Friday, February 27, 2015

The latest report on President’s Malaria Initiative

U.S. aid devoted to malaria increased from $149 million in 2000 to $1.2 billion in 2008.
In June 2005, President George W.Bush launched President’s Malaria Initiative PMI, “a major 5-year, $1.2 billion initiative to support a rapid scale-up of malaria prevention and treatment interventions in 15 high-burden countries in sub-Saharan Africa.The Initiative is led by the U.S.Agency for International Development (USAID) and implemented together with the U.S.Department of Health and Human Services’ Centers for Disease Control and Prevention (CDC).When it was launched, the goal of PMI was to reduce malaria-related mortality by 50 percent across the 15 PMI-supported countries through a rapid scale-up of four proven and highly effective malaria prevention and treatment measures: ITNs; IRS; accurate diagnosis and prompt treatment with ACTs; and IPTp. [insect treated nets; indoor residual spraying; artemisinin-based combination therapies;  intermittent preventive treatment of pregnant women . ] http://www.pmi.gov/docs/default-source/default-document-library/pmi-reports/president's-malaria-initiative-strategy-2015-2020.pdf

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But as you can see from this graph in 2012, the rates and deaths from malaria are still much higher than when DDT was allowed.  This chart starts with 1983, and DDT ended in the 1970s after Silent Sprint written by Rachel Carson, a non-scientist, became popular.     She may have killed more people than WWII.

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http://www.theguardian.com/society/2012/feb/03/malaria-deaths-research

 http://journalistsresource.org/studies/international/development/global-malaria-mortality-1980-2010-systematic-analysis#sthash.pTcujSy1.dpuf

  • Global malaria deaths increased from 995,000 in 1980 to a peak of 1,817,000 in 2004, and then decreased to 1,238,000 in 2010.
  • In Africa, malaria deaths increased from 493,000 in 1980 to 1,613,000 in 2004, and then decreased by about 30% in 2010 to 1,133,000. Outside of Africa, malaria deaths have steadily decreased, from 502,000 in 1980 to 104,000 in 2010.
  • The majority (65%) of all malaria deaths occur in children under age 15. Individuals ages 15-49 years, 50-69 years, and 70 years or older accounted for 20%, 9% and 6%, respectively, of malaria deaths in 2010.
  • Overall, 433,000 more deaths occurred worldwide in individuals aged 5 years or older in 2010 than was suggested by official WHO estimates In 2012 an important research report on malaria was published pointing out serious errors in the tracking of malaria deaths. (The Lancet, “Global Malaria Mortality Between 1980 and 2010: A Systematic Analysis,”) Their figure of 1.2 million deaths for 2010 is nearly double the 655,000 estimated in last year's World Malaria Report.

"You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults," said [Christopher] Murray, IHME director and the study's lead author. "What we have found in hospital records, death records, surveys and other sources shows that just is not the case."

Most deaths are still in children, but a fifth are among those aged 15 to 49, 9% are among 50- to 69-year-olds and 6% are in people over 70, so a third of all deaths are in adults. In countries outside sub-Saharan Africa, more than 40% of deaths were in adults.

In Africa, though, the contribution of malaria to children's deaths is higher than had been thought, causing 24% of their deaths in 2008 and not 16% as found by a report by Black and colleagues, whose methodology was used in the World Malaria Report.

The current PMI funding and goals ended with 2014.  The only budget information I found for post 2015 is a draft.  Don’t know if it was approved, but it does report a funding gap.  Since 2009 the funding definitely has not kept up with the initial push.

http://www.pmi.gov/docs/default-source/default-document-library/tools-curricula/pmi-strategy-2015-2020-draft-for-external-review.pdf?sfvrsn=6

http://reliefweb.int/report/world/president-s-malaria-initiative-strategy-2015-2020

http://www.fightingmalaria.org/

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