An Expat’s Guide to Surviving Malaria | 

The following is an excerpt from Expat Etiquette: How to Look Good in Bad Places, by Michael Bear and Liz Good.

The first time I got malaria was, as is often the case, the worst. No, actually, that’s not true: the fourth (and most recent) time I got malaria was the worst, but only because it was an unexpected relapse that struck while Christmas’ing in Athens. Talk about unfair.

expat etiquette

But anyway, the first time was definitely the scariest. I’d started getting sick on a Friday, and being new to West Africa, and thus not knowing how to get help or who to call, I decided to ride out the weekend in the hopes that my body aches and fever were “just” the flu and/or might miraculously go away on their own.

Besides, I told myself: people here live and work with malaria all the time. Right? Right. Surely if they can do it, so can I. Right?


By Monday my fingernails had turned blue and my bedroom walls had begun to undulate. By the time my coworkers showed up to rescue me, in response to my hysterical phone call, I could barely move, let alone walk. They all but dragged me down to the car, before starting a frantic round of phone calls to determine which hospital was our best bet. In a country that boasted only 50-60 local, legitimately-licensed doctors to serve a population of 3.5million, this was not as simple a question as you might think.

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Progress at risk despite millions of lives saved from malaria, warns WHO | 

Vestergaard Frandsen

Some 3.3 million lives were saved since 2000 from malaria, says a new WHO report.

Deaths worldwide fell by 45% and were more than halved for African children under five years old.

However, a lack of funds and recent problems with bednet makers means the progress made over the last decade is as risk.

“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” says Dr Margaret Chan, WHO Director-General. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century.”

Cases of malaria fell by 29% worldwide over the period, but an estimated 3.4 billion people remain at risk for malaria. The problem is concentrated. According to the WHO, 80% of global malaria cases occur in southeast Asia and in Africa.

The number of bed nets distributed has declined over the past three years from 145 million in 2010 to 70 million in 2012. That falls short of the 150 million needed each year to ensure every person at risk is protected, says the WHO.
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Visualizing progress against AIDS, tuberculosis and malaria | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) announced this week that donors pledged a total of US $12 billion to save lives through prevention and treatment of these three diseases.

The $12 billion represents the largest amount pledged to the Global Fund to date, as shown in the figure below. Many celebrated this milestone while others, as Humanosphere reported earlier this week, emphasized that it fell short of the goal of $15 billion, an amount advocates said was needed to continue to make progress against these killers.

Global Fund ATM

Significant progress has been made in reducing deaths from AIDS, tuberculosis, and malaria worldwide. The video below charts the decline in deaths from HIV/AIDS worldwide from 1990 to 2010 using the Institute for Health Metrics and Evaluation’s (IHME) data visualization tools:

The video shows how deaths from HIV/AIDS increased in most age groups through 2005 but started to drop by 2010. Continue reading

Desperate situations bring back old malaria interventions | 

By Amy Maxmen, contributor

In Mali, a mother administers anti-malarial drug to her child.
In Mali, a mother administers anti-malarial drug to her child.
Amy Maxmen

An abandoned measure in malaria prevention has been resurrected in six African nations this year. About 1.2 million healthy children are swallowing malaria drugs to prevent the disease during the rainy season in regions where malaria mainly strikes within those months.

Fifty years ago, public health officials stopped administering antimalarial drugs to massive numbers of people in malaria-endemic areas because it leads to drug resistance, and also it’s complicated to implement. Yet the strategy is making a comeback out desperation. Despite bed nets, insecticides and treatment, about 600,000 children die from malaria each year in sub-Saharan Africa.

As Humanosphere reported last April, Robert Newman, director of the malaria program at the World Health Organization (WHO), stressed the instability of malaria control. “If we let the pressure off,” Newman said, “the disease will spring back.” To keep that coil compressed, health workers administered malaria drugs prophylactically in parts of Mali, Togo, Chad, Niger, Nigeria and Senegal.

The version of mass drug administration that the WHO recommended last year – called seasonal malaria chemoprevention or SMC – will not work in East and South African countries where resistance to the medicines SMC uses, SP (sulphadoxine and pyrimethamine) and amodiaquine, is already widespread. Continue reading

The 10 stories you missed while following the Philippines | 

The disaster following Typhoon Haiyan in the Philippines rightly has dominated the global twenty-four hour news cycle. Humanosphere has devoted more of our reporting time to the issue than anything else this week. With nearly one million people displaced and close to twelve million affected, the scope of the problem is vast and the relief effort has a long way to go.

While we were paying attention to the Philippines, there were other notable news stories that garnered less attention. Here are ten notable events and happenings (presented in no particular order) that you might have missed this week. It is by no means a comprehensive list. Do add anything else of note in the comments section.

1) Polio is worse this year in Pakistan, so the region is taking on the challenge by working together.

Gates Foundation

The number of polio cases in Pakistan have already exceeded the total from 2012. Health officials announced Wednesday that there are sixty-two cases of polio in 2013. The total for 2012 was fifty-eight. Pakistan is one of only polio-endemic countries, alongside Afghanistan and Nigeria.

Attacks on polio workers over the past year have hampered the effort to vaccinate children. An estimated 240,000 children living in the northwest were not vaccinated in August due to a ban by the Taliban.

The problem is affecting neighboring countries. An outbreak of polio in Syria was recently linked to Pakistan. To deal with the issue, the WHO is working with twenty-one Middle Eastern countries to stop polio in its tracks. However, much of what happens in Pakistan is out of the control of the UN and its neighbors.
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Scientists say using DDT against malaria could be fueling global obesity | 

Could the fight against malaria be making us fat?

That’s what one scientist who studies an increasingly important, if counterintuitive, branch of genetics thinks.

Spraying DDT in Italy, during World War II
Spraying DDT in Italy, during World War II
Flickr, otisarchives4

The pesticide DDT, though banned for use throughout much of the rich world because of its environmental persistence and potential for harm, is still widely used throughout the developing world to fight malaria. On balance, the World Health Organization thinks the health benefit from reducing malaria outweighs – in these countries anyway – the potential health and environmental safety risks of DDT.

Michael Skinner, a geneticist and founder of the Center for Reproductive Biology at Washington State University, thinks the potential harm of DDT needs to be looked at not just in terms of its immediate impact but across generations.

“The potential transgenerational actions of DDT need to be considered in the risk-benefit analysis of its use,” says Skinner.

You probably know that genes make proteins which do the work in living creatures. And that bad genes make bad proteins, which can cause disease or perhaps make us prone to mix plaids or drink red wine with fish … or some other kind of deleterious outcome. Scientists know this as the central dogma of molecular biology and it implies a simple, linear formula in which our genes operate in one deterministic direction.

But science, if it teaches you anything, teaches that what we don’t know is usually much greater than what we do. Continue reading

Gates-backed test malaria vaccine is celebrated, half glass full | 

African child with cerebral malaria
African child with cerebral malaria
Mike Urban

An experimental malaria vaccine, made by GSK with backing and support on the research side from the Bill & Melinda Gates Foundation and Seattle-based PATH, has (again) been shown to protect half the children in the study were immunized against malaria.

The results, announced today in Durban, South Africa, are pretty much the same as earlier findings that continue to emerge from a long, ongoing study of GlaxoSmithKline’s RTS,S vaccine.

The scientific gist of the latest findings, as was reported back in 2008, is that the vaccine appears to protect about half the kids from getting sick, its ability to protect drops significantly following vaccination, it requires repeat doses and GSK estimates it will cost a few dollars at least.

Is that a glass half full or half empty? Continue reading

What global health needs is more (value for) money | 

There’s been a lot of hoo-hah this week in and around the UN General Assembly meeting in New York City focused on maintaining the world’s progress against poverty, especially diseases of poverty – aka global health.

GlobalFundLogoNothing perhaps inspires more hoo-hah in the global health arena than the Global Fund to Fight AIDS, Tuberculosis and Malaria – and for good reason. The Global Fund has saved millions of lives by getting life-saving drugs to people with HIV, TB and malaria, by getting tens of millions of bed nets out to prevent malaria and by literally bringing back to life many of the poorest, most ravaged communities on Earth. It now pays for most TB and malaria care worldwide, and one-fifth of the world’s response to HIV-AIDS.

It’s easy to forget how hopeless we all felt little more than a decade ago regarding the deadly threat of these major killers. It’s easy to forget how crazy ambitious it was to launch the Global Fund. AIDS was burning a wide swath through Africa, which the Economist magazine notoriously dubbed “The Hopeless Continent.” Hardly anyone even thought much about the millions dying from TB and malaria.

The Global Fund was, and is, one of the most hopeful, compassionate and impressive things the international community has done in a long time. That’s why it’s being celebrated in and around the grand UN confab this week. That’s why everyone cheered at the stunning statistics of lives saved, as well as when Britain announced this week it would give another $1.6 billion to the Global Fund, and it’s also why some are clamoring for even more funds – since many millions more are still not reached.

But like most things we humans do when we rush in to fix something, the Global Fund was also seriously flawed.

And it’s high time we deal with the flaws. Or so says Amanda Glassman, a global health expert and author of a new report called More Health for the Money. Here’s the video version:

What? There are 200 different kind of bed nets to prevent malaria? How can that be? Continue reading