Significant progress has been made in delivering life saving malaria nets and treatments over the past few years, but the coverage of malaria programmes needs to be stepped up drastically in order to meet the Millennium Development Goals (MDGs), according to a report released today by the World Health Organization (WHO).
The World Malaria Report 2009 found that the increase in international funding commitments (US$ 1.7 billion in 2009 compared to US$ 730 million in 2006) had allowed a dramatic scale up of malaria control interventions in several countries, along with measurable reductions in malaria burden. However, the amounts available still fall short of the US$ 5 billion required annually to ensure high coverage and maximal impact worldwide.
The WHO Director-General, Dr Margaret Chan, described the findings in the report as cause for cautious optimism and said "While much remains to be done, the data presented here clearly suggest that the tremendous increase in funding for malaria control is resulting in the rapid scale up of today's control tools. This, in turn, is having a profound effect on health - especially the health of children in sub-Saharan Africa. In a nutshell, development aid for health is working."
The report found that more life-saving malaria nets and treatments were delivered in 2007 and 2008 compared to 2006.
More African households (31%) own at least one insecticide-treated net (ITN), and more children under 5 years of age used an ITN in 2008 (24%) compared to previous years. These averages are affected by low ITN ownership in several large African countries for which resources for scale-up are only now being made available. Household ITN ownership reached more than 50% in 13 of the 35 highest burden African countries.
Use of artemisinin-based combination therapies (ACTs) is increasing but remains low in most African countries with fewer than 15% of children with fever receiving an ACT.
More than one-third of the 108 malarious countries (9 African countries and 29 outside of Africa) documented reductions in malaria cases of more than 50% in 2008 compared to 2000.
Where scale-up of proven interventions has occurred, and surveillance systems are functioning, remarkable impact has been documented:
In countries and areas that have achieved high coverage with bed nets and treatment programmes (e.g. Eritrea, Rwanda, Sao Tome and Principe, Zambia and Zanzibar, the United Republic of Tanzania) recorded cases and deaths due to malaria have fallen by 50% (target set by World Health Assembly for 2010) suggesting that MDG target for malaria can be achieved if there is adequate coverage of key interventions.
Large decreases in malaria cases and deaths have been mirrored by steep declines in all-cause deaths among children less than 5 years of age suggesting that intensive efforts at malaria control could help many African countries to reach, by 2015, a two-thirds reduction in child mortality as set forth in the MDGs.
High levels of external assistance were shown to be linked to decreases in malaria incidence. However, many external funds are concentrated on smaller countries with lower disease burdens. More attention needs to be given to ensuring success in large countries that account for most malaria cases and deaths.
Parasite resistance to anti-malarial medicines and mosquito resistance to insecticides are major threats to achieving global malaria control. Confirmation of artemisinin resistance was reported in 2009, and WHO is leading a major resistance containment effort in South East Asia. Key elements in the global strategy to prevent the spread of drug resistance include: 1) Rapidly reducing the spread of malaria using malaria preventive tools 2) ensuring that all malaria infections are correctly diagnosed, effectively treated and followed-up to ensure that they do not spread the disease to others 3) halting the marketing and use of oral artemisinin monotherapies and importantly, 4) carefully monitoring the efficacy of medicines to detect early evidence of resistance.
The report noted that there was urgent need for the global community to completely fund the Global Malaria Action Plan in order to sustain early success and achieve the 2015 MDGs. The African Region had the largest increase in funding of all regions, led by investments by the Global Fund, the U.S. President's Malaria Initiative, and other agencies.
The success of malaria control efforts will be in reducing the burden of malaria and improving child survival. Investing in malaria control is not only helping the world to reach the MDGs, but is also helping to build health systems that will ensure that these development gains are sustained.
Tuesday, December 15, 2009
Oncologist at Children's Hospital of Philadelphia to Chair International Childhood Cancer Organization
Will Lead Children's Oncology Group -- Collaborative Organization in Pediatric Cancer
Peter C. Adamson, M.D., a pediatric oncologist and leading scientist at The Children's Hospital of Philadelphia Research Institute, has been selected to lead the Children's Oncology Group (COG) in its efforts to find cures for children with cancer.
An internationally recognized leader in pediatric cancer drug development, Dr. Adamson will assume his new role with COG on Jan. 1, 2010. He was elected by principal investigators of more than 200 COG sites. COG unites more than 5,000 experts in childhood cancer at leading children's hospitals, universities, and cancer centers across North America, Australia, New Zealand, and Europe in the fight against childhood cancer.
Dr. Adamson, who came to The Children's Hospital of Philadelphia in 1999 from the National Cancer Institute, is the director of Clinical and Translational Research and chief of the Division of Clinical Pharmacology and Therapeutics at Children's Hospital. He also is a professor of Pediatrics and Pharmacology at the University of Pennsylvania School of Medicine. He will remain on the staff of Children's Hospital and on the Penn faculty while serving as COG chair.
Emerging research shows that even the more common childhood cancers are actually a mix of different diseases, each potentially requiring a different specific therapy. Creating such disease-targeted therapies for children with cancer requires a better pathway for moving from the bench to the bedside, which Dr. Adamson will lead through expanding COG's role at Children's Hospital and fostering new and enhanced collaborations with COG sites throughout the world.
The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. www.chop.edu
The Cancer Center at The Children's Hospital of Philadelphia's large basic and clinical research programs are particularly strong in pediatric neuro-oncology, neuroblastoma, leukemia and lymphoma, and sarcomas.
Physicians at Children's Hospital have had pioneering roles in developing international standards for diagnosing and treating neuroblastoma, and in developing programs for survivors of childhood cancer.
Peter C. Adamson, M.D., a pediatric oncologist and leading scientist at The Children's Hospital of Philadelphia Research Institute, has been selected to lead the Children's Oncology Group (COG) in its efforts to find cures for children with cancer.
An internationally recognized leader in pediatric cancer drug development, Dr. Adamson will assume his new role with COG on Jan. 1, 2010. He was elected by principal investigators of more than 200 COG sites. COG unites more than 5,000 experts in childhood cancer at leading children's hospitals, universities, and cancer centers across North America, Australia, New Zealand, and Europe in the fight against childhood cancer.
Dr. Adamson, who came to The Children's Hospital of Philadelphia in 1999 from the National Cancer Institute, is the director of Clinical and Translational Research and chief of the Division of Clinical Pharmacology and Therapeutics at Children's Hospital. He also is a professor of Pediatrics and Pharmacology at the University of Pennsylvania School of Medicine. He will remain on the staff of Children's Hospital and on the Penn faculty while serving as COG chair.
Emerging research shows that even the more common childhood cancers are actually a mix of different diseases, each potentially requiring a different specific therapy. Creating such disease-targeted therapies for children with cancer requires a better pathway for moving from the bench to the bedside, which Dr. Adamson will lead through expanding COG's role at Children's Hospital and fostering new and enhanced collaborations with COG sites throughout the world.
The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. www.chop.edu
The Cancer Center at The Children's Hospital of Philadelphia's large basic and clinical research programs are particularly strong in pediatric neuro-oncology, neuroblastoma, leukemia and lymphoma, and sarcomas.
Physicians at Children's Hospital have had pioneering roles in developing international standards for diagnosing and treating neuroblastoma, and in developing programs for survivors of childhood cancer.
Afghanistan first in world to use new vaccine against polio Critical step as global eradication effort faces entrenched challenges
A new vaccine against polio will be used for the first time today in polio immunization campaigns in Afghanistan. The bivalent oral polio vaccine (bOPV), recommended by the Advisory Committee on Poliomyelitis Eradication, the global technical advisory body of the Global Polio Eradication Initiative as a critical tool to eradicate polio, can provide the optimal concurrent protection needed by young children against both surviving serotypes (types 1 and 3) of the paralysing virus. This will vastly simplify the logistics of vaccination in the conflict-affected parts of this country. This sub-national immunization campaign, from 15-17 December, will deliver bOPV to 2.8 million children under five in the Southern, South-Eastern and Eastern Regions of Afghanistan. Of the three wild polioviruses (known as types 1, 2 and 3), type 2 has not been seen anywhere in the world since 1999. This achievement led to the development of monovalent vaccines, which provide protection against a single type with greater efficacy than the traditional trivalent vaccine. To determine whether a bivalent vaccine could effectively protect children living in areas where both types circulate, a clinical field trial completed in June 2009 compared bOPV with the existing vaccines. For both types 1 and 3 polio, bOPV was found to be at least 30% more effective than the trivalent vaccine and almost as good as the monovalent vaccines, yet in a package that could deliver both at once.
The bOPV allows countries to simplify vaccine logistics and to optimize protection using a mix of the available polio vaccines according to local needs. In southern Afghanistan, where access to children can be limited depending on the security situation, using bOPV helps maximise the impact of each contact with a child.
Most of Afghanistan is polio-free: 28 out of the 31 children paralysed by polio this year come from 13 highly insecure districts (of 329 districts in the country). In 2009, polio eradication efforts in Afghanistan have focused on improving operations and creating a safe environment for vaccination teams. Nongovernmental agencies have been contracted and local leaders involved to ensure that parties in conflict are approached, safe passage for vaccinators assured and children reached. Due to such preparations and strengthened supervision and staffing, the proportion of the nearly 1.2 million children under five years old in the Southern Region who could not be reached was reduced from more than 20% in early 2009, down to 5% during the July and September 2009 campaigns. The availability of bOPV multiplies the effect of such improvements. However, in the 13 highest-risk districts of Kandahar and Helmand provinces in the Southern Region, the proportion of children who are still unimmunized is well above 20% – and more than 60% in some areas.
Four countries in the world have never stopped polio transmission – Afghanistan, India, Nigeria and Pakistan. Types 1 and 3 polio circulate in limited parts of all these countries, and the others will follow Afghanistan's lead in using bOPV during the coming months, marking the adoption of a major new tool in the international effort to eradicate polio. While the Global Polio Eradication Initiative, a public-private partnership leading the effort, has reduced the incidence of polio by more than 99% (from an estimated 1000 children affected daily in 1988 to 1483 children in all of 2009 to date) polio still has a foothold in the four endemic countries. The consequences are severe beyond those areas: 16 previously polio-free countries are currently suffering outbreaks following importations of the virus; in four of these, polio transmission has lasted more than a year.
The availability of bOPV is part of a range of new and area-specific tactics in 2009 to reach eradication more quickly. The swift production of the vaccine was the result of extraordinary collaboration between the World Health Organization, UNICEF, vaccine manufacturers and regulatory agencies.
The vaccination campaign in Afghanistan is financed by the Government of Canada. Canada, which assumes presidency of the G8 in 2010, first placed polio on the group's agenda when it last held the presidency in 2002. The G8 is the single-largest donor bloc to polio eradication.
The Global Polio Eradication Initiative is spearheaded by the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention and UNICEF.
The bOPV allows countries to simplify vaccine logistics and to optimize protection using a mix of the available polio vaccines according to local needs. In southern Afghanistan, where access to children can be limited depending on the security situation, using bOPV helps maximise the impact of each contact with a child.
Most of Afghanistan is polio-free: 28 out of the 31 children paralysed by polio this year come from 13 highly insecure districts (of 329 districts in the country). In 2009, polio eradication efforts in Afghanistan have focused on improving operations and creating a safe environment for vaccination teams. Nongovernmental agencies have been contracted and local leaders involved to ensure that parties in conflict are approached, safe passage for vaccinators assured and children reached. Due to such preparations and strengthened supervision and staffing, the proportion of the nearly 1.2 million children under five years old in the Southern Region who could not be reached was reduced from more than 20% in early 2009, down to 5% during the July and September 2009 campaigns. The availability of bOPV multiplies the effect of such improvements. However, in the 13 highest-risk districts of Kandahar and Helmand provinces in the Southern Region, the proportion of children who are still unimmunized is well above 20% – and more than 60% in some areas.
Four countries in the world have never stopped polio transmission – Afghanistan, India, Nigeria and Pakistan. Types 1 and 3 polio circulate in limited parts of all these countries, and the others will follow Afghanistan's lead in using bOPV during the coming months, marking the adoption of a major new tool in the international effort to eradicate polio. While the Global Polio Eradication Initiative, a public-private partnership leading the effort, has reduced the incidence of polio by more than 99% (from an estimated 1000 children affected daily in 1988 to 1483 children in all of 2009 to date) polio still has a foothold in the four endemic countries. The consequences are severe beyond those areas: 16 previously polio-free countries are currently suffering outbreaks following importations of the virus; in four of these, polio transmission has lasted more than a year.
The availability of bOPV is part of a range of new and area-specific tactics in 2009 to reach eradication more quickly. The swift production of the vaccine was the result of extraordinary collaboration between the World Health Organization, UNICEF, vaccine manufacturers and regulatory agencies.
The vaccination campaign in Afghanistan is financed by the Government of Canada. Canada, which assumes presidency of the G8 in 2010, first placed polio on the group's agenda when it last held the presidency in 2002. The G8 is the single-largest donor bloc to polio eradication.
The Global Polio Eradication Initiative is spearheaded by the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention and UNICEF.
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