Posts or Comments 28 January 2023

Monthly Archive for "December 2007"

Advocacy &Policy Bill Brieger | 03 Dec 2007

Malaria on the Campaign Trail

Many candidates for the 2008 US Presidential Election have mentioned an interest in continuing disease control commitments made by the US government to date. Last week more specific numbers were given to these proposals by Hillary Clinton. On 29 October the Roll Back Malaria Partnership reported that “U.S. Presidential candidate Hillary Clinton today pledged to expand the U.S. government commitment to malaria to US$1 billion a year if elected, setting the goal of ending malaria-related deaths in Africa by the end of her second term. The campaign said this funding would be in addition to U.S. government support of malaria control through the World Bank and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which finances the majority of malaria control efforts around the world.”

This pledge can also be considered in light of recent discussions to eradicate malaria, which certainly will be an extremely costly endeavor. An RBM meeting participant did just this -“It’s encouraging to see a leading U.S. presidential candidate step out with such a bold commitment on malaria,” said Rajat Gupta, Chairman of the Global Fund to Fight AIDS, Tuberculosis, and Malaria. “We have the opportunity to eliminate malaria as a global health concern but we’ll need continued American leadership to do it.”

The candidate is said to have pledged for$50 billion for HIV/AIDS. The proposed $1 billion dollars over five years for malaria is not much different that the current requests/projections for the President’s Malaria Initiative, which covers only 15 countries. So $1 billion for malaria seems paltry, especially in light of the candidate’s own words that, “To end AIDS, we need to end malaria in Africa. Malaria is overwhelming the health infrastructures in the developing world, accounting for 40 percent of health spending in many countries – money we need to fight AIDS.”

At any rate, the candidate’s commitment to tackle malaria is sincere as evidenced by her comments that, “Malaria is a challenge to our conscience in its own right. It is appalling that more than a million people die every year from a bug bite. And nearly all of them are children. A child in Africa dies from malaria every 30 seconds. We made a decision to eradicate malaria in North America and in Europe. And we can do the same in Africa and Asia. So I’ll set a goal of ending all deaths from malaria in Africa by the end of my second term. We can do this if we are committed together.”

There seems to be little doubt that the next President of the United States will be under moral obligation to continue funding the international partnership against malaria. The US public has certainly joined in with many NGOs raising money to buy ITNs. In this regard the public may be out in front of most candidates who should all catch up before the primaries and caucuses start.

HIV Bill Brieger | 01 Dec 2007

World AIDS Day and Malaria

The recent announcement that global HIV/AIDS estimates were in over six million cases lower [] is probably not a cause for celebration on World AIDS Day since those who actually are affected and infected still suffer. According to the New York Times, “In only a few countries, such as Kenya and Zimbabwe, do the figures reflect widespread behavioral changes, such as decisions by many people to have sex with fewer partners.” The rest of the reduction is due to changes in the way the estimates were calculated. Now Nigeria and South Africa top the list with the most people living with HIV/AIDS. The fact that a large portion of those who suffer also live in malaria endemic areas, is cause for further concern.

CBS News HealthWatch of 24 October 2007 posted the news that, “Malaria is fueling the spread of AIDS in Africa by boosting the HIV in people’s bodies for weeks at a time, says a study (by University of Washington researchers reported in Nature) that pins down the deadly interplay between the dual scourges. It’s a vicious cycle as people weakened by HIV are, in turn, more vulnerable to malaria.” (

itns-help-reduce-hiv-mortality.jpgRecent studies have shown that there is need to combine efforts in malaria control and HIV/AIDS management to save lives. Kamya et al. (AIDS 2007; 21:2059-2066) reported from Uganda that a combination of prophylaxis with Trimethoprim-sulfamethoxazole and insecticide treated bednets was associated with “a dramatic reduction in malaria incidence among HIV-infected children.” Similar results had been found with adults.

Also in Uganda a study by Malamba et al. concluded that, “HIV-infected children with severe malarial anemia suffered higher all-cause mortality and malaria-related mortality than HIV-uninfected children. Children with HIV and malaria should receive aggressive treatment and further evaluation of their HIV disease, particularly with regard to cotrimoxazole prophylaxis and antiretroviral therapy.” (

Distribution of ITNs to people living with HIV/AIDS is underway in a number of PEPFAR supported programs. More collaborative efforts are needed between malaria, HIV and MCH programs, and countries need joint planning for HIV and malaria control when preparing and implementing their Global Fund grants.

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