Researchers trying to create the world’s first malaria vaccine are launching a massive medical trial as early as next month involving 16,000 children that could be the largest such trial ever conducted on children in Africa.

British-drugmaker GlaxoSmithKline PLC is teaming with the PATH Malaria Vaccine Initiative, which is an anti-malaria charity funded by the Bill & Melinda Gates Foundation, and clinics and research centers in Africa to develop a malaria vaccine.

"This is probably going to be one of the largest studies in infants and in children in Africa," said Joe Cohen, a top vaccine researcher for GlaxoSmithKline.

Malaria, caused by parasites and spread by mosquitoes, kills nearly 1 million people every year, most of them children in Africa. The trial may start as early as next month, and should be well under way by January, said Cohen.

The massive vaccine trials will be conducted in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. Dr. Christian Loucq, director of the Malaria Vaccine Initiative, said the project has been working over the past year to upgrade laboratory, computer and other equipment in those countries, train technicians, and even help develop local equivalents of the U.S. Food and Drug Administration to ensure the trials are properly monitored.

The Malaria Vaccine Initiative has so far spent $107 million on the project and has not yet calculated how much more it will spend. GlaxoSmithKline has spent $300 million so far, and estimates it will spend up to $100 million more.

Researchers working on the trial said in an interview in Johannesburg that much of the groundwork already has been laid in preliminary trials involving 4,000 children conducted since 2003. They said that even if their vaccine does not succeed, the widespread investment needed to conduct the trials means that Africa will be left with better communications, research and other infrastructure that could be used in the search for vaccines against other diseases such as AIDS.

While the researchers were optimistic, it will be several years before they know whether their vaccine candidate is safe and effective enough for wide use.

The preliminary trials showed the vaccine was likely to be at least 30 percent effective against mild malaria cases and about 50 percent effective against severe malaria. That may sound low compared to, for example, the injectable polio vaccine that is at least 90 percent effective. But researchers have found it difficult to pin down a vaccine for parasites, and further tests may show the GlaxoSmithKline candidate is more effective, Cohen said.

Dr. Michel Van Herp, an epidemiologist with the aid group Medecins Sans Frontieres, said a vaccine might have to be more effective than the GlaxoSmithKline candidate has been shown to be so far to be worth the effort of putting it in use. But he acknowledged that matching the effectiveness of the polio vaccine has proven difficult, and said a partially effective vaccine "at least will reduce the workload on the health sector."

Medecins Sans Frontieres, also known as Doctors Without Borders, is not involved in vaccine research, but is at the forefront of treating malaria among the poor in Africa and elsewhere.

The vaccine would have to be used along with preventive measures like mosquito nets and insecticides to save lives.

Dr. Eusebio Macete, who is director of the Manhica Research Centre in Mozambique and was involved in some of the early field trials, said stopping any percentage of the disease would be welcomed in areas "where people are dying every day of malaria."

"It’s a huge, huge burden, this disease," Macete said. "Whatever percentage we can get will be useful in reducing the impact of the disease."

After years of death and despair, opportunity has finally begun knocking at the door of malaria eradication.  A report released in September by the World Health Organization (WHO) showed promising signs of progress in the fight against the disease that kills one million people every year.

It found that, between 2000 and 2006, more than 25 countries managed to cut their malaria death totals in half. What’s more, the total number of infections around the world now stands at 247 million, down from the 350-500 million estimated in WHO’s 2005 report.

These drops are credited to what the report calls “a renewed assault on malaria,” which includes ever-more effective and affordable anti-malaria pills as well as a greater distribution of insecticide-laced bed nets to repel mosquitoes that carry the disease.

This is good news indeed, especially since malaria often doesn’t get the attention it deserves.

But the worst thing the world can do now is to stop and celebrate. That’s because these steps forward are just the beginning of a long road ahead. Malaria still kills some 3000 people every day in sub-Saharan Africa alone, mostly children under five.

Nearly half the world’s population lives in areas where malaria is a constant threat. Yet despite recent improvements, far too few people have access to life-saving medicine and only 2 per cent of African children sleep under a bed net.

Aside from the overwhelming human toll, the disease also wreaks havoc on economies and on social stability. The UN says that in Africa, where most cases occur, malaria costs $12 billion a year in lost GDP. Add to that the resulting poverty and increased health care costs and it becomes clear that the disease hurts far more than just those infected.

So if the battle against malaria is going to be won, we must maintain and even step up our “renewed assault.”

There’s little doubt that malaria can be completely eradicated. As the latest statistics prove, we have the knowledge and tools to defeat the disease. All that remains is to stir up enough political will.

Any global leader with enough compassion and foresight will find a wonderful opportunity to make a real difference in the world by investing in malaria treatment and prevention.

Such an investment wouldn’t even cost that much. According to the UN, just $2 billion a year is needed to halve the global impact of malaria by 2010. Even simple bed nets, which help drastically reduce the number of cases, cost less than $10 a piece to produce and ship.

Yet right now the world spends a mere $600 million on the disease.

When you consider that makeup and perfume is a $33 billion industry, or that Europeans and Americans spend just under $20 billion a year on pet food, $2 billion a year for malaria prevention is a tiny investment with a huge return.

Even in the U.S., where dire economic turmoil makes increased funding for international development very unlikely, whoever wins the upcoming election will find a straightforward and affordable way to begin restoring America’s image abroad by taking the lead on malaria eradication.

At around the same time that the WHO released its 2008 malaria report, Bill and Melinda Gates were co-hosting the UN Malaria Summit, which brought together politicians, celebrities and activists to discuss ways to tackle the disease.

What resulted from the meeting was the Global Malaria Action Plan, step-by-step instructions on how the world can improve distribution of life-saving drugs and bed nets, while also increasing funding for malaria research.

The plan estimates that more than four million lives can be saved by 2015.

This means time is of the essence. If the world can build upon its small successes, malaria can go the way of smallpox, which was eradicated in 1977. That accomplishment is heralded as one of the greatest achievements of modern medicine.

But if global attention wavers, millions of men, women and children will continue to suffer and die, not just at the hands of tiny mosquitoes, but also as a result of our indifference.

The Global Fund to Fight AIDS, Tuberculosis and Malaria is pleased to announce that its Board has approved 94 new grants worth US$2.75 billion over two years. It is the eighth time the Global Fund Board approved new proposals to support programs fighting the three diseases and it is the largest round in the history of the organization, well over twice the size of any previous round.  The decision was made in New Delhi over the weekend, where the Global Fund held its board meeting.

Round 8 now brings the Global Fund’s overall portfolio to US$ 14.4 billion in 140 countries. 

“This is the highest amount of new financing approved by the Global Fund ever. These new resources will significantly help the world in achieving global targets such as universal access to AIDS treatment and prevention, and cutting the number of deaths from tuberculosis and malaria by half by 2015,” said Rajat Gupta, Chair of the Global Fund Board.

“This exceptional expression of increased demand requires a renewed resource mobilization effort,” said Michel Kazatchkine, the Executive Director of the Global Fund. “We have a fantastic message to bring back to the rich nations of the world: Programs to fight these three diseases save lives, reduce disease burdens, and strengthen health systems. We are asking you for resources for an effective way to reduce the gap between rich and poor and build a better and safer world.”

Of the approved proposals, the majority of resources go to malaria programs accounting for 51 percent.  Proposals for AIDS and tuberculosis account for 38 percent and 11 percent, respectively, of the approved funding.

Ninety percent of the approved grants today are for low-income countries, with the majority of resources – 77 percent – for Africa and the Middle East. Asia and the Western Pacific will receive 14 percent of the newly approved funding, Latin America and the Caribbean 6 percent, and Eastern Europe and Central Asia 6 percent.

The Global Fund’s next funding round will be approved in November 2009.

In a separate development, Friends of the Global Fund South- and West Asia was launched in New Delhi.  Friends South- and West Asia will be a leading advocate for programs supported by the Global Fund in the region. The new advocacy organization will also seek to help Global Fund recipient countries to get the best possible results from the grants that they receive.  Its Board of Directors and Advisory Board include a number of leading regional business leaders, health experts and academics.

Friends South- and West Asia is the latest such organization to be established since the Global Fund’s creation in 2002 and joins a network of associations around the world including the United States, Japan, Europe, Africa and Latin America

www.mrcglobal.org/rfp

Deadline for proposal submission: 16 January 2009

The McLaughlin-Rotman Centre for Global Health (MRC) and its Ethical, Social and Cultural Program (ESC) for the Grand Challenges in Global Health (GCGH) Initiative are pleased to invite individuals, institutions, organizations and companies from the developing world to submit proposals to carry out projects that will facilitate the implementation and use of technologies in the developing world that arise from the GCGH projects.

The goal of this Request for Proposals (RFP) is to select and commission research on strategies that will facilitate the implementation and appropriate use in the developing world of technologies that arise from the GCGH projects related to diagnostics, modified insect vectors, nutritionally enhanced foods, and vaccine delivery.

Attached is the advertisement that we are currently circulating internationally. We invite you to consider this RFP for any related work you may be involved in and would also be grateful if you could kindly forward this advertisement to any of your colleagues who may be interested in applying.

Please visit www.mrcglobal.org/rfp for further information. The deadline to submit proposals is January 16th, 2009.

Giha HA, Elghazali G, A-Elgadir TM, A-Elbasit IE, Elbashir MI. Severe malaria in an unstable setting: clinical and laboratory correlates of cerebral malaria and severe malarial anemia and a paradigm for a simplified severity scoring. Eur J Clin Microbiol Infect Dis. 2008 Nov 12. [Epub ahead of print]
An interpretation of historical, clinical, and laboratory data was made to identify the correlates of and the diversity between cerebral malaria (CM) and severe malarial anemia (SMA) in a setting of low, seasonal, and unstable malaria transmission in eastern Sudan. Hemoglobin (Hb), random blood glucose (RBG), and anti-MSP antibodies were measured. Results showed that SMA and CM were significantly different with regard to age, malaria history, fever duration, convulsions, and hepatosplenomegaly…

Kursula I, Kursula P, Ganter M, Panjikar S, Matuschewski K, Schüler H. Structural Basis for Parasite-Specific Functions of the Divergent Profilin of Plasmodium falciparum. Structure. 2008 Nov;16(11):1638-48
Profilins are key regulators of actin dynamics. They sequester actin monomers, forming a pool for rapid polymer formation stimulated by proteins such as formins. Apicomplexan parasites utilize a highly specialized microfilament system for motility and host cell invasion…

Pombi M, Caputo B, Simard F, Di Deco MA, Coluzzi M, Della Torre A, Costantini C, Besansky NJ, Petrarca V. Chromosomal plasticity and evolutionary potential in the malaria vector Anopheles gambiae sensu stricto: insights from three decades of rare paracentric inversions. BMC Evol Biol. 2008 Nov 10;8(1):309. [Epub ahead of print]
In the Anopheles gambiae complex, paracentric chromosomal inversions are non-randomly distributed along the complement: 18/31 (58%) of common polymorphic inversions are on chromosome arm 2R, which represents only ~30% of the complement. Moreover, in An. gambiae sensu stricto, 6/7 common polymorphic inversions occur on 2R. Most of these inversions are considered markers of ecological adaptation that increase the fitness of the carriers of alternative karyotypes in contrasting habitats...

Behrens RH, Carroll B, Smith V, Alexander N. Declining incidence of malaria imported into the UK from West Africa. Malar J. 2008 Nov 10;7(1):235. [Epub ahead of print]
Two thirds of all falciparum malaria cases reported in the United Kingdom (UK) are acquired in West Africa (WA). To ensure recommendations and guidelines for malaria prophylaxis in travellers to West Africa correlate to the risk of infection, a study was undertaken to examine recent trends and predict future patterns of imported malaria acquired by UK residents visiting West Africa and West African visitors to the UK between 1993 and 2006...

Beare NA, Harding SP, Taylor TE, Lewallen S, Molyneux ME. Perfusion Abnormalities in Children with Cerebral Malaria and Malarial Retinopathy. J Infect Dis. 2008 Nov 10. [Epub ahead of print]
In patients with cerebral malaria (CM), retinal angiography allows the study of infected central nervous system microvasculature in vivo. We aimed to examine retinal perfusion in children with CM by use of fluorescein angiography to investigate the pathophysiology of CM...

Durand PM, Naidoo K, Coetzer TL. Evolutionary patterning: a novel approach to the identification of potential drug target sites in Plasmodium falciparum. PLoS ONE. 2008;3(11):e3685. Epub 2008 Nov 10
Malaria continues to be the most lethal protozoan disease of humans. Drug development programs exhibit a high attrition rate and parasite resistance to chemotherapeutic drugs exacerbates the problem. Strategies that limit the development of resistance and minimize host side-effects are therefore of major importance. In this study, a novel approach, termed evolutionary patterning (EP), was used to identify suitable drug target sites that would minimize the emergence of parasite resistance...

Hargreaves S. Malaria advances still not reaching patients, warns charity. Lancet Infect Dis. 2008 Nov;8(11):667
A new report from the international medical organisation Médecins Sans Frontières (MSF) says that measures to ensure new diagnostics and artemisinin-based combination therapy (ACT) actually reach patients are now crucial. Merely shipping drug treatment to resource-poor countries is not enough, say the authors, citing weak distribution and health systems and a lack of qualified staff as just some of the problems. The report was published in the wake of the high-level UN Millennium Development Goal m...

The MIM Website is now bilingual, available both in English and French.

To access the French version, click http://www.mimalaria.org/fr/

L’Initiative multilatérale sur le paludisme (MIM) fut établie en 1997 avec mission de renforcer et de soutenir la capacité des pays d’Afrique sévèrement touchés par le paludisme à effectuer les recherches nécessaires au développement et à l’amélioration des outils servant à.. Lire plus

The Multilateral Initiative on Malaria (MIM) is now accepting abstracts for the Fifth MIM Pan-African Malaria Conference to be held 2-6 November, 2009 at the Kenyatta International Conference Centre (KICC), Nairobi, Kenya.

MIM Conferences are currently the largest meetings worldwide entirely devoted to malaria research and control and provides a unique forum for the malaria community including junior scientists to meet senior researchers and discuss recent findings, representatives of the malaria stakeholders to identify priority research areas, translation of operational problems to researchable questions and available research results into policy and operational guidelines.

A limited number of scholarships are available for junior scientists/researchers from malaria endemic countries.

Visit www.mimalaria.org/pamc for more information, online registration and abstract submission.

Researchers from Nijmegen and Leiden have found potential malarial therapeutic targets that may in the development of a vaccine to treat the disease.

They have identified a large number of parasite proteins that help in bringing human malaria vaccine closer to reality.

Malaria is spread by mosquito bite, once injected the parasites migrate to the liver where they mature and then their sporozoites (infective cells) are released into the blood, causing disease and fatal complications.

During the study the researchers genetically modified the proteins essential for sporozoite development, and could weaken these parasites such that they invade liver cells and stimulate an immune response, but don”t develop further.

Previous studies have shown how to successfully vaccinate mice using a rodent malaria which had one of these liver stage genes removed, specifically p36p.

The researchers showed the first transition of such a vaccination from the rodent system to humans, by inactivating the equivalent gene (p52) in the major human malaria parasite, P. falciparum. These human parasites are unable to develop in liver cells.

The researchers believe that the findings may open up new pathways for its use as a human vaccine.

The findings are published October 31st in the open-access journal PLoS Pathogens

Incidence of malaria in Gambia has plunged thanks to an array of low-cost strategies, offering the tempting vision of eliminating this disease in parts of Africa, a study published Friday by The Lancet said.

At four key monitoring sites in the small West African state, the number of malarial cases fell by between 50 percent and 82 percent between 2003 and 2007, its authors found.

The tally of deaths from malaria, recorded at two hospitals where there had been a total of 29 fatalities out of 232 admissions in 2003, fell by nine-tenths and 100 percent in 2007. A fall of 100 percent means that no deaths attributed to malaria occurred that year.

"A large proportion of the malaria burden has been alleviated in Africa," the study concludes.

The authors also found a substantial shift in the age of Gambian children being admitted for care -- from an average of 3.9 years in 2003 to 5.6 years in 2007.

This is important because young children and infants bear the brunt of malaria mortality.

According to figures released on September 18 by the UN’s World Health Organization (WHO), around 247 million cases of malaria occurred in 2006, causing nearly a million deaths, mostly of children aged under five.

Gambia’s success is due to a combination of several factors that have especially benefited pregnant women and children, says the paper.

These include distributing insecticide-treated bed nets; programmes to spray homes; and the use of the more powerful drugs to replace treatments to which the malaria parasite has become resistant.

"(...) Increased investment in malaria interventions in Africa can have a major effect on reducing morbidity and mortality from the disease," said one of the authors, David Conway, of the London School of Hygiene and Tropical Medicine.

"We need to consider the possibility of future elimination of malaria from some areas in Africa but we also emphasize the importance of continuous surveillance, and there is no room for complacency with this disease."

A study out today shows a dramatic fall in the number of people dying from malaria infection in coastal Kenya. The research, funded by the Wellcome Trust and the Kenya Medical Research Institute (KEMRI), highlights the importance of the prevention and rapid treatment of malaria infection in preventing a potential resurgence of the disease.

Malaria is one of the world’s biggest killers, responsible for over a million deaths every year, mainly in children and pregnant women in Africa and south east Asia. It is caused by the malaria parasite, which is injected into the bloodstream from the salivary glands of infected mosquitoes.

In areas where transmission rates of malaria are high, death occurs most frequently in young children, usually as a result of severe anaemia. Surviving children rapidly develop immunity to the disease and severe malaria is rarely seen in older children. Where transmission rates are lower, the proportion of older children infected with malaria increases – in older children, malaria can lead to even more serious complications as the parasites reach the brain.

Researchers from the KEMRI-Wellcome Trust programme in Kilifi, eastern Kenya, have analysed eighteen years of detailed hospital surveillance data in a large endemic area of the Kenyan coast to look at whether incidence of malaria have been falling and what impact this will have on disease and mortality in the population. The results are published today in the journal The Lancet.

Whilst the researchers found that transmission rates for malaria have been steadily falling over the past ten years, the number of cases of severe malaria only began to fall more recently. However, the past five years have seen a remarkable fall of over 75% in the number of severe malaria deaths from malaria, down from 10.8 per 10,000 to 1.2 per 10,000.

"These are incredibly positive findings and reflect what is being seen along the east African coast," says Professor Kevin Marsh, head of the KEMRI Wellcome Trust programme and a researcher at the University of Oxford. "It gives us hope that tackling malaria across the continent is an achievable goal."

Professor Marsh and colleagues believe that a number of reasons may be behind this dramatic reduction in incidence of the disease, reflecting the success of control measures and early treatment. These include changes since the mid ’90s in the first line therapy, with new drugs replacing the previously widely-used treatment, chloroquine, which had become ineffective due to drug-resistance.

Other factors that may have contributed to the decline include the increasing use of insecticide-treated bednets and better management of mosquito breeding sites.

Researchers had predicted that falling transmission rates would have left older children unexposed to malaria and therefore with no immunity, resulting in an increase in cases of cerebral malaria. In fact, whilst they indeed found a small rise in the number of cases of cerebral malaria, this was more than offset by the marked decrease in severe malarial anaemia and other forms of malaria.

"There are many factors that may have contributed to this dramatic reduction in malaria deaths, but one thing is clear: we must not become complacent," says Professor Marsh. " As transmission rates continue to fall, younger children are growing up with less exposure to malaria. It’s essential that we maintain control measures, look for new ones and emphasise early treatment to prevent a resurgence of this deadly disease."

The findings have been welcomed by Dr Mark Walport, Director of the Wellcome Trust.

"These are important results - they show that malaria can be controlled in parts of the world where for centuries it has been a major killer of children and pregnant women," says Dr Walport. "These findings should provide encouragement to those dedicated to the control and ultimately the eradication of malaria.

No one can doubt that over the past few years, Africa has embarked on a path of unprecedented economic growth and social development. Several countries on the continent have made significant strides on delivering better education, health, and poverty reduction results. At the same time, African leaders have taken concrete steps toward improving governance, and have initiated reforms to boost trade and make the investment climate more attractive. Even though poverty has not been eradicated, the growth indicators, which show an average of 5.4% GDP per capita over the past decade, suggest an emergent continent on the path of securing a more prosperous future for its people.

This is unlikely to be sustained unless the productivity of Africa’s human capital is guaranteed.  The good news is that massive efforts by the international community and African countries themselves have resulted in thousands of lives being saved and many healthier. Still, millions of Africans die every year unnecessarily from entirely preventable causes. Malaria is one of these causes, a disease that infects more than 500 million people around the world, mostly women and children. Over 90 percent of the million worldwide annual deaths from malaria occur in Africa. This ruthless disease is estimated to cost the continent about US$12 billion a year in lost productivity. A growing Africa cannot afford this burden. There is no question that the progress already achieved will be seriously undermined if the magnitude of the disease continues at current levels.

Of all the issues Africa still faces, malaria is what one can call “a low hanging fruit”. Global partners and countries have seized the intense focus and energy around malaria by making a commitment to eliminate it from the continent. Our optimism and bold ambition are not unfounded.  We have effective medicines, bed nets and a wealth of knowledge being shared across countries and programs. We have the resources to take on regional interventions that cross borders, like the mosquitoes themselves. The international community, under the umbrella of the Roll Back Malaria Partnership, has been mobilized – governments, NGOs, global organizations, research institutions, and the private sector are working together to halve malaria deaths by 2010. Artists worldwide are putting human voices and faces behind the numbers to make malaria resonate for those unaware of its impact.  Health workers in Africa are helping people affected by malaria and parents are increasingly taking more measures to protect themselves and their children. The war to eliminate this scourge is spreading.

African countries are leading this war, but they cannot do it alone. The global community needs to help Africa massively scale up malaria control efforts. Partners have entirely subscribed to this vision and will support African countries in their efforts to provide universal coverage with effective malaria control methods to the entire Sub-Sahara African population at risk of malaria.  As one of the three largest malaria control financiers, the World Bank is contributing significantly to the progress being made.  Through its Booster Program for Malaria Control in Africa, the Bank has committed about US$470 million to malaria control efforts in Africa and plans to commit significantly more so that several countries can quickly ramp up their efforts to bring the disease under control. Responding to the urgency of the disease and with clear evidence of African countries’ commitment to doing something about it, other partners are also putting more resources on the table. The Global Fund provided more funding for malaria programs in its last round than ever before. The United Kingdom recently announced it would buy 20 million bed nets for Africa.

Increased funding is important and necessary, but it is not sufficient. The world needs to know about the progress made in the fight against malaria.  Action by African artists and musicians in this regard has been successful. The 2005 AFRICA LIVE: Roll Back Malaria Concert – a two-day stadium show in Dakar featuring seventeen of Africa’s most celebrated musicians – reached the hearts and minds of more than a billion people in broadcast coverage worldwide We need to support more of these endeavors that show malaria’s human side. A faceless disease will not be enough to spark off the commitment needed to control it.

We have before us an extraordinary window of opportunity to improve the future prospects for millions of people in Africa.  This opportunity may not come again. We have an obligation to turn the current momentum into concrete results, to help Africa defeat malaria.  Africa’s time is now and malaria’s time is up. Working together we will ensure that future generations stay alive to eat well, go to school, enjoy clean water and electricity, and fuel Africa’s transition into prosperity and sustained growth

Applications are now being accepted through December 1, 2008, for the 2010 Cunningham Memorial International Fellowship. The award is given annually to citizens or permanent residents from countries outside the United States and Canada who have both an undergraduate degree and a master’s level library degree and are working or preparing to work in a health sciences library in their countries.

The program will provide a three-week learning experience including attending MLA 2010 and a one-to-two week stay at one or more medical library host sites.  Two Cunningham awards of $3500 each are available.

The Cunningham Fellowship was established in 1967 and named in honor of Eileen Cunningham.

Go to www.mlanet.org/awards/grants/ for links to a fact sheet and application.

For more information, please contact:

Lisa C. Fried
Credentialing, Professional Recognition, and Career Coordinator at

Tel. 312.419.9094, ext 28 or
E-mail: mlapd2@mlahq.org

Deadline for applications: 15 December 2008

In collaboration with the University of Siena Medical School, Novartis Vaccines is organising a two-year Masters Programme in Vaccinology and Clinical Development which will start in May 2009.

The purpose of this Masters is to provide graduates in Medicine with training on all aspects of developing vaccines, from basic research to clinical development, health authority approval and beyond.

Students will participate in real life clinical and regulatory activities within the company and will be intensively involved in development programs.

The two year Masters will be completed with a dissertation leading to an M.Sc. degree from the University of Siena.

A 2-year grant will be provided to students who are accepted.

We are confident that participation in this Masters will prepare the students for a career in academia, public health or vaccine clinical development within the pharmaceutical industry.

In the enclosed brochure you will find more information about the Masters programme and the procedures to be followed for the application.

Apply by sending your curriculum vitae and a letter of motivation to vaccines_master.nvdit@novartis.com before December 15th, 2008.

For further information concerning applications, please consult the university website:

http://www.unisi.it/ammin/udss/affari_generali/stranieri_english.htm

For further information, contact:

Audino Podda, MD                                                                                  
Head, Clinical Development      
Novartis Vaccines Institute for Global Health (NVGH)                                   
Via Fiorentina, 1
53100 Siena
Tel. +39 0577 243496
Cell +39  335 70 26 950 

email audino.podda@novartis.com

Ouma C, Davenport GC, Were T, Otieno MF, Hittner JB, Vulule JM, Martinson J, Ong’echa JM, Ferrell RE, Perkins DJ. Haplotypes of IL-10 promoter variants are associated with susceptibility to severe malarial anemia and functional changes in IL-10 production. Hum Genet. 2008 Oct 30. [Epub ahead of print]
Plasmodium falciparum malaria is one of the leading global causes of morbidity and mortality with African children bearing the highest disease burden. Among the various severe disease sequelae common to falciparum malaria, severe malarial anemia (SMA) in pediatric populations accounts for the greatest degree of mortality…

Kyabayinze DJ, Tibenderana JK, Odong GW, Rwakimari JB, Counihan H. Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda. Malar J. 2008 Oct 29;7(1):221. [Epub ahead of print]
Parasite-based diagnosis of malaria by microscopy requires laboratory skills that are generally unavailable at peripheral health facilities. Rapid diagnostic tests (RDTs) require less expertise, but accuracy under operational conditions has not been fully evaluated in Uganda. There are also concerns about RDTs that use the antigen histidine-rich protein 2 (HRP2) to detect Plasmodium falciparum, because this antigen can persist after effective treatment, giving false positive test results in the absence of infection…

McCallum FJ, Persson KE, Mugyenyi CK, Fowkes FJ, Simpson JA, Richards JS, Williams TN, Marsh K, Beeson JG. Acquisition of growth-inhibitory antibodies against blood-stage Plasmodium falciparum. PLoS ONE. 2008;3(10):e3571. Epub 2008 Oct 29.
Antibodies that inhibit the growth of blood-stage Plasmodium falciparum may play an important role in acquired and vaccine-induced immunity in humans. However, the acquisition and activity of these antibodies is not well understood. METHODS: We tested dialysed serum and purified immunoglobulins from Kenyan children and adults for inhibition of P. falciparum blood-stage growth in vitro using different parasite lines...

van Schaijk BC, Janse CJ, van Gemert GJ, van Dijk MR, Gego A, Franetich JF, van de Vegte-Bolmer M, Yalaoui S, Silvie O, Hoffman SL, Waters AP, Mazier D, Sauerwein RW, Khan SM. Gene disruption of Plasmodium falciparum p52 results in attenuation of malaria liver stage development in cultured primary human hepatocytes. PLoS ONE. 2008;3(10):e3549. Epub 2008 Oct 28
Difficulties with inducing sterile and long lasting protective immunity against malaria with subunit vaccines has renewed interest in vaccinations with attenuated Plasmodium parasites. Immunizations with sporozoites that are attenuated by radiation (RAS) can induce strong protective immunity both in humans and rodent models of malaria. Recently, in rodent parasites it has been shown that through the deletion of a single gene, sporozoites can also become attenuated in liver stage development and, importantly, immunization with these sporozoites results in immune responses identical to RAS...

Tatem AJ, Guerra CA, Kabaria CW, Noor AM, Hay SI. Human population, urban settlement patterns and their impact on Plasmodium falciparum malaria endemicity. Malar J. 2008 Oct 27;7(1):218. [Epub ahead of print]
The efficient allocation of financial resources for malaria control and the optimal distribution of appropriate interventions require accurate information on the geographic distribution of malaria risk and of the human populations it affects. Low population densities in rural areas and high population densities in urban areas can influence malaria transmission substantially. Here, the Malaria Atlas Project (MAP) global database of Plasmodium falciparum parasite rate (PfPR) surveys, medical intelligence and contemporary population surfaces are utilized to explore these relationships and other issues involved in combining malaria risk maps with those of human population distribution in order to define populations at risk more accurately...

Download GMAP at: www.rollbackmalaria.org/gmap/

Four million malaria deaths can be diverted by 2015 cites RBM Partnership

More than 4 million lives can be saved by 2015 if resources are scaled up, reports a new malaria elimination plan today, launched by members of the international community attending the UN Summit in New York.

The Global Malaria Action Plan (GMAP) details how to accelerate action against malaria, across countries and regions, leading to elimination of the disease. Developed through the framework of the Roll Back Malaria (RBM) Partnership, it rallies 30 endemic countries and regions and 65 international institutions behind an unprecedented effort to achieve more rapid results against malaria.

Malaria affects half of the world’s population – 3.3 billion people in 109 countries – causing nearly 1 million deaths per year. According to GMAP’s projections, more than 4.2 million lives can be saved between 2008 and 2015, if the plan is put into action. In addition, millions of dollars of lost GDP can be recovered and critical healthcare resources freed up in regions to tackle other health and social challenges.

Effective malaria control will cost only a fraction of the losses that endemic countries endure today due to malaria, the GMAP posits. Africa alone is estimated to lose at least $12 billion per year in direct costs and much more in GDP losses. Achieving full control in all endemic countries, including strengthening health systems, will cost approximately $5.3 billion in 2009, $6.2 billion in 2010 and $5.1 billion annually from 2011 to 2020.

“The action plan that we are putting forward to global leaders today is a historic milestone in the fight against malaria,” said Professor Awa Marie Coll-Seck, Executive Director of the RBM Partnership. “Putting the plan into action should now become the next priority for the international community," Coll-Seck added, explaining that implementing the plan will help achieve six of the eight Millennium Development Goals.

The GMAP offers a comprehensive blueprint for reducing malaria. It provides timelines for delivering nets and drugs to all people at risk in Africa, Asia-Pacific, the Americas, the Middle East and Eurasia. It also outlines a strategy for increasing investment in research for new tools to eliminate and eventually eradicate malaria globally. Research will cost at least $750 million annually over the next ten years, according to the plan’s estimates.

"In Ethiopia, we provided universal access to protective nets in 18 months only,” said Dr Tedros Adhanom, Ethiopia’s Minister of Health and Chair of the RBM Partnership Board. “The challenge now is to make such successes work on a larger scale and in all affected regions.

This is what the Global Malaria Action Plan will help us do."

Reflecting malaria’s global scale, the plan is being launched today in all malaria endemic regions, including in the Philippines, Kenya, Mali and Brazil. It is endorsed politically at a UN Malaria Summit taking place at UN headquarters in New York.

During the New York launch event, co-hosted by the Bill & Melinda Gates Foundation, Malaria No More, the British Government as well as the UN Special Envoy for Malaria, heads of state, business leaders, and international celebrities are expected to pledge their commitment to turning the RBM plan into action.

In his opening address at the UN General Assembly earlier this week, Secretary-General Ban Ki-moon requested world leaders to honor their commitments to achieve the Millennium Development Goals, including Goal 6 which addresses malaria, AIDS and tuberculosis. Mr. Ban cited leadership and partnerships as vital ingredients in combating malaria and other pressing global challenges.

Similar calls to action were echoed by several heads of states at this week’s commencement of the 63rd Session of the General Assembly, including African Union President Jakaya Mrisho Kikwete and G8 leaders US President George W. Bush and French President Nicolas Sarkozy.

Earlier this month at a malaria awareness campaign in Paris, Nicolas Sarkozy, speaking as President of the Council of the European Union, urged his international counterparts to mobilize around efforts to eradicate malaria.

The Global Malaria Action Plan is available for download at: www.rollbackmalaria.org/gmap/

Bill Gates announced today that the Bill & Melinda Gates Foundation will provide $168.7 million to PATH for its Malaria Vaccine Initiative to develop vaccines for malaria—a disease that kills thousands of African children every day.

The PATH Malaria Vaccine Initiative (MVI) is working with GlaxoSmithKline Biologicals to develop a first-generation vaccine candidate, known as RTS,S, which could become the first-ever approved malaria vaccine. With the new grant announced today, MVI will support the development of next-generation vaccines that could provide even greater and longer-lasting protection.

"I’m very hopeful that the malaria vaccine currently in advanced testing will be proven effective, but that will just be the first step," said Gates, co-chair of the Gates Foundation. "Now it’s time to develop a new generation of vaccines that are even more effective, and could someday help eradicate malaria altogether."

Gates announced the new funding at the UN Millennium Development Goals Malaria Summit, a meeting of heads of state, CEOs, UN officials, and other leaders. At the event, the Roll Back Malaria Partnership launched the Global Malaria Action Plan, a comprehensive global strategy to fight malaria. The Gates Foundation grant and other commitments announced today will help address key priorities in the Action Plan.

Grant to Support Research on a New Generation of Malaria Vaccines

The Gates Foundation grant will support MVI’s efforts to expand its vaccine R&D pipeline with projects ranging from early-stage laboratory research to advanced clinical testing.  MVI will work with partners to discover new antigens and adjuvants that could lead to more effective vaccines, and develop new tools to select the most promising candidates for further development.

MVI will also work to foster a more competitive vaccine marketplace and help ensure that future vaccines will be affordable and accessible in developing countries.  They will conduct market assessments, demand forecasting, and modeling studies to guide policymakers and vaccine manufacturers, and partner with vaccine makers in developing countries to keep costs low.

"These new funds are recognition that we have a solid research and development strategy, and the team to deliver on it," said Dr. Christian Loucq, Director of MVI. "This commitment should signal to potential research partners that the time is ripe to work with us to help defeat this horrible disease. Already, we have added to our roster of partners and entered into collaborative agreements on vaccine components, ways to boost their potency, and methods for testing their biological activity."

"Our strategy for developing a malaria vaccine follows the PATH approach to neglected diseases, which has shown that investment in core areas of research and development, particularly vaccine technology, does yield important advances," said Dr. Christopher J. Elias, president and CEO of PATH. "The PATH Malaria Vaccine Initiative is now ready to accelerate further the development of what the world urgently needs: safe, effective, and affordable vaccines that reduce the suffering caused by malaria."

The grant addresses one of the priorities in the new Global Malaria Action Plan, released today by the Roll Back Malaria Partnership. The plan provides a unified global strategy for fighting malaria, including greater use of today’s tools, and research on vaccines and other new technologies.

"The Global Malaria Action Plan makes a compelling case for greater investment in malaria," said Gates. "If we have the chance to save millions of lives, and a clear plan to make it happen, we have an obligation to act. We’re committed to supporting a range of efforts to make the Action Plan a reality—today’s grant is just the first step."

New Malaria Control Success in Zambia and Ethiopia

Gates hailed new data from the World Malaria Report, released last week by WHO, showing encouraging progress against malaria in several African countries through 2006. He also highlighted more recent data from Zambia and Ethiopia that further demonstrate the impact of aggressive, large-scale malaria control programs.

The Zambian health ministry reported this week that since 2006, malaria control efforts have helped to reduce malaria parasite prevalence in children by 50 percent. Since 2002, the percentage of households with at least one insecticide-treated mosquito net has increased from 14 percent to 60 percent, and malaria control successes have helped to reduce overall child mortality by 29 percent.

Earlier this month, Ethiopia’s health ministry announced that it has reached nearly 70 percent of households in high-risk areas with at least one insecticide-treated mosquito net and/or indoor residual spraying, and that effective malaria treatment with artemisinin-based combination therapy is now available nationwide.

"The good news from Ethiopia and Zambia demonstrates that extraordinary progress can be made against malaria, even in the poorest and most remote communities," said Gates. "By building on and replicating these successes globally, we can save millions of lives."

Both countries are partners in the Malaria Control and Evaluation Partnership in Africa (MACEPA), a PATH initiative that is funded by the Gates Foundation

African malaria research experts have welcomed today’s announcements by Roll Back Malaria (RBM) and the Bill & Melinda Gates Foundation which pledged continued support and additional funding for malaria vaccine research.

AMANET (African Malaria Network Trust), with headquarters in Dar-es-Salaam, Tanzania and INDEPTH Research Network (the International Network for Demographic Surveillance of Populations and their Health in Developing Countries), with headquarters in Accra, Ghana, are two African research institutions currently building research capacity and searching for a malaria vaccine. Their trial sites are spread throughout Africa, and have candidate malaria vaccines being tested in Burkina Faso, Gabon, Ghana, Kenya, Mali, Sudan, Tanzania and Uganda.

Recent reports on the incidence of malaria showcase progress in providing access to short-term malaria control tools – specifically, preventive measures such as long lasting insecticidal nets (LLINs) and indoor residual spraying.

Good progress is also being made in the early diagnosis and correct appropriate treatment to cure malaria particularly in children under five years of age and pregnant women; these two constitute the most vulnerable groups in much of sub-Saharan Africa.

The enhanced malaria control as envisaged in the ambitious new Global Malaria Action Plan, when successfully implemented, will reduce malaria disease burden considerably, though in the long-term, the reduction to near zero will depend on entirely new malaria control tools. There is need therefore to focus on researching, developing and deploying the next generation of efficacious malaria control tools – and especially a successful malaria vaccine.

“Africa is where malaria strikes the hardest,” says Professor Wen Kilama, the Managing Trustee of AMANET. “Some 800 000 Africans – mainly children younger than five – die from malaria each year. This is over 90% of the global mortality from malaria, according to World Malaria Report 2008.

“Malaria also compounds Africa’s poverty and slows down its socio-economic development. It costs Africa at least USD 12 billion a year in direct losses and many times more than that in lost economic growth when examined over a long term. It is thus crucial that African scientific organisations are equipped and involved in searching for new and more effective malaria control tools,” argues Professor Kilama.

“As efforts to treat and prevent malaria are continuously being frustrated because the malaria parasite and mosquitoes are increasingly resistant to medicines and insecticides, an effective vaccine against malaria will help. Vaccines, in general, are the backbone of public health interventions, especially in poor countries, where they help contain or even eradicate leading killers. The Bill and Melinda Gates Foundation support for next generation malaria vaccines will greatly enhance current combined global efforts against malaria,” said Professor Kilama.

Speaking at the eighth INDEPTH Annual General Meeting being held in Dar es Salaam, Dr Osman Sankoh, the Executive Director of INDEPTH Network, says that malaria vaccine research in Africa has begun to provide critical leads towards an effective malaria vaccine for Africa. Commenting on just released funding commitments, Dr Sankoh said: “Sustainability of funding is so important, as effective research in Africa entails building capacity and strengthening health facilities. We are heartened by today’s announcements made by RBM and other partners, and look forward to playing our part in the global efforts to control and eventually eradicate malaria.”

Issued on behalf of AMANET & INDEPTH

By Meropa Communications, Johannesburg, South Africa, tel +27-11-772-1000

For further information or to schedule interview, please contact:

Charles Wanga, AMANET, P +255-22-2700018 M +255-78-433-7232

Samuel Mikenga, INDEPTH, P +233 21 519 395 M +27-72-529-6769

Khomotso Makuse P +27-11-7721000 Email kgomotsom@meropa.co.za or Maria Djordjevic M +27-82-334-6192 Email mariad@meropa.co.za

Sponsored by the UNICEF/UNDP/World Bank/WHO  Special Program for Research and Training in Tropical Diseases (TDR)

Organized by WHO/HQ Health Security and Environment Hosted by Faculty of Science and Techniques, University of Bamako, Mali

Dates: 3-7 December 2008

Application deadline:  15 October 2008

http://www.who.int/tdr/grants/grants/bl5_laboratory_biosafety.htm

Introduction

Vector-borne diseases occurring in more than 100 countries and affecting about half of the world’s population are emerging and resurging. Consequently, they result in high burden of disease. This worsening situation reflecting an inadequate impact of control measures is due to various factors including poor implementation of interventions, limited resources, and development of resistance to insecticides. However, it is generally recognized that effective prevention strategies can reverse this trend, and vec tor control is a key component of such strategies aiming at interrupting transmission. In addition, genome sequencing of the main vectors of malaria, dengue, and Human African Trypanosomiasis (HAT) carries the promise of radically improved vector control methods but this new approach will require careful and coordinated development, corroboration, and field evaluation.

TDR has participated for the past ten years with other organizations, in facilitating the development of genetically modified malaria and dengue vectors for interrupting pathogen transmission. This activity is actually mainly supported through the Gates Foundation Grand Challenges for Global Health projects on vector control. Therefore, TDR new strategy is focusing on the requirements to be addressed for potential field deployment of the genetic control methods. Most importantly, these include ensuring the  new methods are efficacious and particularly safe for humans and the environment.

In order to address this key aspect, TDR new strategy will help building capacity in Disease Endemic Countries (DECs) to prepare them to acquire the knowledge and experience necessary for the application of biosafety and biosecurity regulatory principles and practices. More specifically, it will strengthen their capabilities for effective and timely assessment and management of the potential risks for humans and the environment of the use of genetically-modified vectors(GMV) in view of the implementation of effective and safe genetic control tools for interrupting pathogen transmission. For this purpose, TDR has funded a project for developing best practice guidance for deployment of genetic control methods in disease endemic countries. In addition, TDR has already funded a biosafety training course for Africa and will be funding two others for Asia and Latin America. Furthermore, TDR has fund ed the  course, object of this call, to focus mainly on laboratory biosafety and biosecurity and complementing the three Regional biosafety training courses.

Objectives of the course

The course aiming at training the potential trainers in laboratory biosafety and biosecurity will run in theoretical and practical aspects for five days with the following specific objectives:

1. Highlighting the importance of implementation of biosafety and biosecurity standards to protect personnel and environment through good practices as well as safeguarding the GMVs 
2. Providing proper information to laboratory management and personnel on the principles and practices of laboratory biosafety and biosecurity guidelines.
3. Stressing the need for institutions and laboratories in Disease endemic countries to implement effective biosafety and biosecurity principles  and practices

Course content

Biosafety

1. Introduction. Principles of Laboratory Biosafety
2. Hazards and risks associated with handling of GMVs
3. Laboratory Biosafety Protocols
4. Containment Levels: Facility Design and Work Practices
5. Laboratory Animal facility
6. Biological Safety Cabinets
7. Accidents in handling GMVs/ Reporting of Accidents
8. Sterilization and Disinfection in the Laboratory
9. Risk assessment
10. Safe Handling of Laboratory Equipment and Materials
11. Personal Protective equipment PPE
12. Waste Disposal
13. Transport and Transfer of GMVs

Biosecurity

1. Introduction

2. Laboratory Biosafety VS Laboratory Biosecurity

3. Principles of Laboratory Biosecurity

4. Components of a biosecurity programme:

   - Risk assessment

   - Physical security

   - Personnel management

   - Accountability of GMVs

   - Biosecurity issues in transfer of  GMVs

   - Information security

   - Management of biosecurity activities

Course language: English

Participants eligibility

Decision makers, laboratory managers and researchers working or having the back ground knowledge on vector research and/or control from vector-borne disease endemic countries are mainly expected to participant in this course.

Selection Criteria

1. Good knowledge of vector biology and molecular entomology
2. Demonstrated experience in laboratory research on disease vectors
3. Basic knowledge and experience in laboratory biosafety and biosecurity
4. Involvement in development and implementation of laboratory based research projects
5. Ability to apply the training skill in home institution
6. Fluency in English
7. Availability for the entire duration of the course

Application procedure

All applications must be submitted using the application form (in MS Word format) to be downloaded from http://www.who.int/tdr/grants/grants/bl5_laboratory_biosafety.htm 

The completed application form, with a letter of recommendation from their institution should be sent electronically to: mohammadia@who.int 

1. All applications must be received by the deadline of 15 October 2008
2. Successful applicants will be notified by 1 November 2008
3. Course dates: 3-7 December, 2008
4. Course Venue: Faculté des Sciences et Techniques, Universite de
5. Bamako, Bamako, Mali

Course Coordinator:

Dr Ali A. Mohammadi
Scientist, Biosafety
Health security and Environment
World Health Organization
20 Avenue Appia
CH-1211  Geneva
Switzerland

Tel: +41 22-791 1804
Fax: +41 22-791 4666

E-mail: mohammadia@who.int

Mather MW, Vaidya AB. Mitochondria in malaria and related parasites: ancient, diverse and streamlined. J Bioenerg Biomembr. 2008 Sep 24. [Epub ahead of print]
Parasitic organisms have emerged from nearly every corner of the eukaryotic kingdom and hence display tremendous diversity of form and function. This diversity extends to their mitochondria and mitochondrion-derived organelles. While the principles of the chemiosmotic theory apply to all these pathogens, the differences from their hosts provide opportunities for therapeutic development. In this review we discuss examples of mitochondrial systems from a deep-branching phylum, Apicomplexa. Many important human pathogens, such as malaria parasites, belong to this phylum. Unique features of their mitochondria are validated targets for drugs that are selectively toxic to the parasites…

Chaudhuri R, Ahmed S, Ansari FA, Singh HV, Ramachandran S. MalVac: Database of malarial vaccine candidates. Malar J. 2008 Sep 23;7(1):184. [Epub ahead of print]
The sequencing of genomes of the Plasmodium species causing malaria, offers immense opportunities to aid in the development of new therapeutics and vaccine candidates through Bioinformatics tools and resources…

Vigan-Womas I, Guillotte M, Le Scanf C, Igonet S, Petres S, Juillerat A, Badaut C, Nato F, Schneider A, Lavergne A, Contamin H, Tall A, Baril L, Bentley GA, Mercereau-Puijalon O. An in vivo/in vitro model of Plasmodium falciparum rosetting and autoagglutination mediated by varO, a group A var gene encoding a frequent serotype. Infect Immun. 2008 Sep 22. [Epub ahead of print]
In the Saimiri sciureus monkey, erythrocytes infected with the varO antigenic variant of the Plasmodium falciparum Palo Alto 89F5 clone bind uninfected red blood cells ("rosetting"), form autoagglutinates and display a high multiplication rate, three phenotypic characteristics associated with severe malaria in human patients. We report here that varO parasites express a var gene presenting the characteristics of group A var genes, and show that the varO-DBL1alpha1 domain is implicated in the rosetting of both Saimiri sciureus and human erythrocytes...

Noland GS, Hendel-Paterson B, Min XM, Moormann AM, Vulule JM, Narum DL, Lanar DE, Kazura JW, John CC. Low prevalence of antibodies to pre-erythrocytic but not blood-stage Plasmodium falciparum antigens in an area of unstable as compared to stable malaria transmission. Infect Immun. 2008 Sep 22. [Epub ahead of print]
According to entomological studies conducted over the past 30 years, there was low malaria transmission in suburb of Dakar but little evidence of it in the downtown area. However; there was some evidence of local transmission based on reports of malaria among permanent residents. An entomological evaluation of malaria transmission was conducted from May 2005 to October 2006 in two areas of Dakar...

Aonuma H, Suzuki M, Iseki H, Perera N, Nelson B, Igarashi I, Yagi T, Kanuka H, Fukumoto S. Rapid identification of Plasmodium-carrying mosquitoes using loop-mediated isothermal amplification. Biochem Biophys Res Commun. 2008 Sep 19. [Epub ahead of print]
With an aim to develop a quick and simple method to survey pathogen-transmitting vectors, LAMP (loop-mediated isothermal amplification) was applied to the identification of Plasmodium-carrying mosquitoes, specifically a Plasmodium-transmitting experimental model using rodent malaria parasite (Plasmodium berghei) and anopheline mosquitoes (Anopheles stephensi). The detection sensitivity limit of the LAMP reaction amplifying the SPECT2 gene was determined to be 1x10(2) purified Plasmodium parasites, estimated to be sufficient for reliable identification of infectious mosquitoes...

Li L, Bian L, Yan G. A study of the distribution and abundance of the adult malaria vector in western Kenya highlands.  Int J Health Geogr. 2008 Sep 22;7(1):50. [Epub ahead of print]
A sharp rise in the malaria mortality rate has been observed recently in western Kenya. Malaria is transmitted by mosquito vectors. Malaria control strategies can be more successful if the distribution and abundance of mosquito vectors is predicted. However, how mosquito vectors are distributed in space remain poor understood, and this question is rarely studied using spatial methods. This study aims to provide a better understanding of the distribution and abundance of mosquito vectors

Half of the world’s population is at risk of malaria, and an estimated 247 million cases led to nearly 881 000 deaths in 2006. The advent of long-lasting insecticidal nets and artemisinin-based combination therapy, plus a revival of support for indoor residual spraying of insecticide, presents a new opportunity for large-scale malaria control. The World malaria report 2008 describes the global distribution of cases and deaths, how WHO-recommended control strategies have been adopted and implemented in endemic countries, sources of funding for malaria control, and recent evidence that prevention and treatment can alleviate the burden of disease.

Download the full report [pdf 4.9Mb] Corrigenda to the printed report

Summary & Key points English [pdf 144kb] | French [pdf 121kb] | Spanish [pdf 103kb] | Chinese [pdf 515kb] | Russian [pdf 150kb] | Arabic [pdf 100kb] | Portuguese [pdf 50kb]

New report finds more funding leading to increased coverage of malaria control interventions

The global burden of malaria remains enormous, but access to malaria control interventions, especially bednets in Africa, increased sharply between 2004 and 2006, says a new report released today.

"With dramatic increases in funding and intense momentum towards reducing the malaria burden in recent years, we have a greater need for reliable information and analysis," said WHO Director-General Dr Margaret Chan. "This report begins to answer that need. Progress in malaria control has accelerated dramatically since 2006, especially in the wake of the UN Secretary-General’s call for universal malaria control coverage by the end of 2010. We expect these expanded efforts to be reflected in future reports."

The World malaria report 2008, which draws upon data collected between 2004 and 2006, paints a complex picture. Some highlights are:

• New methods estimate that the number of malaria cases in 2006 was 247 million.
• Small children remain by far the most likely to die of the disease.
• Malaria deaths have declined in several countries, and a few African nations have managed to reduce deaths in half by following the recommended measures.
• As of 2006, more funding resulted in accelerated access to malaria interventions, including bednets and effective medicines.
• In Africa, the artemisinin-based combination therapy (ACT), which is recommended by WHO, reached only 3% of children in need.

Bednet coverage increasing

The report finds that recent increases in malaria funding were beginning to translate into coverage of key malaria interventions, especially bednets, by 2006. The percentage of children protected by insecticide-treated nets increased almost eightfold, from 3% in 2001 to 23% in the 18 African countries where surveys were held in 2006. Procurement of antimalarial medicines also increased sharply between 2001 and 2006. About 100 million people, including 22 million in Africa, were protected by indoor spraying of insecticide.

However, much more work remains to be done. In Africa, only 125 million people were protected by bednets in 2007, while 650 million are at risk.

"Malaria is a primary cause of child mortality," said Ann M. Veneman, Executive Director of the United Nations Children’s Fund (UNICEF). "If the availability of bednets and other key interventions can be increased, lives can be saved."

Positive impact

For the first time, three African countries reported dramatic reductions in malaria deaths by 50% or more. Eritrea, Rwanda and Sao Tome and Principe achieved this result between 2000 and 2006/2007 through a mix of bednet distribution, indoor spraying, improved access to treatment and advances in disease surveillance. Furthermore, significant improvements were observed in other African countries such as Madagascar, Zambia and the United Republic of Tanzania.

Six more countries reported a fall in malaria deaths by 2006: Cambodia, the Lao People’s Democratic Republic, the Philippines, Suriname, Thailand and Viet Nam.

"We know that malaria control interventions work and that we can make rapid progress towards ending malaria deaths," said Ray Chambers, the United Nations Secretary-General’s Special Envoy for Malaria. "Now is the time to expand these results to all of Africa and the rest of the world."

According to data from national malaria control programmes, Africa had a larger increase in funding than any other region between 2004 and 2006. The investments were led by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and supported by bilateral and multilateral organizations and national governments.

In other regions, sources of funding were highly variable, but national governments provided the bulk of monies. While funding for malaria was higher than ever before in 2006, it is not yet possible to judge which countries have adequate resources and there are still significant gaps.

For more information please contact:

Dick Thompson
News Team Leader
WHO, Geneva
Telephone:  +41 22 791 1492
Mobile:  +41 79 475 5534        
E-mail: thompsond@who.int

Fadela Chaib Telephone: +41 22 791 3228        
Mobile: +41 79 475 5556        
E-mail: chaibf@who.int

AT FIRST blush, the change seems like staggeringly good news. The World Health Organisation (WHO) has just issued a new report on malaria. The agency’s experts estimate that each year there are some 250m cases of malaria globally. That is a huge fall from the previous 350m-500m figure in a 2005 report.

A happy confluence of funding, political will and practical tools is indeed making a difference. Drug treatment that combines artemisinin, a powerful anti-malaria treatment, with other medicines, and the use of insecticide-embedded bed nets, are particularly effective.

Thanks to that, 20-plus countries outside Africa have seen their malaria burden decline in recent years. And even within Africa, which accounts for most of the world’s 880,000 or so malaria deaths each year, a handful of countries have made excellent progress. The number of new malaria cases in Eritrea fell by more than a half between 2001 and 2006. Rwanda and São Tomé and Príncipe made big gains too.

Sadly, the bigger reason for the seeming drop in the total number of malaria cases is the way the WHO counts them, a tricky task in countries with weak health-care systems. Previous reports relied on estimates dating back to the 1950s and 1960s in some countries outside sub-Saharan Africa. The new methodology takes the actual number of malaria cases reported by local health authorities as a starting point. Nearly half the fall comes thanks to counting cases in India by the new method.

The report comes on the eve of a United Nations malaria summit in New York on September 25th. Governments, philanthropic outfits (notably the Gates foundation), activists and celebrities will launch a new global strategy and collect hefty pledges in its support. Campaigners say that malaria’s moment has finally arrived.

If so, the assembled worthies may pay attention to a point made by Amir Attaran of the University of Ottawa. He argues that malaria and similar diseases need to be monitored like the weather, with what he calls “sentinel surveillance networks” throughout the developing world. This is essential both to measure malaria incidence more accurately and to assess the success or failure of various policies.

With enough time and effort, big reductions in malaria caseloads reported in future WHO studies could even be cause for celebration rather than embarrassment.

The World Health Organization (WHO) has cut its global estimate of yearly malaria cases by more than 100 million, according to a report released Thursday by the health agency. Almost all of that downward revision was attributable to updated surveillance numbers — mostly in Asia, and particularly in India — rather than a measurable reduction of actual malaria cases, agency staff said.

The last World Malaria Report in 2005, tallied the global incidence rate at between 350 million and 500 million new cases of malaria per year. The current report downgrades that figure to 247 million. Likewise, where the last report claimed that the disease kills "more than 1 million" people each year, the 2008 update, which is based on 2006 data (the most recent numbers available), suggests that figure is now closer to 800,000.

The impact of malaria, however, is still massive. "Whether it’s 200 million or 500 million [cases], that’s a lot of infections with a big health burden and a big economic burden," says Bernard Nahlen, deputy coordinator of the U.S. President’s Malaria Initiative — especially, he says, "for something that is treatable and to a large extent preventable. If your child’s life can be saved by treatment for 50 cents, you should treat."

But the WHO’s correction comes less than a year after the United Nations made a similar announcement, acknowledging last November that its AIDS-battling agency, UNAIDS, had overstated its estimates of the global HIV burden by about 6 million cases; that agency revised its numbers also based on newer and more accurate surveys. At the time, the U.N. came under fire from critics for inflating its estimates in order to exaggerate the urgency of the epidemic — and to spur bigger donations.

There may have been some truth to that argument. Money funneled to HIV and malaria control has soared in the last decade, to almost $9 billion and roughly $1 billion a year, respectively (those figures, too, are hazy estimates), although in the case of HIV especially, money has not always been channeled into disease-control programs based on the best scientific evidence. (That’s particularly true for politically sensitive — and, therefore, under-funded or ignored — interventions that aim to prevent high-risk sex and drug abuse.)

In large part, such massive miscalculations have less to do with politics than with the simple fact that epidemiology involves an inordinate amount of guesswork. Routine re-evaluations of existing data often result in data shifts, sometimes huge ones, which global health experts and epidemiologists have come to expect. "If you go up to a little clinic in Africa, first of all, the staff are overwhelmed with patients," says Nahlen, who used to do monitoring work for WHO. The data, if it’s properly recorded, then goes up to the officials, who may also be overwhelmed. Those records then get passed along to WHO. "It’s sometimes hard to know what these numbers actually mean," he says.

The WHO ascribes most of the current revision to a reassessment of the malaria epidemic in Asia (although the vast majority of malaria cases and deaths still occur in Africa, where the numbers for the continent remain mostly unchanged). Much of the Asian data, which was used in the 2005 WHO report to predict which regions had malaria-carrying mosquitoes — and therefore higher disease incidence — was already 40 years old, says Mac Otten, coordinator of the surveillance, monitoring and evaluation unit at the WHO’s Global Malaria Program. Over the past four decades, the situation across Asia has changed dramatically. "With urbanization, deforestation and then malaria control, [the data] is just out of date," he says. Malaria zones in Asia, especially India, where much of the revision took place, have become "patchy," as Otten puts it.

Epidemiologists are often described by the media as "disease detectives," who use statistical tools — carrying out the occasional survey, for example, or, in the case of malaria, using temperature and terrain maps to help predict where disease-carrying mosquitoes may live — to hunt down and eliminate global killers. The comparison is useful for another reason: Disease trackers, like crime solvers, often spend a lot of time sifting through a few, imperfect clues — hunches, really — to piece together a fuller picture. But that picture often ends up being indistinct as well. The WHO says, for example, that the "confidence interval" of its new estimate — the numerical range within which scientists believe the actual malaria incidence most likely lies — is 189 million cases to 327 million cases per year.

It is an enormous but unavoidable margin of error. Unlike in developed countries, such as the U.S., that have the infrastructure to compile more detailed population-wide medical records, disease surveillance in places like the Democratic Republic of the Congo, a large central African country with few doctors, few roads, limited medical infrastructure and a recent history of bloody conflict, is a much more difficult undertaking. Officials have trouble counting births and deaths in some regions, let alone getting a sense of how many people may have suffered from a particular disease.

What’s more, even where records exist, there is usually no way to confirm their validity. Doctors in the developing world often lack lab facilities to authenticate cases of suspected malaria. Perhaps more often, they never even get to see patients who have the disease — many patients either cannot afford the time or money to see a doctor or they simply self-diagnose and take cheap over-the-counter medications to battle malaria-like symptoms. The WHO estimates that nationally reported (but often unvalidated) malaria cases account for just 40% of the global estimate; the other 60% comes from "detective work" by epidemiologists.

The fuzzy math aside, the good news is that malaria control efforts are working. The 2008 World Malaria Report singles out Eritrea, Rwanda, Sao Tome and Principe, and the Tanzanian region of Zanzibar for their remarkable improvements in cutting malaria illness and death. Since 2000, all of them have managed a greater than 50% drop in both rates, and all of them have done it through a combination of familiar methods: using long-lasting insecticidal bed nets to prevent mosquito bites; treating the disease with the newer, more effective artemisinin-based combination drug therapy; and spraying homes with insecticide. In these countries, there is little doubt that interventions are working, but the impact doesn’t translate to a measurable reduction in global figures because the populations involved are relatively small. Larger countries like Nigeria have been slower to implement prevention and treatment programs.

But similar programs are underway across much of Africa, and so malaria workers are newly optimistic. "When the coverage of the malaria interventions — the nets, the medicines and the spraying — was high, cases came right down and deaths came down as well," says Otten. With luck, for the next World Malaria Report, global figures will be more accurate still — and they’ll be falling because real people are really healthier.

TRANSVAC is a 10 million Euro EC-funded project to accelerate the pharmaceutical and clinical development of promising vaccine candidates for public health use, and aims to bridge the gap between academic research and early phase clinical development, through carefully managing the advancement of promising vaccine candidates from preclinical animal experiments to proof-of-principle studies in humans.

TRANSVAC is managed by the European Malaria Vaccine Initiative and the TB Vaccine Initiative, under the guidance of the TRANSVAC Coordinator. In order to support the TRANSVAC Programme Manager in the day-to-day running of TRANSVAC, a Project Manager and Trainee Project Manager are required. These posts present an exciting and unique opportunity for two individuals to be part of an unprecedented advancement of the European vaccine development infrastructure, and provide excellent opportunities for personal and professional development in a multinational environment.

Responsibilities:

1. Facilitate delivery of projects to agreed time lines, quality and budget
2. Drive progression of the project within the defined parameters
3. Ensure the project team adherence to group policies, standards and procedures, legal requirements and good practices
4. Provide guidance and leadership to the cross-functional members of the Project teams
5. Drive continuous improvement across the project
6. Identify and drive the communication and inter-personal relationships within the project
7. Clearly identify and solve problems, as well as implementing plans to eliminate any forthcoming issues and problems
8. Ensure the preparation and presentation of reports, project budgets and financial evaluations to tight deadlines
9. Provide the Senior Management with key project information throughout the project
10. Understand and promote the project goals and objectives
11. Manage complex relationships with project participants and ensure participant satisfaction
12. To escalate items appropriately through the governance structure and ensure contractual obligations are met
13. Provide input to strategic management
14. Organisation of meetings and workshops

Essential Skills/Competencies for both positions:

•          A high standard of written and spoken English
•          Organised, with drive and motivation
•          Hold, or be about to complete, one of the following: MBA, PhD, or other relevant biology-related degree (e.g. microbiology, vaccine development etc.)
•          Strong co-ordination skills and ability to work in a team
•          Good communication and presentation skills
•          Demonstrated ability to deliver results against deadlines, to a high level of quality
•          The ability to travel occasionally to international meetings, conferences, workshops etc.
•          Competent with Microsoft Office
•          Management experience (for Project Manager position only)

Desired Skills/Competencies:

•          People management experience
•          Experience in managing projects
•          Knowledge of poverty related diseases and/or the vaccine development process
•          Experience in preparing and maintaining websites

On offer to the successful candidates are superior benefits packages and career development opportunities in a dynamic and stimulating environment. Both positions will include a comprehensive project management training package. The posts will be based in Berlin or in a member country of the TRANSVAC consortium. Informal enquiries regarding the posts may be made to Dr. Roland Ventura (ven@ssi.dk).

If you feel that you possess the relevant skills and working background please send a Curriculum Vitae and cover letter explaining:

1. Your preferred choice of post (Project Manager or Trainee Project Manager (or both))
2. Your suitability for the post(s)
3. Your salary range expectations

Applications providing all of the requested information should be received no later than 17:00 (CET) on Friday the 17th of October 2008, and sent by email to:

Dr. Odile Leroy
Executive Director
oly@ssi.dk

Oshaughnessy PT. Parachuting Cats and Crushed Eggs: The Controversy Over the Use of DDT to Control Malaria. Am J Public Health. 2008 Sep 17. [Epub ahead of print]
The use of DDT to control malaria has been a contentious practice for decades. This controversy centers on concerns over the ecological harm caused by DDT relative to the gains in public health from its use to prevent malaria. Given the World Health Organization’s recent policy decisions concerning the use of DDT to control malaria, it is worth reviewing the historical context of DDT use. Ecological concerns focused on evidence that DDT ingestion by predatory birds resulted in eggs with shells so thin they were crushed by adult birds. In addition, DDT spraying to control malaria allegedly resulted in cats being poisoned in some areas, which led to increased rodent populations and, in turn, the parachuting of cats into the highlands of the island of Borneo to kill the rodents, a story that influenced the decision to ban DDT spraying. I focus on this story with the intention of grounding the current debate on lessons from the pas …

Lundie RJ, de Koning-Ward TF, Davey GM, Nie CQ, Hansen DS, Lau LS, Mintern JD, Belz GT, Schofield L, Carbone FR, Villadangos JA, Crabb BS, Heath WR. Blood-stage Plasmodium infection induces CD8+ T lymphocytes to parasite-expressed antigens, largely regulated by CD8{alpha}+ dendritic cells. Proc Natl Acad Sci U S A. 2008 Sep 17. [Epub ahead of print]
Although CD8(+) T cells do not contribute to protection against the blood stage of Plasmodium infection, there is mounting evidence that they are principal mediators of murine experimental cerebral malaria (ECM). At present, there is no direct evidence that the CD8(+) T cells mediating ECM are parasite-specific or, for that matter, whether parasite-specific CD8(+) T cells are generated in response to blood-stage infection. To resolve this and to define the cellular requirements for such priming, we generated transgenic P. berghei parasites expressing model T cell epitopes. This approach was necessary as MHC class I-restricted antigens to blood-stage infection have not been defined. Here, we show that blood-stage infection leads to parasite-specific CD8(+) and CD4(+) T cell responses…

Mayor S. WHO report shows progress in efforts to reduce malaria incidence. BMJ. 2008 Sep 17;337:a1678. doi: 10.1136/bmj.a1678
…The World Malaria Report 2008 found an estimated 247 million cases of malaria and 881 000 deaths from the disease, mostly among children in Africa, meaning that it remains one of the world’s leading causes of death. However, several countries had achieved a sharp fall in the number of people affected by malaria after increasing control measures.

Eritrea, Rwanda, São Tomé and Príncipe, and Zanzibar (in Tanzania) each reported reductions of 50% or more in the number of malaria cases and deaths between 2000 and 2006 or 2007...

Pages F, Texier G, Pradines B, Gadiaga L, Machault V, Jarjaval F, Penhoat K, Berger F, Trape JF, Rogier C, Sokhna C. Malaria transmission in Dakar: a two-year survey. Malar J. 2008 Sep 16;7(1):178. [Epub ahead of print]
According to entomological studies conducted over the past 30 years, there was low malaria transmission in suburb of Dakar but little evidence of it in the downtown area. However; there was some evidence of local transmission based on reports of malaria among permanent residents. An entomological evaluation of malaria transmission was conducted from May 2005 to October 2006 in two areas of Dakar...

Hetzel MW, Obrist B, Lengeler C, Msechu JJ, Nathan R, Dillip A, Makemba AM, Mshana C, Schulze A, Mshinda H. Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania. BMC Public Health. 2008 Sep 16;8(1):317. [Epub ahead of print]
Malaria is still a leading child killer in sub-Saharan Africa. Yet, access to prompt and effective malaria treatment, a mainstay of any malaria control strategy, is sub-optimal in many settings. Little is known about obstacles to treatment and community-effectiveness of case-management strategies. This research quantified treatment seeking behaviour and access to treatment in a highly endemic rural Tanzanian community. The aim was to provide a better understanding of obstacles to treatment access in order to develop practical and cost-effective interventions...

Zikusooka CM, McIntyre D, Barnes KI. Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests?  Malar J. 2008 Sep 15;7(1):176. [Epub ahead of print]
Within the context of increasing antimalarial costs and or decreasing malaria transmission, the importance of limiting antimalarial treatment to only those confirmed as having malaria parasites becomes paramount. This motivates for this assessment of the cost-effectiveness of routine use of rapid diagnostic tests (RDTs) as an integral part of deploying artemisinin-based combination therapies (ACTs)…

The African Malaria Network Trust (AMANET) is pleased to announce the expansion of its web based training. AMANET has launched today an Advanced Course on Health Research Ethics, which becomes the fourth web-based course provided by AMANET and funded by the European-Developing Countries Clinical Trials Partnership (EDCTP).  Other ongoing AMANET web-based courses are Basic Health Research Ethics (English version), Basic Health Research Ethics (French version) and Basic Good Clinical Practice.  All courses are freely available at http://webcourses.amanet-trust.org/.

The Basic Health Research Ethics Course provides a basic understanding of ethical issues and equips trainees (members of ethics committees, health researchers, scientists and other key personnel in health research) with the necessary tools and knowledge required to safeguard the safety and welfare of human research participants.

The Advanced Health Research Ethics (HRE) Course  aims to flag topical ethical issues that are relevant to health research in developing country settings particularly in Africa, and explores various schools of thought regarding contemporary ethical challenges and dilemmas.

Commenting on the launch, Prof Wen Kilama, AMANET Managing Trustee, said “Since the founding in 1995 of the African Malaria Vaccine Testing Network (AMVTN) the predecessor of AMANET, we have been very much concerned not only on attaining high scientific standards  in health research undertaken in Africa, we have further aspired at attaining high ethical standards. But given the ever increasing challenges to health researchers particularly in Africa, AMANET has found it appropriate to launch this Advanced Course on Health Research Ethics, which will address newer challenges and contemporary issues likely to face African health researchers.”

“I very much hope that this course will benefit not only health researchers, but also managers of health research institutions, researchers in other fields, policy and decision makers, sponsors of health research undertaken in developing countries, regulatory authorities, and professional bodies” added Prof Kilama,

The Advanced HRE course has seven modules namely; Ethical Principles in Health Research and Review Processes; Responsibilities in Health Research; Ethical Issues in Research Design and Recruitment of Research Participants; Models and Practicalities of Community Engagement; Ethical Issues in International Collaborative Health Research; Animal Research Ethics; and Ethical Issues in Traditional Medical Practice and ‘Research.

 “It is hoped that successful completion of the course will bring participants up to date with topical ethical issues surrounding current research practices, and enable them to effectively address pertinent ethical and practical challenges of research from the design stage, through the implementation stage, to post-research stage. Indeed the ultimate goal is to enhance the protection of the welfare of research participants in the wake of increasing volume of health research in the developing world” said Dr Aceme Nyika, AMANET Ethics Coordinator, one of the Facilitators for the online course.

Dr Roma Chilengi, AMANET Clinical Trials Coordinator and Facilitator for this course said “The faculty for the course constitutes one of the best in Africa as far as health research ethics is concerned. It’s been rewarding developing this and the preceding HRE course. As faculty, we have probably learned ethics all over and are very excited to take HRE training to a higher level and wider audience, for free”

AMANET continues to strengthen human resource capacity required for ethical and high standard research in Africa. AMANET has organized short-term training workshops which have benefited over 1000 African health researchers and scientists: Good Clinical Practices (GCP), Good Laboratory Practices (GLP), Health Research Ethics, molecular biology and immunology, and data management.

# # #

For further information contact:

Dr Charles L. Wanga
Communications Officer
African Malaria Network Trust [AMANET]
PO Box 33207
Dar es Salaam, Tanzania.
Email : clwanga@amanet-trust.org 
www.amanet-trust.org 
Tel: +255 22 2700018
Fax: +255 22 2700380

The war against malaria in tropical countries was fought and lost in the 20th Century on the basis of faulty intelligence, a ’dodgy dossier’ which argued that the same methods used to tackle the disease in temperate countries would also work in the tropics.

Eradication failed in almost every tropical and sub-tropical country, because tactics that had been proven to work in countries such as the USA, Greece and Italy were also deployed in tropical countries, despite the existence of evidence that they would they not work, particularly in sub-Saharan Africa.

Dr. Colin Sutherland, a Senior Lecturer at the London School of Hygiene & Tropical Medicine, who is contributing to a session entitled ’How science addresses developing world issues’ at the BA Festival of Science in Liverpool today, explains: ’Previous efforts to eradicate malaria, if considered on a nation-by-nation basis, only succeeded in countries where the Plasmodium parasite was weak and its mosquito vector was vulnerable, particularly where populations were wealthy enough to afford the best tools available.

’The failure to eradicate malaria in tropical countries, where the parasite is now at its strongest, and the mosquitoes are doing very well, thank you very much is, in part, due to the miscalculation that a one-size-fits-all approach would be effective in every setting – a miscalculation that could have been avoided if we had heeded the evidence from Africa over half a century ago’, he adds.

Dr. Sutherland cautions against the obsession among the western media with the ’scientific breakthrough’, a concept which consequently dominates popular notions of science. Although breakthroughs do occur, and are undoubtedly newsworthy when they do, it is the careful synthesis of incremental advances in knowledge, and the dissemination of that knowledge to key decision-makers, health ministries and governments that will help us win the war against malaria. Today’s session will look at ways of best achieving this, with a particular focus on open access publishing. It will also emphasise the importance of training and support for high calibre African scientists.

’In the war against malaria, knowledge is the most powerful weapon we have’, concludes Dr. Sutherland.

All current anti-malaria drugs target the parasite that causes the disease, but those are becoming less effective due to increasing drug resistance. Now, Howard Hughes Medical Institute researchers report that they may be able to fight malaria by targeting human liver cells instead of parasites.

HHMI international research scholar Maria M. Mota and her colleagues have identified a receptor on human liver cells that appears to help the malaria parasite sneak inside to fully develop. The SR-BI receptor is normally an entry point for HDL cholesterol and other lipids from the bloodstream into liver cells, which break them down. But new experiments show that the malaria parasite may also be using this doorway. When scientists disabled the SR-BI receptor, they saw a dramatic reduction in the number of infections from two species of malaria in mouse and human cells. The experiments are presented in the September 2008 issue of Cell Host & Microbe.

“This study establishes the first clear molecular link between malaria infection and cholesterol uptake pathways, thus describing a new intervention strategy in the fight against malaria,” says Mota, a faculty member at the Instituto de Medicina Molecular at the University of Lisbon in Portugal.

Malaria parasites enter the human bloodstream via mosquito bites and travel to the liver, where they burrow into liver cells, multiply, and return to the bloodstream to wreak havoc on the body.

Previous research had linked the lipoprotein clearance rate by the liver to increased malaria infection, so Mota thought the parasite might enter liver cells by hijacking the liver’s own cellular machinery. The group focused its attention on the part of liver cells that filter fatty molecules like cholesterol and other lipids out of the bloodstream.

Mota’s team used RNA interference (RNAi) to examine the receptors that filter lipoproteins. The RNAi technique permitted the researchers to create cell lines with specific genes inactivated. They then tested each cell line to see how it responded to the malaria parasite. “We looked through 53 lipoprotein receptors and found one that really stood out from the rest,” Mota says. That receptor was SR-BI (class B, type I scavenger receptors). Removing SR-BI cut down infections in these cells more than any other receptor they tested.

To confirm their suspicions about SR-BI’s key role in malaria, the team conducted a series of experiments that examined mouse cells, human cells, and living mice. First, they induced mouse cells to produce much more of the protein than usual. When they exposed those cells to the parasite that causes malaria in mice, they found the cells were infected more readily than cells with a normal amount of the receptor. The team then tested the receptor’s role in a line of human cells with a human-specific malaria parasite, and got similar results.

Cells in living animals often respond differently than cultured cells, so Mota’s team explored SR-BI’s role in live mice. First they suppressed the gene for SR-BI in these mice, and later injected them with a malaria-causing parasite. Forty hours after exposure, the researchers examined whether the parasite infected the animals’ liver cells. They found that the mice with reduced SR-BI had liver infection levels 50-70 percent lower than the normal mice.

Read full story at: http://www.hhmi.org/news/20080910mota.html

It has been a bad few months for mosquitoes. First, billionaire Bill Gates resigned his Chairmanship of Microsoft to concentrate on funding the fight against malaria.

Next, scientists in Australia invented a new drug that prevents the malaria parasite binding with human red blood cells, thereby preventing its spread. However, the mosquitoes are regrouping in the world’s malaria capital.

Statistical data obtained from Apac District Health Department shows there were 88,286 reported cases of malaria in Apac district between January and June 2008. That is approximately 467 people diagnosed with malaria everyday. But it is business as usual for Apac, where the malaria incidence rate is arguably the highest in the world.

The claim is backed by studies conducted in Apac by the National Malaria Control Programme of Uganda’s Ministry of Health, with funding from USAID, the American government’s international development agency. They determined the local Entomological Inoculation Rate (EIR), that is, "how many times somebody can get bitten at night by one specific species, the female anopheles mosquito, the one that transmits malaria parasites," elaborates Dr. Matthew Emer , the Apac District Health Officer. "Anybody living in Apac is bitten by an infected mosquito, i.e. one able to transmit the malaria parasite, about six times in a night. That translates to about 1,560 times per person per year."

In comparison, Kampala residents receive an average of seven infected bites per year.

The most recent study to track EIR in Apac was carried out by the Malaria Control Programme between January and March 2008, as it assessed the feasibility of using the chemical DDT (dichlorodiphenyltrichloroethane) as a deterrent to mosquitoes. Earlier studies conducted by the Epidemiological Surveillance Division of the Ministry of Health in 2001-02 had mapped EIR in seven Ugandan districts. They found Apac to not only have the highest incidence in the country (at 1,586 infected bites per year), but also amongst the highest reported in Africa. These studies, along with existing data on global EIRs, show Apac to have the highest malaria levels on record.

Big threat

The malaria burden is hardly surprising. Over one-quarter of Apac district’s land area is covered by swamps and it is bordered by freshwater bodies like Lake Kwania and the Victoria Nile. Brick-making enterprises, which create pools of stagnant water, are scattered around it. These are ideal habitats and breeding grounds for anopheles mosquitoes, and help make malaria the district’s single biggest threat to public health. EIRs are also astonishingly high in Lango sub-region (where Apac is situated) as a whole, with 314,796 reported cases of malaria in the first six months of 2008.

Records at Apac Hospital’s outpatient department reveal malaria to be the highest cause of sickness in the district, with nearly 40% of those admitted, ultimately prov