It is heartening to see progress in the fight against malaria. Over the past thirty years and with hundreds of millions of dollars invested thus far, the RTS,S malaria vaccine was officially rolled out yesterday in Malawi. In 2017, I wrote about the vaccine trials that began in 2009 and the announcement of the three countries that had been chosen for the vaccine rollout: Kenya, Malawi, and Ghana. 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. Now two years later the vaccine is officially in use to curb the unnecessary deaths of hundreds of thousands of African children under the age of five. The Malaria Vaccine Implementation Program will continue through 2022.
For decades, there has been consistent chatter, research, and hope for a potential malaria vaccine. Now, all three are finally coming to fruition to roll out the world’s first clinical malaria vaccine trials. The World Health Organization Regional Office for Africa (WHO/AFRO) announced today that Ghana, Kenya, and Malawi have been chosen for the WHO-coordinated pilot implementation program that will make the world’s first malaria vaccine available in 2018.
“The prospect of a malaria vaccine is great news. Information gathered in the pilot will help us make decisions on the wider use of this vaccine,” said Dr Matshidiso Moeti, WHO Regional Director for Africa, in a statement. “Combined with existing malaria interventions, such a vaccine would have the potential to save tens of thousands of lives in Africa,” she added.
Sub-Saharan Africa records 90% of all global malaria cases. Even though the number of cases and deaths have dropped dramatically since 2001, the rate is still astronomically high. In fact, malaria still remains one of the deadliest killers on the African continent, especially for children under the age of five.
To date, the most effective way to curb malaria cases is via the use of bed nets and indoor residual spraying. Unfortunately, 43% of sub-Saharan Africans are not protected against either and 429,000 people died from malaria in 2015. After spending time with mothers in Tanzania with Malaria No More, I saw this to be true. I met moms standing in long lines to receive new nets, but the ones they had used for years had holes throughout, rendering them virtually worthless.
There is now new hope to curb child deaths with the injectible malaria vaccine targeted to children within five to 17 months called RTS,S. The vaccine developed by GlaxoSmithKline. Malawi, Kenya, and Ghana were chosen for the following reasons according to the World Health Organization:
- high coverage of long-lasting insecticidal treated nets (LLINs)
- well-functioning malaria and immunization programs
- a high malaria burden even after scale-up of LLINs,
- and participation in the Phase III RTS,S malaria vaccine trial
The countries themselves will determine the areas in their country where the trials will ultimately take place. The $49.2 million cost of the trials will be taken up by Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and UNITAID. The World Health Organization and GlaxoSmithKline will additionally provide complimentary funds for the malaria trial efforts.
Photo: UN Photo/Marie Frechon
Thesla Palanee-Phillips, University of the Witwatersrand
The results of the two studies showing that a vaginal ring can help reduce the risk HIV infection among women is being hailed as an important HIV prevention breakthrough.
Launched four years ago, the two clinical trials, known as ASPIRE and The Ring Study, set out to determine how safe and effective the ring was in prevention of HIV infection in women. The ring, which is used for a month at a time, contains an antiretroviral drug called dapivirine that acts by blocking HIV from multiplying.
The studies enrolled close to 4500 women aged 18 to 45 in South Africa, Uganda, Malawi and Zimbabwe. Each study found that the ring helps reduce the risk of HIV infection in women. In ASPIRE, the ring reduced the risk of HIV infection by 27% overall. In The Ring Study, infections were reduced by 31% overall.
Every year Bill Gates, the Co-Chair of the Bill and Melinda Gates Foundation, writes an annual letter laying out his vision for the future of global health and poverty eradication. This year’s letter, which can be read at billsletter.com, espouses the critical importance of measurement in saving more lives. In fact, Gates uses measurement in business as an example of its parallel importance in global health programs and delivery to those in most need.
Gates writes about global health and education programs that have used measurement as a key driver of their work. For example, using MDGs as a framework and by learning from the successes of the Indian state of Kerala in health delivery to its most vulnerable communities, Ethiopia has subsequently been able to successfully lower its rate of child mortality. As Gates writes, “Ethiopia’s effort on health has lowered child mortality over 60 percent since 1990”. Ethiopia was able to achieve a proven decrease in child mortality with the implementation of 34,000 female frontline health workers who are in charge of 15,000 health posts scattered throughout the country. These health workers provide health care for those in their communities where previously health care was relegated to those who were near hospitals and health centers. Now, using Ethiopia as an example, Nigeria, Malawi and Rwanda are in the process of creating their own country-wide models for frontline health workers and better health care delivery to its citizens.
Gates also shares the prolific work India did in conjunction with Rotary International to eradicate polio from the country. This year marks the second year India is polio-free. This is thanks in large part to the work of health workers as well as robust geographic assessments that showed parts of the country that were not being reached for routine polio vaccine coverage. When measurements and changes were put into place, polio was eradicated from the country. Now polio is only found in Afghanistan, Pakistan and Nigeria.
Melinda Gates, Co-Chair of the Bill and Melinda Gates Foundation, wrote a section in the annual letter that discusses her family planning efforts and the critical need for precise measurements in order to provide more family planning options for women who live in the world’s poorest countries.
“I didn’t feel I had an accurate picture of how many women currently have or lack access to contraceptives, or what could realistically be done to drive improvement,” Gates wrote.
Through her work leading the London Summit on Family Planning last year data was sifted through in order to clearly determine that 120 million women need access to family planning services.
In all, Bill Gates’ push for more measurement in global health programs is sure to help save millions more lives in the coming decades because the more everyone knows the more can be done.
To read Bill Gates’ full annual letter visit billsletter.com or you can download it as a PDF. Additionally if you would like to share your hope for the 2030, visit the Gates Foundation Facebook page where you can have your voice heard on the My Hope for 2030 app.
Photo: Gates Foundation
It sounds seemingly impossible, but there is yet another area of Africa that is under threat of a food shortage due to erratic rains during the growing season. While the Sahel is still experiencing food shortages, southern Africa is now joining ranks with the northwestern part of the continent.
According to the World Food Programme, 3.5 million people are living in drought-hit areas in Malawi, Lesotho, and Zimbabwe and are in need of food assistance. The hunger season lasts from December through March.
“Large numbers of smallholder farmers and their families are in the grip of what is set to be one of the harshest hunger seasons of recent years,” says Brenda Barton, WFP Deputy Regional Director for Southern Africa. “With the help of governments, donors and regional organizations, we’re mobilizing resources to help the most vulnerable, not only with food distributions but also with innovative solutions like cash transfers via mobile phones so people can buy their own food.”
|1.8 million people are receiving food assistance||200,000 people are receiving food assistance||1.6 million people are receiving food and cash assistance|
What can you do to help? You can donate securely on the World Food Programme web site. There is currently a $4 million emergency operation shortfall in Lesotho and a $14 million shortfall in Malawai, so every donation counts.
- Lesotho: hungry and largely forgotten as donor pledges ring hollow (guardian.co.uk)
- UN: Southern Africa food shortages worsen (kansascity.com)
- Warning over Africa food shortages (independent.ie)
UN Photo/WFP/Phil Behan