Tropical Health Matters

Today’s news featured a media briefing by the RBM Partnership and AMMREN on the challenges of protecting pregnant women from malaria. Additional news expands on these challenges. Research looks at how malaria parasites withstand the heat of a patient’s fever. Finally examples are presented of collaboration between international organizations and the private sector for malaria and disease control. Follow the links to gain more information.

Speed Up IPTp Scale-Up: a media briefing on maternal health

A panel discussion and media briefing on new approaches and lessons learned formed part of an online global call to end malaria in pregnancy with intermittent preventive treatment. The briefing on Tuesday, 6 October 2020, was sponsored by the Roll Back Malaria Partnership and AMMREN. The RBM website features background on the call to action.

The panel discussion included Dr. Aminata Cisse ep. Traore, Sous Directrice de la Santé de la Reproduction/Direction Générale de la Santé et de l’Hygiène Publique, Ministére de la Santé et de l’Hygiène Publique, Mali; Dr. Anshu Banerjee, Director Department of Maternal, Newborn, Child, Adolescent Health & Ageing, World Health Organization (WHO), and Dr. Pedro Alonso, Director Global Malaria Programme, WHO. The discussion was moderated by Mildred Komey, Malaria in Pregnancy Focal Person, National Malaria Control Program, Ghans Health Service.

The discussion covered the importance of launching this call now, what we’ve learned over the last few years, and examples of innovative strategies from Mali. There was a Q&A session with journalists after the presentations.

The presentation by Dr Alonso showed the progress in achieving IPTp coverage goals. He also pointed out the social and economic factors that affect access and equity to intermittent preventive treatment of malaria in pregnancy and protection of maternal health (see slides).

Experts say Africa must scale-up malaria protection for pregnant women

In support of the RBM/AMMREN briefing described above, Sola Ogundipe reports that amidst the COVID-19 pandemic in sub-Saharan Africa, malaria – one of the world’s oldest diseases – is impacting disproportionately on pregnant women and children aged under five.

For a pregnant woman, her fetus, and the newborn child malaria infection carries substantial risks. Calling for a speedy scale-up to boost protection against malaria for pregnant women in Africa, the Roll Back Malaria, RBM Partnership to End Malaria Working Group is issuing an urgent appeal to leaders and health policymakers to increase access to Intermittent Preventive Treatment during pregnancy, IPTp, among eligible pregnant women in sub-Saharan Africa.

Along with stakeholders, the RBM Partnership is pushing for scale-up coverage of three doses of IPTp to reach all eligible women in sub-Saharan Africa by 2025. In 2019, according to the RBM Partnership, an estimated 11 million pregnant women in sub-Saharan Africa, or 29 percent of all pregnancies were infected with malaria.

How malaria parasites withstand a fever’s heat

The parasites that cause 200 million cases of malaria each year can withstand feverish temperatures that make their human hosts miserable. Now, a team is beginning to understand how they do it. The researchers have identified a lipid-protein combo that springs into action to gird the parasite’s innards against heat shock.

Understanding how malaria protects its cells against heat and other onslaughts could lead to new ways to fight tough-to-kill strains, researchers say. Findings could lead to ways to maximize our existing antimalarial arsenal.

Global Fund and Chevron – United Against HIV, TB and Malaria

The Global Fund and Chevron Corporation have celebrated a 12-year partnership that served as an example of the private sector’s contribution to the fight against infectious diseases and to building resilient health systems. Chevron, a Global Fund partner since January 2008, has supported Global Fund programs against HIX4 tuberculosis and malaria for a total investment of US$60 million in Angola, Indonesia, Nigeria, the Philippines, South Africa, Thailand and Vietnam.

Chevron’s partnership has contributed to helping more than a million people living with HIV access lifesaving antiretroviral therapy; supported efforts to distribute over one million long-lasting insecticide-treated mosquito nets to families to prevent malaria; helped detect thousands of TB cases; promoted education programs for the young, and helped build stronger health systems.

In Nigeria, Chevron’s $5 million investment from October 2017 to December 201 9 supported the national HIV and TB programs, reaching key and vulnerable populations, as well as interventions aimed at strengthening the health system. Sustainable and resilient systems for health are indispensable in the fight against the epidemics of HIV TB and malaria, as well as the first line of defense against new diseases like COVID-19. “With rising cases of COVID-1 9, the stakes are very high. Deaths from HIV, TB and malaria are likely to increase. Investments by partners like Chevron are fundamental.

A variety of malaria and related issues have arisen over the past two days. A media coalition for malaria elimination formed in Ghana. A Nigerian NGO stresses the importance of addressing malaria on Nigeria’s 60th Independence Day (October 1). An innovative technology foundation is supporting various malaria and NTD treatment and diagnostic research efforts. Click on links below to read the details.

Media Coalition for malaria control and elimination launched

A Media Coalition comprising of selected journalists and editors, has been launched in Ghana under the umbrella of the “Zero Malaria Starts with Me” campaign to eliminate malaria by 2030. The Coalition, which aimed to enhance the quality and quantity of malaria coverage, and support broader advocacy efforts, was launched at a workshop in Accra organized by the National Malaria Control Programme (NMCP), in collaboration with the African Media and Malaria Research Network and Speak Up Africa, an advocacy and communication Organisation based in Senegal.

The workshop brought together media personnel from across the regions, who nominated their Regional Executives, with two National Co-Chairpersons coming from Greater Accra. The Members of the Coalition, made a firm declaration of their commitment towards the elimination of malaria in Ghana by the year 2030, by championing the fight, taking responsibility for their roles through proactive, regular, accurate, and high-quality media output of news on malaria.

Chinwe Chibuike Foundation Set To Flag-off Full Scale Malaria Eradication Program On Independence Day

A Nigeria indigenous and international non-governmental organization, envisioned to create a conducive environment towards the accessibility of healthcare facilities and improved educational opportunities, has joined the fight against the bizzare challenges of Malaria. The renowned Nigeria-USA humanitarian organization, Chinwe Chibuike Foundation is collaborating with other organizations to flagoff a full scale malaria eradication exercise tagged “Nigeria at 60 Malaria Eradication Project”, on the 1st of October 2020.

According to the founder and President of Chinwe Chibuike Foundation, Ms Gloria Chibuike, during an interview session with Pulse TV few days ago, she noted the forthcoming Nigeria At 60 Malaria Eradication Program will be different and of more impact, especially with the full scale approach and introduction a new Malaria repellant Band.

While emphasizing on the extensive features of the project, Ms Gloria described Malaria as one of the biggest problems in Africa at the moment, considering the increased number of recorded deaths and infection. She narrated that the discovery of the new malaria repellent band was timely and off-course very efficient, especially with testimonies from few persons who have already tried the brand.

Drugs and Diagnostics: Malaria and NTDs

The Global Health Innovative Technology (GHIT) Fund announced today a total of 1.37 billion yen (US$13 million*) to invest in seven partnerships to develop new lifesaving drugs and diagnostics for malaria, Buruli ulcer, Chagas disease, leishmaniasis, schistosomiasis, and soil-transmitted helminths (STH). This includes three newly funded projects and four that will receive continued funding. The RBM Partnership is planning on how to monitor and provide technical support for ITN programs. Click the links within each section to read details.

As of September 29, GHIT’s portfolio includes 50 ongoing projects: 26 discovery projects, 16 preclinical projects and eight clinical trials (Appendix 3). The total amount of investments since 2013 is 22.3 billion yen (US$211 million).

Support the Improvement of Operational Efficiency of ITN Campaigns

The Alliance for Malaria Prevention (AMP) is a workstream within the RBM Partnership to End Malaria. With malaria indicators stagnating and intense pressure to improve access and use of effective ITNs, WHO has renewed focus on stratifying vector control strategies in countries. Along with the introduction of new, more expensive ITNs, countries are now challenged to determine where they should deploy different ITN types to manage insecticide resistance within limited funding envelopes, as well as to identify more efficient ways to implement mass ITN distribution.

Countries that have accessed AMP technical assistance have significantly improved their capacity to modify and update strategies and tools to increase ITN access, use and accountability. They have also continued to identify further gaps and look for effective ways to address them. Now AMP planning to support update and finalization of ITN tracking tool, aligned with priorities across major partners (GF, PMI, RBM).

 

Today’s selection of abstracts and news looks at the role of the media in supporting malaria programs, mass treatment to prevent Imported malaria, problems managing malaria in pregnancy services, malaria research in Mali and health systems strengthening to support malaria control in Guinea. Follow links to read mor details.

GHS calls for media support to eradicate malaria

The Ghana Health Service (GHS) has called on journalists to support the Service to deliver integrated health package through accurate messages towards malaria eradication in the country.“Also, we need your support to set malaria as a national development agenda. This will drive advocacy for political will, increase partnership, availability and accessibility of effective tool for prevention, diagnoses and treatment of malaria in all the vulnerable populations.”

Dr Anthony Adofo Ofosu, the Deputy Director General, GHS, said this at the launch of “Zero malaria starts with me” campaign in Accra.  The launch coincided with a sensitisation programme by the African Media and Malaria Research Network (AMMRN), the National Malaria Control Programme and the Speak Up African Organisation. The Deputy Director General said “It is the belief of the GHS that with effective engagement…we will be able to eradicate malaria from the country in the near future.”

Mass radical treatment of a group of foreign workers to mitigate the risk of re-establishment of malaria in Sri Lanka

Following malaria elimination, Sri Lanka was free from indigenous transmission for six consecutive years, until the first introduced case was reported in December 2018. The source of transmission (index case) was a member of a group of 32 migrant workers from India and the location of transmission was their residence reporting a high prevalence of the primary vector for malaria. Despite extensive vector control the situation was highly susceptible to onward transmission if another of the group developed malaria. Therefore, Mass Radical Treatment (MRT) of the group of workers for Plasmodium vivax malaria was undertaken to mitigate this risk.

The workers were screened for malaria by microscopy and RDT, their haemoglobin level assessed, and tested for Glucose 6 phosphate dehydrogenase deficiency (G6PD) using the Care Start RDT and Brewers test prior to treatment with chloroquine (CQ) 25 mg/kg body weight (over three days) and primaquine (PQ, based on G6PD test results) (0.25 mg/kg/day bodyweight for 14 days) following informed consent. All were monitored for adverse events. None of the foreign workers were parasitaemic at baseline screening.

Mass treatment may be an option in prevention of reintroduction settings for groups of migrants who are likely to be carrying latent malaria infections, and resident in areas of high receptivity. However, in the case of Plasmodium vivax and Plasmodium ovale, a more reliable and affordable point-of-care test for G6PD activity would be required. Most countries which are eliminating malaria now are in the tropical zone and face considerable and similar risks of malaria re-introduction due to massive labour migration between them and neighbouring countries. Regional elimination of malaria should be the focus of global strategy if malaria elimination from countries is to be worthwhile and sustainable.

Managing intermittent preventive treatment of malaria in pregnancy challenges: an ethnographic study of two Ghanaian administrative regions

Malaria in pregnancy (MiP) is an important public health problem across sub-Saharan Africa. The package of measures for its control in Ghana in the last 20 years include regular use of long-lasting insecticide-treated bed nets (LLINs), directly-observed administration (DOT) of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and prompt and effective case management of MiP. Unfortunately, Ghana like other sub-Saharan African countries did not achieve the reset Abuja targets of 100% of pregnant women having access to IPTp and 100% using LLINs by 2015.

This ethnographic study explored how healthcare managers dealt with existing MiP policy implementation challenges and the consequences on IPTp-SP uptake and access to maternal healthcare. Healthcare managers addressed frequent stock-outs of malaria programme drugs and supplies from the National Malaria Control Programme and delayed reimbursement from the NHIS, by instituting co-payment, rationing and prescribing drugs for women to buy from private pharmacies.

Some clients did not receive the recommended 5?+?doses of SP, others did not obtain LLINs early and some did not obtain treatment for MiP. Healthcare providers felt frustrated whenever they could not provide comprehensive care to women who could not afford comprehensive maternal and MiP care. For Ghana to achieve her goal of controlling MiP, the Ministry of Health and other supporting institutions need to ensure prompt reimbursement of funds, regular supply of programme drugs and medical supplies to public, faith-based and private health facilities.

Malaria prevention program continuation in Guinea

CRS Guinea is the Principal Recipient (PR) in Malaria prevention program continuation grant by the Global Fund for the new cycle of funding (NFM) (January 2021-December 2023). Community health is a top priority of the Ministry of Health as a primary strategy to increase accessibility and coverage to basic health services. Under the new Global Fund grant, the community health component will be expanded to six districts, in addition to two pilot districts, Kindia and Telimele. CRS will also support coordination with other donors, including World Bank, UNICEF, Gavi, European Union and the Guinea Ministry of Health to implement the national community health strategy in 12 health districts supported by Global Fund malaria project.

The United States and Mali Celebrate 60 Years of Friendship and Partnership

Thirty years ago, our National Institutes of Health created a Malaria Research and Training Center, which is now a component of the International Center for Excellence in Research in Mali. Until today, it serves as a reference center with over 700 Malian scientists and support staff who work on malaria and other infectious diseases. Together, we have dropped malaria prevalence rates in Mali by an astounding 60 percent since 2012.