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AFRICA HEALTH NEWS
A WHITAKER GROUP PUBLICATIONMARCH-APRIL 2009
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REVENTION
AFRICA ON TRACK TOMALARIA MILESTONE
A new United Nations report estimates that more than 40% of peo-ple living in malaria-endemic countries in Africa now have access tolong-lasting insecticide-treated mosquito nets (LLINs), putting thecontinent almost halfway to the UN goal of providing 100% of thosein endemic countries with malaria control interventions by 2010.
Over 140 million LLINshave been distributed overthe past three years, the re-port stated, providing pro-tection for nearly 300 mil-lion people. Preparations areunderway to distribute over240 million additional netsby December 2010.e results of the massivedistribution effort are already apparent. Last September the World Health Organization (WHO) an-nounced that at least seven African countries or regions have cut thenumber of malaria deaths by half since the global effort was stepped upin 2005. e WHO estimated that in 2006, 247 million people world-wide were infected with malaria, of which 881,000 died. Ninety-onepercent of those who died were in Africa, and of that number 85% werechildren under five.e success of the distribution effort, stated the UN Special Envoy forMalaria, Mr. Ray Chambers in the report, “signifies perhaps the mostencouraging development in a year that featured many noteworthy ac-complishments.”Epidemiologists attribute these accomplishments to an extraordinary array of public-private partnerships between governments in malaria-endemic countries, the US President’s Malaria Initiative (PMI), theGlobal Fund to Fight AIDS, Tuberculosis and Malaria, UN agencies,the World Bank, non-governmental and community-based organiza-tions, global foundations, the private sector and academic and researchinstitutions.e WHO predicts that the world can reach near-zero deaths frommalaria by 2015 by using a combination of interventions including theuse of bed nets, treatment of those who become infected and the elimi-nation of malaria-carrying mosquitoes by spraying.Mr. Chambers cautioned, however, that momentum must not be lost.“At this unique moment in history, when dedicated leadership, proveninterventions, available resources and collective will have converged toturn the tide against this scourge, we cannot permit complacency todull our resolve,” he said.He added that the “same thought and energy that guided LLINs in2008” will govern efforts pertaining to other essential interventions,such as treatment in public health facilities, the provision of rapid diag-nostic tests and the production of an adequate quantity of antimalarialmedicines such as artemisinin-based combination therapies (ACTs).Funding for malaria is estimated to have increased threefold between2004 and 2008, with about $1.5 billion going for treatment and preven-tion in 2007. is trend is expected to continue, supported largely by increased funding from the United States, which has pledged to con-tribute $5 billion over the next five years to the effort.
Swiss pharmaceutical manufacturer Novartis, in partner-ship with Medicines for Malaria Venture, has developed asweet-tasting child-friendly liquid version of its arteme-sinin-based antimalarial Coartem
®,
and is making itavailable at cost to 17 African countries where it has beenapproved by regulatory agencies.
Until now, healthcare workers and parents have had tocrush bitter-tasting tablets for children to swallow oftenresulting in incomplete doses being taken by the reluctantpatients. The new Coartem Dispersible is expected to over-come this difficulty, resulting in better treatment for thosemost likely to die from malaria - children under the age of five.“This represents a major advance towards our target of achieving universal coverage with treatment by 2010,” saidProfessor Awa Marie Coll-Seck, Executive Director of RollBack Malaria (RBM) Partnership, a coalition of Africangovernments, United Nations agencies, donor governments,the World Bank and the private sector.A clinical study reported in
The Lancet 
medical jour-nal by Dr. Salim Abdulla of the Ifakara Health Initiative inTanzania showed that the new drug provides a cure rate of 97.8%, which is comparable to the 98.5% cure rate of regu-lar Coartem, the leading artemesinin-based combinationtherapy (ACT) in Africa.Since 2001, Novartis has provided more than 215 millionCoartem treatment courses at cost for public sector use inmalaria-endemic countries. A full treatment course for anadult costs just 80 cents and for a child 37 cents.To date, Coartem Dispersible has been approved by regu-latory agencies in Benin, Burkina Faso, Côte d’Ivoire, Dem-ocratic Republic of Congo (DRC), Gabon, Ghana, Guinea,Kenya, Madagascar, Mali, Mauritania, Niger, Nigeria, Sen-egal, Tanzania, Togo and Zambia.Medicines for Malaria Venture is a public-private part-nership that is currently managing the largest-ever portfo-lio of antimalarial projects in collaboration with over 100pharmaceutical, academic, and endemic-country partnersin 38 countries.
NOVARTIS RELEASES CHILD-FRIENDLY ANTIMALARIAL
 
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Spurred by recent setbacks to the global cam-paign to eradicate polio, the Bill and MelindaGates Foundation and Rotary Internationalare partnering with the Governments of Ger-many and Great Britain to inject $635 millioninto redoubling the effort.
The funds will be used to intensify vac-cination campaigns in northern Nigeria andnorthern India, which account for more than80% of the remaining cases. The virus is alsoactive in Afghanistan and Pakistan.In 1988, 166 national governments joinedforces with the World Health Organization(WHO), Rotary International, the US Centersfor Disease Control and Prevention (CDC)and UNICEF to launch the global polio eradi-cation initiative. Since then, about $6.17 bil-lion has been spent on the effort.While occurrence of the disease has sincebeen cut by 99% to about 1,625 cases a yearworldwide, in recent years numbers havebeen rising again in parts of Nigeria and Indiawhere vaccination campaigns have not beeneffective.The Gates Foundation will provide $255million over the next five years and Rotary willadd $100 million. Britain has pledged $150million and Germany will give $130 million.The funding will support the Global PolioEradication Initiative through the purchaseof oral vaccine, the development of new vac-cines and enhanced monitoring of and rapidresponse to new outbreaks. In February, theGates Foundation announced it had boughtmore than 100 million doses of oral vaccine inNigeria.
 A hild receives the oral polio vaccine
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GLOBAL COMMUNITY REDOUBLESEFFORTS TO ERADICATE POLIO
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AFRICAN INITIATIVE LAUNCHED TO FUND LOCALHEALTH RESEARCH IN KENYA & MALAWI
Two new grant-giving bodies have beenlaunched in Kenya and Malawi to give localstakeholders greater control over fundingfor locally-developed strategies for health re-search.
In Kenya, a new NGO, the Consortium forNational Health Research, will administer thefunds, and in Malawi activities will be under-taken by the existing National Research Coun-cil of Malawi.e two new funding bodies were estab-lished in collaboration with the WellcomeTrust and the Department for InternationalDevelopment (DFID) in the United Kingdom,and with the International Development Re-search Center in Canada.e Wellcome Trust and DFID have agreedto commit ₤10 million (approximately $14 mil-lion) over the next five years to each country.“Countries need to be able to develop andimplement their own research strategies tomeet their own priorities,” said Dr. Jimmy Whitworth, Head of International Activitiesat the Wellcome Trust. “rough the HealthResearch Capacity Strengthening Initiativewe aim to build the capacity of these Africancountries to make their own grants accordingto their own needs.”“DFID’s focus is to ensure that researchmakes a much greater impact on policy andpractice in our partner countries,” said Mr.Graham Teskey, Head of Governance and So-cial Development at DFID. “It is our hope thatthe training fellowships, research grants, in-stitutional grants and other forms of support,which will be provided by this initiative, willhelp counter the brain drain and attract youngbright African scientists and researchers backto Africa to undertake high quality research.”e initiative is the first time that interna-tional donors have worked together to estab-lish funding schemes planned and developedlocally. Other African countries such as Zam-bia have expressed interest in developing simi-lar schemes in their own countries.
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DELEGATION VISITSEAST AFRICA TOEXPLORE PARTNERSHIPS
A delegation from Global Health Progress(GHP), an initiative of the global research-based bio-pharmaceutical industry, visitedRwanda and Kenya in March to explorestrengthening public-private partnershipswith governments and NGOs in the region.
e group, led by Mr. Chris Singer, President,International Section of PhRMA (Pharmaceu-tical Research and Manufacturers of America),and Ms. Alicia Greenidge, Director General of the International Federation of Pharmaceuti-cal Manufacturers and Associations (IFPMA),met with a host of health ministry officials andother health stakeholders to learn about ex-isting public-private partnerships with phar-maceutical companies and challenges on theground in Rwanda and Kenya, and to examinehow GHP can enhance and expand partner-ships in the region.While in Rwanda, GHP held a recep-tion honoring Her Excellency Mrs. JeannetteKagame, Rwanda’s First Lady, and presentedher with a leadership award for her dedicationto improving access to HIV/AIDS care andtreatment for Rwandans. e award was ac-cepted on her behalf by Minister of Health Dr.Richard Sezibera.To better learn about healthcare challengesand to celebrate Mother and Child HealthWeek in Rwanda, GHP hosted a roundtablediscussion on the successes and challenges of maternal and child health in the country.e delegation observed the ACCESS Proj-ect, a US-based NGO dedicated to improvingthe public health system in Rwanda, during itssecond countrywide mass drug administrationcampaign. Over four million Rwandan chil-dren between the ages of five and 16 receivedMebendazol to combat intestinal worms andover 100,000 received Praziquantel for theparasitic disease schistosomiasis.In Kenya, the delegation visited the AfricanMedical and Research Foundation (AMREF)and the Johnson & Johnson Management De- velopment Institute (MDI). MDI partners withAMREF, the University of California at LosAngeles and the Global Business Schools Net-work to hold intensive management seminarsfor leaders of AIDS service organizations.GHP also held meetings with officials fromthe Academic Model Providing Access toHealthcare (AMPATH), a working model of HIV preventive and treatment services in Ke-nya.
 
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A clinical trial involving more than 3,000women in the US and southern Africa hasdemonstrated the potential of a vaginal mi-crobicide gel in helping women to protectthemselves against HIV infection.
Results from the trial, conducted betweenFebruary 2005 and September 2008, showedthat one 0.5% dose of the HPTN 035 microbi-cide was 30% effective in preventing HIV fromattaching to cells in the genital tract.“ese findings provide the first signalthat a microbicide gel may be able to preventwomen from HIV infection,” said Dr. SalimAbdool Karim, Professor of Epidemiology atColumbia University Mailman School of Pub-lic Health, Deputy Vice Chancellor at the Uni- versity of KwaZulu-Natal and Director of theCenter for the AIDS Program of Research inSouth Africa.“Indeed, for the millions of women at riskfor HIV, especially young women in Africa,there is now a glimmer of hope,” he said whilepresenting the trial’s results in February at theConference on Retroviruses and Opportunis-tic Infections (CROI) in Montreal, Canada.e breakthrough could eventually enablewomen to more effectively take control of their health in an epidemic that in Africa dis-proportionately affects them. While consistentand correct use of male condoms is most ef-fective in the prevention of HIV transmission,their use remains beyond the control of mostAfrican women.Dr. Karim cautioned, however, that moreresearch was needed before the microbicidewas ready for widespread use.In sub-Saharan Africa, the World HealthOrganization (WHO) estimates that womenrepresent nearly 60% of adults living with HIV,and in several southern African countriesyoung women are at least three times morelikely to be HIV-positive than young men.Most women are infected with HIV throughsexual intercourse with an infected male part-ner.e six sites in Africa where the trial wasconducted were Durban and Hlabisa in SouthAfrica; Harare, Zimbabwe; Lusaka, Zambia;and Blantyre and Lilongwe in Malawi.e HPTN 035 trial is considered the firstsuccessful clinical screening of a vaginal mi-crobicide.
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COCA-COLA COMMITS $30 MILLIONFOR CLEAN WATER IN AFRICA
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e Coca-Cola Company announced onMarch 16 that it would commit $30 millionbetween now and 2015 to providing accessto safe drinking water and sanitation to atleast two million people throughout Africa.e initiative will not only benefit the com-munities in which the so drink company operates but will also ensure a sustainablewater supply for both local business andCoca-Cola.
e funding will be administered throughe Coca-Cola Foundation’s Replenish Af-rica Initiative (RAIN) and implemented inpartnership with local communities in eachhost country.“No single organization can resolve Af-rica’s development challenges, but togetherwith civic society, nongovernmental or-ganizations and government we can makea positive difference in the lives of peoplewho make up our communities,” said Mr.William Asiko, President of e Coca-ColaFoundation. “Having access to clean waterstill remains a luxury, not a given, in largeparts of the continent. RAIN helps us bothfulfill our environmental goals while alsoproviding health benefits that will allow ourcommunities and our business to grow andprosper.”e strategy for achieving the goal in-cludes three components:■ Improving water efficiency by 20% by 2012;■ Returning all water the company usesfor manufacturing processes to the environ-ment at a level that supports aquatic life andagriculture by the end of 2010; and■ Expanding the company’s support of healthy watersheds and sustainable com-munity water programs to balance the waterused in its finished beverages.e World Health Organization (WHO)reports that more than 300 million Africanslack access to safe drinking water, and mil-lions die each year from preventable water-borne illnesses.“Africa’s water crisis threatens the healthof its population and, therefore, its prospectsfor economic growth,” said Mr. MuhtarKent, President and CEO of the Coca-ColaCompany, which is the largest private sectoremployer in Africa.“Helping African communities tackletheir water challenges is an important prior-ity for our company and our bottling part-ners, and is an area where we can make apositive and lasting impact,” he added.e Coca-Cola Foundation currently has water projects reaching about 300,000people in 19 African countries. ey in-clude Angola, Côte d’Ivoire, Egypt, Ethiopia,Ghana, Kenya, Mali, Malawi, Morocco, Mo-zambique, Niger, Nigeria, Rwanda, Senegal,South Africa, Tanzania, Tunisia, Ugandaand Zambia.e Foundation has implemented over130 programs in total in 32 countries acrossAfrica. Critical areas of focus have been wa-ter, entrepreneurship, education and health.In January, e Coca-Cola Company wasnamed the winner of the World Environ-ment Center’s (WEC) Twenty-fih AnnualGold Medal for International CorporateAchievement in Sustainable Developmentfor implementing strategic business initia-tives in the high impact areas of water stew-ardship, sustainable packaging, energy man-agement and climate protection.Coca-Cola’s Signature Contribution,“returning to nature and communities anamount of water equal to what it uses in allof its beverages and their production,” wascited by the independent international GoldMedal jury as an exceptional demonstrationof leadership in sustainability.e WEC Gold Medal Award will be pre-sented to e Coca-Cola Company at the25th Gold Medal Presentation Gala on May 8, 2009, at the National Building Museum inWashington, DC. WEC is an independentnon-profit whose mission is to advance sus-tainable development through the businesspractices of its member companies in part-nership with government and other stake-holders.
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