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Attack on highland malaria in east Africa
Newsdesk Attack on highland malaria in east Africa Highland malaria in east Africa is the target of a new US$360 724 (UK£224 000) project. Kenya and Uganda, two of the three regional countries besides Tanzania, have launched the Highland Malaria Project, which will seek new systems of predicting and treating the disease. The 4-year pilot project, in partnership with the London School of Hygiene and Tropical Medicine (LSHTM), will focus on malaria-prone areas in the two countries. The project will be coordinated by the ministries of health in the two governments and LSHTM, which will also distribute funds from the Bill Gates Foundation. Areas selected for the pilot phase are Kenya’s districts of Nandi in Rift Valley and Gucha in Nyanza, and two other districts in Uganda. Areas were chosen on the basis of the high numbers of deaths reported annually as a result of regular outbreaks, says Sam Ochola, the divisional malaria-
control head at the Kenyan ministry of health. According to Ochola, there were already studies in Nandi and Gucha to establish why cases of highland malaria were common and the measures needed to contain them. Under the pilot programme regular and intensive studies in the selected districts would enable health teams to detect changes in weather and resultant effects on malaria trends. The key objective of the project is to set up a system for earlier warning and to sensitise the public to seek medication on key malaria symptoms. “In the past we have been taken by surprise. We therefore seek to generate data that will be used to predict malaria epidemics in good time”, Ochola told TLID. Once the pilot phase—which began last October—is completed, the project’s practice and findings will spread to other districts to improve future responses to the disease. Other
African countries are also expected to benefit from the project in future. Annually, malaria parasites infect between 300 and 500 million people worldwide and kill between 1·5 and 2·5 million. In Africa alone, roughly 450 million people live in areas of endemic malaria transmission and a further 50 million experience occasional malaria epidemics. Meanwhile, Kenya could receive a major share of the 5-year US$3 billion grant allocated by the Japanese Government for the fight against infectious diseases and improvement of public health. Although the Japan International Cooperation Agency (JICA) deputy resident representative, Tomoki Nitta, could not say how much Kenya would obtain, he said the grant would help in the country’s development of research networks, primary and secondary education, and access to safe water. Samuel Siringi
Meningitis A conjugate vaccine comes on stream A candidate meningitis A conjugate vaccine developed by the WHOsponsored Meningitis Vaccine Project (MVP) would offer long-lasting protection and herd immunity, two improvements over existing vaccines against meningitis A, concluded an expert panel. “The development is particularly important because 80–85% of meningitis cases in sub-Saharan Africa are caused by strain A and it is the first time in more than 100 years of fighting this disease that a meningococcal group A conjugate vaccine has been developed”, MVP’s spokesperson Monique Berlier told TLID. MVP claims it has reached an agreement with three manufacturers, SynCo, BioSynth, and Serum Institute of India, and the vaccine could be ready for use in subSaharan Africa within the next 4–5 years. “This is excellent news and we have been desperately waiting for it. What particularly satisfies us is the way in which MVP managed negotiations with partners to deliver a product . . . at less
than US$1 per dose”, says Laura Hakokongas, a spokesperson for Médecins Sans Frontières. However, Hakokongas cautioned that the strategy should be adapted to the development of the epidemiological situation in Africa, which entails keeping an open mind about including the W135 strain in a conjugate vaccine. Josef Decosas (Regional Health Advisor, Plan West Africa Region) noted that, initially, the commercial development of conjugate meningitis A and C vaccines were pursued in parallel, but then meningitis A was “detached” from the process, and by 1999 conjugate meningitis C vaccine was widely available and had already shown its efficacy by eliminating bacterial meningitis in several industrialised countries. “The gap in the response time between Europe and Africa is on the order of 10–15 years. The only reason for this gap is the potential for economic return on the finished product. We should be very happy that there is a response at all, but our joy
THE LANCET Infectious Diseases Vol 3 May 2003
Meningitis belt
Countries reporting more than 15 cases per 100 000 population and an epidemic of meningococcal disease from January 1995 to October 1999
Meningitis in Africa
should not blind us to the dysfunction of the global pharmaceutical market that led to a delay in the development of a conjugate meningitis A vaccine in the first place”, Decosas said. Khabir Ahmad
http://infection.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.
263
control head at the Kenyan ministry of health. According to Ochola, there were already studies in Nandi and Gucha to establish why cases of highland malaria were common and the measures needed to contain them. Under the pilot programme regular and intensive studies in the selected districts would enable health teams to detect changes in weather and resultant effects on malaria trends. The key objective of the project is to set up a system for earlier warning and to sensitise the public to seek medication on key malaria symptoms. “In the past we have been taken by surprise. We therefore seek to generate data that will be used to predict malaria epidemics in good time”, Ochola told TLID. Once the pilot phase—which began last October—is completed, the project’s practice and findings will spread to other districts to improve future responses to the disease. Other
African countries are also expected to benefit from the project in future. Annually, malaria parasites infect between 300 and 500 million people worldwide and kill between 1·5 and 2·5 million. In Africa alone, roughly 450 million people live in areas of endemic malaria transmission and a further 50 million experience occasional malaria epidemics. Meanwhile, Kenya could receive a major share of the 5-year US$3 billion grant allocated by the Japanese Government for the fight against infectious diseases and improvement of public health. Although the Japan International Cooperation Agency (JICA) deputy resident representative, Tomoki Nitta, could not say how much Kenya would obtain, he said the grant would help in the country’s development of research networks, primary and secondary education, and access to safe water. Samuel Siringi
Meningitis A conjugate vaccine comes on stream A candidate meningitis A conjugate vaccine developed by the WHOsponsored Meningitis Vaccine Project (MVP) would offer long-lasting protection and herd immunity, two improvements over existing vaccines against meningitis A, concluded an expert panel. “The development is particularly important because 80–85% of meningitis cases in sub-Saharan Africa are caused by strain A and it is the first time in more than 100 years of fighting this disease that a meningococcal group A conjugate vaccine has been developed”, MVP’s spokesperson Monique Berlier told TLID. MVP claims it has reached an agreement with three manufacturers, SynCo, BioSynth, and Serum Institute of India, and the vaccine could be ready for use in subSaharan Africa within the next 4–5 years. “This is excellent news and we have been desperately waiting for it. What particularly satisfies us is the way in which MVP managed negotiations with partners to deliver a product . . . at less
than US$1 per dose”, says Laura Hakokongas, a spokesperson for Médecins Sans Frontières. However, Hakokongas cautioned that the strategy should be adapted to the development of the epidemiological situation in Africa, which entails keeping an open mind about including the W135 strain in a conjugate vaccine. Josef Decosas (Regional Health Advisor, Plan West Africa Region) noted that, initially, the commercial development of conjugate meningitis A and C vaccines were pursued in parallel, but then meningitis A was “detached” from the process, and by 1999 conjugate meningitis C vaccine was widely available and had already shown its efficacy by eliminating bacterial meningitis in several industrialised countries. “The gap in the response time between Europe and Africa is on the order of 10–15 years. The only reason for this gap is the potential for economic return on the finished product. We should be very happy that there is a response at all, but our joy
THE LANCET Infectious Diseases Vol 3 May 2003
Meningitis belt
Countries reporting more than 15 cases per 100 000 population and an epidemic of meningococcal disease from January 1995 to October 1999
Meningitis in Africa
should not blind us to the dysfunction of the global pharmaceutical market that led to a delay in the development of a conjugate meningitis A vaccine in the first place”, Decosas said. Khabir Ahmad
http://infection.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.
263