Fighting Malaria – The Time is Now

This week’s issue of JAMA is devoted to malaria – a disease that affects over 300 million people each year and takes one million lives annually, most of them small children in Africa. In pregnant women, malarial infection can lead to preterm delivery, low birthweight and anemia.

The combination of increased attention, new drugs and new approaches to this serious global problem has created a window of opportunity that must be grasped now if we are to eradicate malaria from the earth. But it will take a concerted effort from governments, industry and the private sector if it is to work

Weapons in the Fight Against Malaria

• Treatment: Artemisinin-based combination therapy (ACT) is the treatment of choice. Artemesin is a derivative of the plant artemisia annua, a Chinese herb that has been used for many years to treat fever. As is the case with many herbs, its mode of action isn’t entirely understood and it is non-patented. Research is ongoing to find new combinations and delivery systems for ACT’s. Both Novartis and Sanofi-Aventis sell ACT to endemic countries at a reduced, no-profit cost, but cost remains high in many areas and counterfeiting of unregulated product is an increasing problem. There is also increasing concern that resistance will develop.

• Insecticide-Treated Nets (ITN’s): This is one of the easiest and cheapest strategies for preventing malaria. Sleeping under an ITN can reduce the risk of malaria by almost 50% and dramatically reduce perinatal disease and child mortality. A single bed net costs between 4 and 6 US dollars, family nets about $10.

• Indoor Residual Spraying (IRS): Insecticide use remains one of the more controversial but highly effective approaches to eradicating malaria. Opponents are concerned about the environmental and health effects of insecticides. Proponents argue that in malaria endemic areas, until better alternatives are available, the benefits far outweigh the risks. I side with the proponents.

• Prophylaxis in Pregnancy: In endemic areas where prenatal care exists, giving pregnant women sulfadoxine-pyrimethamine (SP) in the latter part of pregnancy can reduce anemia-related deaths and low birthweight.

What Works Best?

That’s a subject of much debate. Probably a combination of all of the above.

What Our Government is Doing

George Bush launched the President’s Malaria Fighting Initiative in 2005, possibly one of the few positive legacies of his presidency. He pledged to increase U.S. malaria funding by more than $1.2 billion over five years and challenged other donor countries, private foundations, and corporations to match his pledge. Of course, if even one quarter of the Iraq war budget were spent on malaria….

What Bill Gates is Doing

A little bit of everything, really, but one interesting thing is investing in One World Health , a non-profit pharmaceutical company that seeks to discover, develop and distribute drugs against malaria (and other diseases in the third world). He’s also donating to Medicines for Malaria, a public/private partnership between existing pharmaceutical companies and the public sector, which seeks to do the same thing.

What You Can Do

You can join the fight against malaria by donating to any one of the causes listed at the end of this blog post. Or just Google “malaria”. In an amazing show of how the internet can be a power for good, this will find you over a dozen organizations that are helping the cause.

I’m sending my dollars to Veto the Squito, a campaign launched by the Love, Hallie Foundation to buy ITN’s for kids in Africa.

Why Love, Hallie? Well, I have a bit of a personal connection. Love, Hallie was founded by my friend Sofia and her husband Ted in memory of their amazing daughter Hallie. Raising money to buy ITN’s is exactly what Hallie would have done, so that’s what I and my girls are going to do.

You do what seems right for you. But do something. Because the time is now.
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Organizations that are Leading the Fight Against Malaria

Malaria Foundation International – $ 5 per net, 100% of your donation buys nets. Or set up a fundraiser. Or raise money via your website.

Veto the Squito: Kids helping other kids

CDC – Bed Nets for Children

Malaria No More – If you’re a soccer fan, this is your organization. Beckam is their spokesperson. His motto? “We need nets”. This is where American Idol gave part of their Give Back donations.

Nothing But Nets – Buy a net. Save a life.

AMREF (African Medical & Research Foundation) – They have projects in Tanzania, Ethiopia, Kenya and Uganda.

Sweat for Nets – Children helping children in partnership with the CDC.