Fighting Malaria: a New Way of Thinking What’S the Most Dangerous Animal on the Planet? It’S Not a Lion, a Shark Or Even a Human

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Aloe Blacc The singer speaks out on how we can be the generation to #EndMalaria

INSIDE The role of community volunteers in Kenya’s ﬁght against malaria P4

PERSONAL STORIES Meet three women ﬁghting malaria head on P12 PHOTO: MALARIA NO MORE UK END MALARIA. FOR GOOD.

Eliminating malaria will make the world a better, safer place for future generations and enable millions of people to reach their full potential. www.rollbackmalaria.org 2 MALARIAAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET

IN THIS ISSUE READ MORE ON MALARIAAWARENESS.CO.UK What’s the most Home stretch Thunderclap! dangerous animal Mark Dybul on Join in and pledge on the planet? how the battle your support in the Richard Allan on the against malaria effort to #EndMalaria need for a new way can be fought - once and for all of thinking in order and won to beat malaria P8 P10 The hardest task is yet to come

t’s no understate- made a huge impact, avert- complacent. Up to now, the targeted action on a regional ment to say that ing an estimated 6.2 million gains have been relatively and country level. historical, un- deaths with an effective com- easy, but the picture is be- We know we can deliver precedented pro- bination of vector control, coming more complex. In the results given the right in- gress has been improved diagnostics and addition to the challenges of vestment. History has shown made in the fight treatment. reaching populations at risk that. We need continued in- against malaria of malaria, drug and insec- vestment and commitment in the last 15 years. The situa- Tipping point ticide resistance threaten to to deliver programmes on the Ition we faced in the mid-1990s But the fight is far from make the job even harder. ground. At the same time, we was out of control. More than over. There are still an Dr Pedro Alonso Malaria is a highly hetero- need to broaden our intelli- a million people were losing astonishing 214 million cas- Director, WHO Global geneous disease, and one ap- gence, develop alternative Malaria Programme their lives to the disease each es of malaria each year and proach will not fit all situa- drugs and insecticides, year and we had no effective more than 400,000 deaths as tions. Last May, the World explore new approaches to tools to combat it. a result. Health Assembly approved vector control and continue Today the picture is very Consequently, we find our- a Global Technical Strategy the search for a successful different. Investment has selves at the tipping point. for Malaria, which gives us a malaria vaccine. In many re- been stepped up to more We either accelerate or we “The fight is far comprehensive framework spects, the hardest task is yet than US$2.5 billion a year. It’s run the risk of becoming from over” that can be translated into to come.

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Within KABS (German Mosquito Control Association), around 100 communities have merged their interest in a unique mosquito control programme based on the use of Bacillus thuringiensis israelensis.

The research institute IfD (Institute for Dipterology) is the daughter institute of the KABS, dealing with the biology of Diptera with special consideration on mosquitoes with public health relevance.

KABS (German Mosquito Control Association) www.kabsev.de IfD (Institute for Dipterology) www.institut-dipterologie.de Tel: +49-6232-990950 Email: [email protected] COMMERCIAL FEATURE Malaria and MDGs: mission accomplished?

At the beginning of the the politicians in the room really asked if the SDGs would under- millennium, the battle wanted to hear. mine progress, Pedro Alonso, against malaria was The partnership between the Director of the WHO Global Mala- being lost.” This is the UK and the USA was described ria Programme, said that this sobering“ opening sentence of the as a gamechanger by Bernard would “come down to investment joint report by WHO and UNICEF, Nahlen, the Deputy Coordina- and political support.” However, launched on 17 Sept at the UK tor of the US President’s Malaria there was a “risk that dilution will Houses of Parliament, on the Initiative. “This commitment reduce impetus.” malaria target of the Millennium Onisillos Sekkides has been crucial,” he said, “in However, Nahlen was more Development Goals (MDGs): Deputy editor, The Lancet 2000 there was evidence that optimistic: despite the minor Achieving the Malaria MDG Tar- Infectious Diseases interventions would work, but mention of malaria among get. However, this is the prelude MDGs. Presented as heatmaps, resources were lacking. Now the SDGs, meeting these goals setting the scene for the report’s this article shows the striking these partnerships have pro- would inevitably mean addres- very welcome news. decline in P falciparum infection. vided those resources.” Provi- sing malaria. He also offered the The headline achievement is One of the paper’s authors, Peter ding additional emphasis of the reminder that, before the MDGs, the 60 per cent fall in the mala- Gething, outlined the crucial importance of tackling malaria, African ministries of health ria-associated death rate — from contribution of this work: he said he pointed out that the Roll Back were the source of the demand 47 per 100,000 at risk in 2000 that since 2000 “surveillance has Malaria Partnership’s report for action on malaria, and this to 19 per 100,000 in 2015. This been transformed and this has Action and Investment to Defeat would certainly continue to be equates to a total of 6.2 million similarly had a transformative Malaria 2016–2030 showed that the case. But his optimism came lives saved. Clearly a great achie- effect on policy.” “malaria represents an impe- with a warning, if we “back off vement. Also, the report shows However, throughout the diment to economic develop- now, it will be a disaster.” that incidence of malaria is in launch event many speakers ment.” This report outlines that Looking ahead, the WHO/ decline. Taken together, with were keen to sound a note of if coverage were to revert to 2007 UNICEF report says that “the the addition of achievements caution and ensure the positive levels then US$1.2 trillion of eco- rate or expansion of malaria pro- on children younger than five news in this report did not obs- nomic output would be foregone grammes between 2016 and 2030 years sleeping under bednets cure the enormous task that still from 2016 to 2030. But Nahlen has been mapped out, and fun- and receiving antimalarials, the lay ahead. Just in 2015, there were offered reassurances about the ding requirements to meet these report states that this means an estimated 214 million new commitment of the USA to mala- milestones for 2020, 2025, and that the malaria-specific tar- cases of malaria with 438,000 ria because of its cross-party sup- 2030 have been identified.” These get of the MDGs “has been met deaths. And despite progress, port in Congress. requirements are $6.4 billion convincingly.” almost half the world’s popula- Now that the MDGs have by 2020, $7.7 billion by 2025, and The source data in the report tion is still at risk of malaria. This reached their conclusion, atten- $8.7 billion by 2030. Although were published simultaneously acknowledgement of the work tion is shifting to the next set of the figures will make many in a research article that map- still needed prompted a remin- goals: the Sustainable Develop- politicians wince, against the ped the effect of malaria control der that despite the significant ment Goals (SDGs). Controver- backdrop of the potential cost of on Plasmodium falciparum in increase in funding for malaria it sially, malaria is now one of nine insufficient action they might be Africa over the lifetime of the is still not enough. Not a message targets for one of 17 goals. When easy to swallow. 4 MALARIAAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

INSPIRATION COLUMN New test Dr Anne Musuva-Njoroge Director, malaria & child health, revolutionises Population Services Kenya fight against Community volunteers are key to Kenya’s fight against malaria malaria ccording to the World Bank, between 2003 and 2014, the percentage of households owning in- In order to successfully eradicate malaria, A secticide treated nets in Kenya rose from six you need to know where to find it. New per cent to 59 per cent. With the increased use of nets, currently around 42 per cent, the country has seen in- technology could hold the key to identifying fant mortality fall by 7.6 per cent each year since 2005. Despite the success of recent malaria control ef- the hidden enemy and stopping it in its tracks forts, Dr Anne Musuva-Njoroge, director of malaria & child health at Population Services Kenya notes, By Kate Sharma “there is a reduction in coverage of nets between the mass net distribution campaigns which occur every three to four years.” hile microscopy laria diagnosis. Using loop mediated isother- Between 2014 and 2015 the country piloted a com- and rapid diag- mal amplification (LAMP) to identify the ma- munity net distribution programme targeting 60,000 nostics testing laria parasite, the technology can produce people in 12,315 households to look for a more cost-ef- is helping to di- results within an hour without the need for fective and efficient way to sustain universal cover- agnose a huge laboratory facilities. The ease with which the age. Through community health volunteers, families number of cas- test can be used is of particular significance were provided with nets on a need by need basis, given es of malaria, some slip through the di- considering the greatest burden of malaria education on how to use them and help to repair or re- Wagnostic net. There are cases of malaria remains in regions where healthcare facili- place them as and when required. which are submicroscopic, meaning they ties are often few and far between. The pilot showed that universal coverage was are unidentifiable under a microscope. For Professor Daouda Ndiaye, chief of increased from 48 per cent to 93 per cent in house- A recently launched malaria test, the laboratory of parasitology and my- holds who participated. “Going forward, we aim to Illumigene Malaria, could hold the key cology at Cheikh Anta Diop University at scale the project up,” continues Musuva-Njoroge. to identifying the hidden threat. The UCAD CHU Le Dantec, who run the clini- “We have strong leadership and commitment from test is much more sensitive than mi- cal studies on this new technology, this the Ministry of Health, but the key to success will be croscopy, more sensitive at detect- is not merely a scientific breakthrough, community health volunteers who have been the ing malaria parasites with conventional it’s a personal one. “My own commit- cornerstone of the project.” rapid tests, potentially revolutionising ma- ment to the fight against malaria began

MOH - National Malaria Control Program Website: www.nmcp.or.ke Address: KNH Grounds, P.O. Box 20750 Nairobi Kenya Phone: +254 20 716934/5 Email: [email protected]

Presidents Malaria Initiative (PMI) Website: www.pmi.gov/where-we-work/kenya Website: www.usaid.gov/kenya AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET 5

New technology has a central role to play in the ﬁght to eradicate malaria

PHOTO: VESTERGAARD

as a child growing up in Senegal,” he benchmarks of success rely on malar- “Faster and more accurate diagno- recalls. “I survived severe malaria. My ia indicators like parasite prevalence. sis is vital in the fight against malar- brother also contracted the disease. I However, the traditional methods of di- ia,” says Ndiaye. “Because of submicro- was still at an early stage of my medi- agnosis, such as microscopy and rapid scopic parasitemia carriage among the cal studies but, thankfully, I was able to diagnostic testing, lack the sensitivity populations, a robust, sensitive and recognise the symptoms and identify it to identify submicroscopic parasitemia. field community-deployable screening so he could be treated.” As malaria can be transmitted from tool is needed to track the malaria res- human to vector in pre-elimination set- ervoir in pre-elimination regions. The Advancements in research tings, the sub-microscopic malaria is study we run in Senegal shows that Ndiaye has devoted his life to studying Professor not just for the carrier but also for the tests such as this newly launched LAMP the disease and achieved his PhD at the Daouda Ndiaye community they live in. Adults with ma- malaria test have this capacity.” Department of Immunology of Infec- Chief of the laboratory laria may express low or delayed symp- Whilst sub-Saharan Africa continues tious Diseases at Harvard University, of parasitology and toms which might be transmitted to the to bear the greatest burden of malaria, as before returning to Senegal where he mycology at Cheikh youngest in the community. This on- populations travel more, so malaria cases now leads the team working to control Anta Diop University at going threat of submicroscopic infec- in Europe and the Middle East are also in- malaria and eliminate the disease. One UCAD CHU Le Dantec tion has justified the development of the creasing. As a result, the new LAMP mo- of the problems Ndiaye noted was that newly launched LAMP molecular test. lecular test is good news for us all. 6 MALARIAAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

NEWS

STATISTICS

214 million HILARY RANSONPHOTOS: There were 214 million new cases of malaria worldwide in 2015.

Source: WHO Facts from World malaria report 2015 Insecticide resistance threatens malaria ﬁght

By Kate Sharma

Advancements in the fight coverage of bed nets, we’ve seen against malaria could be incidence of malaria remain lost if we fail to tackle static or even increase,” explains 438 000 insecticide resistance in Professor Hilary Ranson, head vector control. of vector biology at Liverpool There were 438 000 School of Tropical Medicine. “If deaths caused by Great gains have been made in the we don’t respond the trajectory malaria in 2015. ﬁght against malaria and wide is going to be pretty bleak.” spread vector control initiatives Scientists have been exploring Source: WHO Fact sheet on malaria have played a major role. However, treating nets with an additional insecticide resistance threatens to Professor Hilary Ranson synergist to offer increased effica- reverse these fragile gains. Head of vector biology, Liverpool cy, but while these may help At present there are three School of Tropical Medicine maintain control in the short main techniques used to prevent term it’s certainly not a long-term mosquitoes from transmitting use of pyrethroids, which are the solution. “We’re getting to the 57 countries malaria. Long lasting insecticide only class of insecticides current- point where the existing tools we treated bed nets (LLIN) are used ly recommended for bed nets and have aren’t ﬁt for purpose,” says Between 2000 and extensively to kill mosquitoes also a primary agent used in in- Ranson. “We need to maintain and prevent them from biting. door spraying. the political momentum and the 2015, 57 countries Indoor residual spraying (IRS) At the moment, there are few, appetite for change or we risk re- achieved reductions in is also used to cover homes with cost-effective alternatives to py- versing years of progress.” new malaria cases of insecticide to kill the insects and rethroid based sprays and no larvicide destroys mosquito lar- alternatives at all to the pyre- least 75%. vae before they mature. throid treated nets. “In some Read more on malariaawareness.co.uk Source: WHO Facts from World malaria report 2015 The problem is that vector con- regions of Uganda and Burki- trol is highly dependent on the na Faso where we have a high

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COMMERCIAL FEATURE Insecticide resistance threatens the potential for the malaria community to stay focused on global eradication

Malaria-carrying mosquitoes are duced more than 660 million Per- when PermaNet® 3.0, and subse- increasingly resistant to the only maNet® bed nets, protecting more quent products that enter the new class of insecticides, the pyre- than a billion people. product class, will be used. throids, approved by WHO for As a research driven company, Vestergaard recognises that use on bed nets. Since 2010, more Vestergaard has been investiga- “the future of vector control than 75 per cent of the 78 coun- ting solutions to overcome insec- depends on a technology race,” but tries reporting data on insecticide ticide resistance. In response, it he points out that “we will only be Mikkel Vestergaard resistance monitoring in malaria developed PermaNet® 3.0, a new able to beat malaria with a highly vectors have found resistance to at net that incorporates a syner- concerted effort and sense of CEO, Vestergaard least one insecticide. gist, called piperonyl butoxide urgency on the part of all stakehol- alaria control over the In a recent report in The Lancet, (PBO), with the pyrethroid. PBO ders. Funding must continue to past 15 years has been experts cautioned that “the threat enhances the effect of the insec- ﬂow, governments must continue Mone of the greatest glo- of resistance derailing malaria ticide by blocking the metabolic to provide tools to their communi- bal health success stories. The control has become an issue of enzymes within the mosquito ties at risk, and the World Health World Health Organisation (WHO) urgency that can no longer be that break down the insecticide Organisation must understand estimates that more than 6.2 mil- ignored without risking a global and make mosquitoes resistant. the urgency and provide guidance lion lives have been saved, and public health catastrophe.” This PermaNet® 3.0 is the only to scale up proven innovations so attributes much of this success to concern is echoed by Mikkel Ves- next-generation LLIN so far they get into the hands and homes the use of long-lasting insecticidal tergaard, CEO of the family-owned to have its product claim for of the people at risk of malaria.” nets (LLIN). LLINs have been cre- global health company that bears increased efficacy against resis- For many families living in dited for reducing malaria deaths his name. Vestergaard is the lar- tant malaria-mosquitoes substan- malaria zones, their best hope is by 68 per cent in Africa, and over gest manufacturer of LLINs under tiated by WHO. However, deploy- not to get bitten by mala- half of Africa sleeps under a bed the PermaNet® brand. Introduced ment of this net at scale has been ria-carrying mosquitoes. They net today. in 2004, PermaNet® 2.0 was the delayed as countries and donors need to have their world covered However, the effectiveness ﬁrst LLIN brought to scale, and wait for normative guidance from by the most effective mosquito of bed nets is being threatened. since then the company has pro- WHO to determine where and nets available now.

Insecticide resistance threatens to derail malaria control

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INSPIRATION

MALARIA IN NUMBERS

55 countries are on track to reduce malaria case incidence rates by 75%, by 2015 (no conﬁrmation yet).

The malaria mortality Globally: by 47% ͌ǍΈǏ rate was reduced in 2000 – 2013 WHO African Region: by 54% ΒǍ͂Ǐ

Fighting malaria: a new way of thinking What’s the most dangerous animal on the planet? It’s not a lion, a shark or even a human. The world’s biggest killer is a mosquito and it’s putting up a hard ﬁght

By Kate Sharma

ccording to the high transmission areas. In some Combating malaria requires a com- World Health cases, I believe incidence may have pletely different approach in coun- Organisation actually increased.” tries where there is little structure (WHO) an esti- or governance. mated 438,000 High Transmission Areas people lost The regions where the disease is A new way of thinking their lives to most prevalent are those that have The good news is that integrated malaria in 2015 alone, which is a 48 experienced humanitarian cri- vector management, through long perA cent decrease from the estimat- ses and natural disasters. “In West lasting insecticidal nets, residu- ed 839,000 individuals who died Africa, the Ebola crisis essential- al spraying and destroying mos- from the disease in 2000. ly shut down the health systems quito larvae before they hatch, Undeniably great progress has for more than a year,” explains Al- is working. These preventative been made, but statistics only tell lan. “As a result, tens of thousands measures, when used alongside part of the story. Success has been Richard Allan of people died from malaria and rapid diagnostics and treatment isolated and the burden of malaria Founder and director, The progress has been set back at least through artemisinin-based com- remains ﬁrmly on the shoulders of Mentor Initiative a decade.” bination therapy (ACT) can reduce a small number of countries. In fact, In many Central African coun- incidence of the disease and the 80 per cent of all malaria cases can be tries, conﬂict remains the great- number of deaths. found in just 18 countries mainly in est barrier to overcome. Coun- The challenge is delivering this West and Central Africa. be even worse. “Many of the statis- tries such as Burundi and South programme in unstable and inse- Richard Allan, founder and direc- tics are only estimations based on Sudan have had their infrastruc- cure environments. However, the tor of the Mentor Initiative, sug- mathematical modeling from coun- ture, healthcare systems and gov- problem is not insurmountable. gests that the real situation could tries that are not representative of ernance decimated by civil war. Following its independence in 2011, AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET 9

The burden lies in countries experiencing, or recovering from humanitarian crises. i.e. these graphs show that in each of these But these 55 conflict-affected counties, the number of people developing severe malaria and dying has increased countries only account for significantly since 2009 (or earlier in the case of DR Congo) and that the significant overall rise in deaths has not been abated by control efforts to date

Burundi 4% 500 80 400 64 300 48 200 32 of the total estimated ABER (%) Cases per 1000 Cases 100 16 0 0 malaria cases 201420132012201120102009200820072006200520042003200220012000 ABER (microscopy & RDT) Cases (all species) Cases (P. vivax)

Chad

80 10 64 8 48 6 32 4 ABER (%) In 2014, 97 countries had on-going malaria transmission per 1000 Cases 16 2 0 0 3.2 billion (1/2 world population) at risk, of whom 201420132012201120102009200820072006200520042003200220012000 ABER (microscopy & RDT) Cases (all species) Cases (P. vivax) 1.2 billion are at high risk 198,000,000 (globally) cases in 2013 Congo

584,000 deaths, estimated in 2013 35 10 90% of these occurred in sub-Saharan Africa 28 8 21 6 78% of deaths were children under ﬁve 14 4 ABER (%)

Cases per 1000 Cases 7 2 80% of all malaria deaths now occur in 18 countries 0 0 201420132012201120102009200820072006200520042003200220012000 40% of malaria deaths occur in Nigeria and the D.R.C ABER (microscopy & RDT) Cases (all species) Cases (P. vivax)

funding poured into South Sudan To date, Allan points out that, “95 and huge efforts were made to work per cent of investment has been Proportion and number of people not receiving an directly with community leaders focused on countries with better intervention, sub-Saharan Africa, 2014 and equip local health workers to governance, better infrastructure take the lead in fighting malaria. and easier access.” Vector control: Live in a household with ОʶǍ Ǐ “For three years there were no If progress is to be made, inter- at least on ITN of malaria epidemics in South Sudan,” vention must be made on the basis covered by IRS 269 million people confirms Allan. “Despite an ini- of need, rather than the ease with tial scale up of emergency funding which a country can respond. IPTp: Pregnant by the international community, “We have to be ready and willing women receive κ̚Ǎ Ǐ at least one dose when civil unrest broke out again to change our mindset,” continues of IPTp 15 million pregnant women in 2014, funding for malaria con- Allan. “We need to realise that we trol amongst displaced and conflict have to invest three or four times Treatment for affected communities was almost as much into countries with the malaria: Children ȾҖǍ Ǐ with malaria completely cut by the start of 2015 highest transmission rates and that receive an ACT 68-80 million children with malaria In June last year, the country expe- change will take time.” rienced the worst malaria epidemic We know where the need is great- Receive intervention Do not receive 0% 20% 40% 60% 80% 100% it’s ever had.” est and we have the tools to respond. The only thing preventing Proportion of population needing intervention Making change happen action is the willingness to invest ACT, artemisinin-based combination therapy; IPTp, intermittent preventive treatment in WHO estimate that US$ 5.1 billion money and time on behalf of those pregnancy; IRS, indoor residual spraying; ITN, insecticide-treated mosquito net Source: Insecticide-treated mosquito net coverage model from the Malaria Atlas Project is needed every year if sustainable who live in the world’s most chal- development goals are to be met. lenging countries. 10 MALARIAAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

INSPIRATION

COLUMN

Making the

Dr David Reddy CEO, Medicines for Malaria Venture impossible, Malaria and the SDGs Fighting malaria is essential to the success of the Sustainable Development Goals possible n January, the 17 Sustainable Development Goals (SDGs) adopted by world leaders in Mark Dybul, Executive Director of the ISeptember 2015— officially came into force. The targets aim to build on the success of the Mil- Global Fund to Fight AIDS, Tuberculosis lennium Development Goals (MDGs) and recognise that ending poverty is multifaceted. and Malaria, explains how the ﬁght “By addressing malaria you can make a positive impact on a number other SDGs too,” states Dr against malaria can be fought – and won David Reddy, CEO of Medicines for Malaria Ven- ture. “For example, goal 3.1 and 3.2 are focused on By Mark Dybul reducing global maternal and child mortality re- spectively. With malaria taking the lives of more than 10,000 women in child birth and more than What are the greatest mosquito nets, compared to two percent 300,000 children in Africa each year, it’s easy to achievements to date in fight in 2000. By working together and by in- see the link between the ﬁght against malaria against malaria? volving people affected by the diseases, and improvements in maternal and child health.” The fight against malaria is one of civil society, the private sector, donors There are other links, too, relating to reducing the biggest success stories of the 21st and implementing governments, we infant mortality, improving access to education century. This has been possible mostly have cut malaria mortality by 60 percent and gender equality. Within the framework of the due to the massive rollout of preven- since 2000, saving millions of lives. World Health Organisation’s Global Technical tion and treatment tools, smarter diag- Strategy for Malaria, Reddy believes we have the nostic tests, and greater availability of What are the greatest challenges tools and knowledge to build upon the success of antimalarial drugs. In sub-Saharan Af- we’ll face in the next 5-10 years? the MDGs. rica, more than half of the population is The most urgent challenge is the emer- now sleeping under insecticide-treated gence and spread of resistance to the drug

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Fund partnership is backing a smart regional initiative with a US$100 million grant to tackle artemisinin resistance in Myanmar, Thailand, Vietnam, Laos and Cambodia, with a special fo- cus on mobile populations such as farming communities and seasonal agricultural workers.

How do you empower communities to take ownership of their malaria response? Country ownership is in the genetic code of the Global Fund partnership. This means that people and governments determine their own solutions to ﬁghting these three diseases, and take full responsibility for them. This approach puts people affected by the diseases at the heart of the decision-making and response.

How will we end malaria as a public health threat? To end malaria, we need to work in Mark Dybul partnership: governments, the private sector, communities, advocates and civil Executive director of the society. There are also substantial cost Global Fund to Fight AIDS, savings and beneﬁts to working together Tuberculosis and Malaria and pooling resources; for example, the Global Fund’s procurement approach has achieved substantial cost savings, ena- bling partners to purchase more mosqui- artemisinin – the most commonly used “Mosquito- hundreds of thousands of people a year, to nets and reach more families. Defeat- drug against malaria. This threatens to most of them young children. ing malaria requires sustained commit- undo hard-fought gains, not only in the borne ment, funding and innovative approach- Mekong region where it has been detect- parasites Do we need to change our es. If not, we risk a resurgence of the dis- ed but worldwide. Artemisinin-resistant know no current strategy to reach more eases, and undermine the last decade of malaria could be globally devastating if communities? investments in global health. it arises independently in other geogra- borders” To defeat these diseases we must fol- phies or crosses more borders. Mosquito- low the people, wherever they are. We borne parasites know no borders, as the need to reach the high transmission Zika virus has reminded us this year. areas, deepening cross border collabo- Read more on malariaawareness.co.uk While the impact of Zika is still being as- ration and regional data sharing. In sessed, we know that malaria kills Southeast Asia, for example, the Global 12 MALARIAAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

NEWS COLUMN Meet the women ﬁghting The battle against malaria is being fought on many levels; one of the most effective is the grassroots offensive of women across the world

Aloe Blacc Singer-songwriter and Malaria No More UK Special Ambassador We can be the generation to #EndMalaria he moment you become a parent your life changes forever, it’s a feeling I will never for- T get. At the start of the year I became a dad for the second time and it’s the most important role I’ve ever had. I would do anything to protect my children. But imagine if you couldn’t protect them. Imagine if you couldn’t afford the life-saving med- ication that costs £1 to treat your child. Imagine if you didn’t have access to a mosquito net to stop your loved ones being bitten at night. Imagine your child develops a terrifying high fever and there’s Jo Yirrell nothing that you can do. Unimaginable right? Yet Special Ambassador for Malaria No More UK this horror is the daily reality for thousands of parents in Africa. orld Malaria Day determined to end malaria we have to keep up the mo- Another moment that I’ll never forget was back in may not be the for good. My story was part of mentum by increasing fi- 2012 when I visited Ghana with Malaria No More UK to Wmost well know the inspiration for the charac- nancing and political com- see how a mosquito net campaign was saving lives. I day in the UK, but for me, ter of Martha in the 2013 film mitment. In January the UK visited a primary school and asked a classroom of kids it’s hugely important. Why? written by Richard Curtis, Government recommitted to to put their hand up if they’d been affected by malaria. Because my beautiful son Mary and Martha. And three investing in the global malar- I was genuinely shocked when every single pupil put Harry died from malaria just years on – I’m as dedicated as ia campaign for the next five their hand up. I think it was the scale of this disease that over 10 years ago, and I believe ever to the fight against ma- years, and that makes me re- took me back – a disease that affects so few of us in the that raising awareness of this laria. We truly have come so ally proud to be a Brit. I know Western world yet disproportionately affects so many disease is the best thing I can far; malaria deaths are down this will dramatically reduce in Africa, mainly young children. What is tragic is that do in Harry’s memory. by a tremendous 60 per cent malaria deaths: aid is work- malaria is so easily preventable and treatable. No child Harry was volunteering in (that’s more than six mil- ing, and it will give so many should die from a mosquito bite. That’s why I’m sup- Ghana and having the time lion lives saved) in the past mothers the chance to see porting Malaria No More UK – I can’t just stand by while of his life when he contracted 15 years, yet half the world is their children grow up and other parents around the world suffer this injustice. the disease. He had given his still at risk. And in 2016, this is watch as their futures unfold Although this is a bleak situation, we know we malaria tablets to local chil- simply not acceptable. – something that I was tragi- can change things. Thanks to a major global push dren, believing their need was I find it unbelievable that cally denied with Harry. and the work of organisations including the Glob- greater than his, but a few every two minutes another We are on the cusp of a his- al Fund, the world’s largest funder of malaria pro- days after coming home he mother loses a child to ma- toric moment and I hope oth- grammes, millions of lives have been saved. In fact became unwell and was ad- laria - a disease that costs ers join me in seeing how im- child deaths have been slashed by 65 per cent since mitted into hospital, ten days less than £1 to treat. But I portant it is for us to act now 2000 – a spectacular achievement. after that, he was gone. know that if we all work to- so parents stop losing their I’m pleased to announce that I’m planning a pro- His death still haunts me gether, we could prevent so children to this horrific dis- ject later in the year with Malaria No More UK to en- – knowing now that malar- much heartbreak for families ease. One day soon we could gage and inspire more people in the global malaria ia is so easy to prevent and around the world. Heartbreak truly be the generation to beat campaign and to get fans excited about the fact treat. That’s why since 2009 I know only too well. malaria once and for all. And I that we can be the generation to end malaria – once I have been working with As more countries work to- vow to keep telling Harry’s and for all. I’m certainly excited about it –watch Malaria No More UK, a charity wards eliminating malaria story until that day comes. this space! AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET 13 malaria head on

he Global Fund to particularly during the rainy The situation in Kenya Fight AIDS, TB and season. Every day the village has improved now and ma- T Malaria is saving would echo with cries from laria cases have dramati- lives from deadly yet pre- families mourning the loss cally declined. But there is ventable diseases; 17 mil- of a child; tragic, needless much more still to do. In lion so far to be exact. Hav- deaths. particular, we must scale ing seen and experienced I had malaria three times up rapid diagnosis and these diseases first hand – alone when I was preg- treatment during outbreak I can categorically say that nant. Fortunately I was di- seasons, increase the sup- aid is working. agnosed early and received ply of mosquito nets, and I first learnt about The treatment quickly, but on- do more community out- Global Fund during a dif- ly because I knew pregnant reach around malaria pre- ficult time in my life; in women are more suscepti- vention. HIV treatment 2002 when I was diag- ble to malaria as immunity and transmission has im- nosed with HIV whilst is lower, what symptoms to proved too, and women pregnant. Back then the look out for and how to get now deliver HIV free chil- healthcare system in the right medicine. The re- dren. Discrimination is still Kenya was a mess, treat- ality is, this is not the case a big issue though. ment was hard to access for many women, in fact, Watching your children and discrimination was a friend of mine tragical- suffer is heart-breaking. But rife. It felt like my life had ly died while pregnant. She the good news is that we no hope. became ill during her last have the tools to prevent But my struggles don’t trimester and was given im- further suffering if we give end with HIV. I have lost proper medical advice and ambitiously to The Global count of the number of treatment – by the time she Fund to reach more people, Maurine Murenga times my children and I got to hospital it was too in more countries. Together, Kenyan Mother, Global Fund Advocate, malaria survivor and person have had malaria. It used to late, and she died five hours I know we can stamp out living with HIV be very common in Kenya, later. It was devastating. these epidemics.

am a school teacher. But until a few Expectant mothers and their children years ago I spent most of my time come to me for help. Ilooking after my pupils instead of Students in my class still get ill from educating them. Up to 10 of them at a the disease, but it’s become much less time would fall sick from malaria. Some common since more people have be- of them would be so ill that they would come volunteers and started raising start convulsing on the floor. awareness about malaria. I give fre- Growing up in Uganda, I became quent health talks, especially on using used to the constant threat of malar- mosquito nets, and teach adolescent ia. My sister died when she was six af- health and life skills. Malaria is still a ter contracting the disease. My own threat in our village, but I don’t live in five children regularly fell sick, as did fear any more. I. Malaria is life-threatening, but it is preventable. Malaria Consortium gave me the chance to train as a volunteer health worker in my village. I learnt how to spot the first signs of the disease, diagnose malaria and provide treatment in simple cases. I’m very proud of the work I do. It’s so easy for me to spot malaria now, and it feels good to Immaculate Nasigye help others and make a positive Ugandan mother-of-five, teacher and volunteer health worker with Malaria Consortium, contribution to my community. which receives funding from Comic Relief 14 MALARIAAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET

NEWS

PHOTO: ACT CONSORTIUM FACTS ABOUT MALARIA

Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female mosquitoes Game changing malaria vaccine

By Kate Sharma Malaria is caused by Plasmodium parasites. After more than 20 planned for children aged ﬁve The parasites are spread to people through the years of research, 2015 to seven months in a number bites of infected female Anopheles mosquitoes, saw the first malaria of sub-Saharan African coun- called “malaria vectors.” There are 5 parasite vaccine successfully tries. The outcome of this pro- species that cause malaria in humans, and 2 complete pivotal Phase ject, which will take rough- of these species – P. falciparum and P. vivax – 3 testing to obtain ly four years, will enable the pose the greatest threat. a positive scientific World Health Organisation to

opinion. make recommendations on a P. falciparum is the most prevalent malaria larger roll out of the vaccine. parasite on the African continent. It is After years of research, the Another consideration is the responsible for most malaria-related RTS,S/AS01 (RTS,S) malaria Professor David cost of the vaccine: the manu- deaths globally. Schellenberg vaccine is the ﬁrst new tool facturers of RTS,S need to ﬁnd

in the fight against malaria Professor of malaria and the most cost-effective way to P. vivax has a wider distribution than P. in more than 15 years. “The international health at London provide it on a large scale. falciparum, and predominates in many School for Health and importance of this step can- “Whatever the results, countries outside of Africa. Tropical Medicine not be overstated,” says Pro- the vaccine won’t be prior- fessor David Schellenberg, field. More research is need- itised over other methods professor of malaria and in- ed to assess the feasibility and to prevent malaria,” states ternational health at London impact of the vaccine when Schellenberg. The current Symptoms School for Health and Trop- used in ‘real life’, before it be- methods of using insecti- Malaria is an acute febrile illness. In a non- ical Medicine. “Given the comes widely available. cide-treated mosquito nets immune individual, symptoms appear 7 days enormous burden of malaria One of the major consid- and indoor spraying, along- or more (usually 10–15 days) after the infective on the world and the lack of erations is the fact that, un- side rapid diagnostic test- mosquito bite. The first symptoms – fever, new tools to deal with it, this like most other vaccines that ing and anti-malarial drugs, headache, chills and vomiting – may be mild is a really important step.” require one to three doses, whilst not perfect, are cer- and difficult to recognise as malaria. If not While excitement for the RTS,S requires infants and tainly working. The addi- treated within 24 hours, P. falciparum malaria vaccine is understandable, it young children to receive tion of a malaria vaccine can progress to severe illness, often is certainly not a miracle cure. four doses: the first three dos- will strengthen the arse- leading to death. Clinical trials show the vac- es at monthly intervals and a nal of tools to fight what cine has an efficacy of around fourth dose 18 months later. remains the world’s most Children with severe malaria frequently develop 50 per cent at best, which This poses a number of chal- deadly disease. one or more of the following symptoms: is modest in comparison to lenges in communities where “We can do an awful lot severe anaemia, respiratory distress in most other vaccinations. the majority of healthcare is more to improve our malaria relation to metabolic acidosis, or cerebral Schellenberg is keen to administered through private response and having new malaria. In adults, multi-organ involvement point out that administering or informal settings. tools is essential,” concludes is also frequent. In malaria endemic areas, vaccines within the highly Schellenberg. “This disease is people may develop partial immunity, allowing monitored environment of a Rollout preventable and we must do asymptomatic infections to occur. clinical trial is also very dif- A pilot implementation of better. It doesn’t have to be ferent from the reality in the RTS,S is currently being like this.” Source: WHO

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