya, this development has been made by Nigerians who say the drug called zogali has been approved by the country's national drug registration agency.

Several herbal malaria cures are being presented at the conference but none from Kenyans despite repeated claims by local herbalists that they can easily treat and even cure the disease.

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