MALARIA: MDG's

MDGs are eight time-bound goals tackling poverty and its various dimensions that member states of the United Nations and other international organisations have agreed to meet by 2015. "We either win this fight or we lose it. There can be no let-up in the fight against the three diseases," said U.N. secretary-general Ban Ki- moon in a message last month, as he described the progress made by the Global Fund, which has been the main contributor to the health-related MDGs. Professor Kevin Marsh, director of the Kenya Medical Research Institute Wellcome Trust programme in Kilifi, Kenya, cites the experience of Africa to stress the impact of efforts to fight one of the world’s killer diseases on meeting the MDGs. "In Africa, if you control malaria, you can reduce childhood mortality down to the levels to achieve MDGs," he says. In coastal Kenya, for instance, malaria has dropped by 90 percent in the last five years and infant childhood deaths have dropped from 115 deaths per 1,000 under-five children to 74 last year, he recounts. Malaria causes 500 million episodes of illness, almost 40 percent of them in Asia, and one million deaths annually, 90 per cent of them in Africa, says WHO. "The changing epidemiology of malaria in Southeast Asia, including the emergence and spread of drug-resistant strains of the parasite, are posing fresh challenges to regional elimination efforts," says Professor Ric Price of the Menzies School of Health research in Darwin. "To achieve the ultimate goal of malaria control, we estimate that four to five billion U.S. dollars are needed per year, sustained over the next 20 to 30 years." Parts of South-east Asia are already witnessing the emergence of malarial strains that are resistant to ‘artemesinins’, drugs the world depends on to treat malaria. If such a situation is not controlled, "it will be a very serious global health issue," warns Marsh, who is also a professor of Tropical Medicine at Oxford University. There are five species of malaria that commonly infect humans, two of which pose the greatest health risks –‘Plasmodium falciparum’ and ‘P. vivax’ to humans. In Asia, the challenge lies in controlling the ‘P. vivax’ malaria. The emergence of another species of potentially fatal adult malaria, ‘Plasmodium knowlesi’, has also been noted in the region, particularly in Malaysia. Pig-tailed and long-tailed macaques monkeys are the reservoirs of this parasite, says Timothy William, head of the Infectious Disease Unit at Queen Elizabeth Hospital in Sabah, Malaysia. "It is difficult to treat or eradicate the reservoirs for obvious reasons. In our study, about 30 percent of the cases presented with severe disease. Therefore it is imperative that these cases are diagnosed early and treated," he says. Research has shown that more than 60 percent of emerging infectious diseases have been related to animal and human contact. "Of these, 70 percent are due to contact between humans and wildlife. In developing countries, these issues are even more important with increasing land clearing, intensive farming of poultry, and infections passing from wild birds into domestic birds," Sorrell tells IPS. Still another major challenge to the global health community is the growing drug resistance of certain diseases, particularly to antibiotics. These include tuberculosis, typhoid, malaria, and sexually transmitted diseases like gonorrhoea. In recent years, there has been a renewed commitment to vaccine research to prevent and treat these infections and other preventable diseases in the developing world. "The issue in the long term is affording the vaccines in routine use," says Marsh, who adds that immunisation has been "one of the most successful international efforts to curb the spread of diseases." Immunisation is particularly crucial for children at risk for pneumococcal disease, says Dr Andrew Pollard, professor of paediatric infection and immunity and director of the Oxford Vaccine Group at Oxford University. "Streptococcus pneumoniae is the leading cause of pneumonia in childhood and kills more children in South Asia and South East Asia than any other disease," he says.
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