A WHITAKER GROUP PUBLICATION
AFRICA HEALTH NEWS
PREVENTION
AFRICA ON TRACK TO
MALARIA MILESTONE
A new United Nations report estimates that more than 40% of peo-
ple living in malaria-endemic countries in Africa now have access to
long-lasting insecticide-treated mosquito nets (LLINs), putting the
continent almost halfway to the UN goal of providing 100% of those
in endemic countries with malaria control interventions by 2010.
Over 140 million LLINs
have been distributed over
the past three years, the re-
port stated, providing pro-
tection for nearly 300 mil-
lion people. Preparations are
underway to distribute over
240 million additional nets
by December 2010.
The results of the massive
distribution effort are already
apparent. Last September the World Health Organization (WHO) an-
nounced that at least seven African countries or regions have cut the
number of malaria deaths by half since the global effort was stepped up
in 2005. The WHO estimated that in 2006, 247 million people world-
wide were infected with malaria, of which 881,000 died. Ninety-one
percent of those who died were in Africa, and of that number 85% were
children under five.
The success of the distribution effort, stated the UN Special Envoy for
Malaria, Mr. Ray Chambers in the report, “signifies perhaps the most
encouraging 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), the
Global 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 research
institutions.
The WHO predicts that the world can reach near-zero deaths from
malaria by 2015 by using a combination of interventions including the
use 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, proven
interventions, available resources and collective will have converged to
turn the tide against this scourge, we cannot permit complacency to
dull our resolve,” he said.
He added that the “same thought and energy that guided LLINs in
2008” 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 antimalarial
MARCH-APRIL 2009
medicines such as artemisinin-based combination therapies (ACTs).
Funding for malaria is estimated to have increased threefold between
2004 and 2008, with about $1.5 billion going for treatment and preven-
tion in 2007. This 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.
NOVARTIS RELEASES CHILD-
FRIENDLY ANTIMALARIAL
Swiss pharmaceutical manufacturer Novartis, in partner-
ship with Medicines for Malaria Venture, has developed a
sweet-tasting child-friendly liquid version of its arteme-
sinin-based antimalarial Coartem®, and is making it
available at cost to 17 African countries where it has been
approved by regulatory agencies.
Until now, healthcare workers and parents have had to
crush bitter-tasting tablets for children to swallow often
resulting in incomplete doses being taken by the reluctant
patients. The new Coartem Dispersible is expected to over-
come this difficulty, resulting in better treatment for those
most 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,” said
Professor Awa Marie Coll-Seck, Executive Director of Roll
Back Malaria (RBM) Partnership, a coalition of African
governments, 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 in
Tanzania 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 combination
therapy (ACT) in Africa.
Since 2001, Novartis has provided more than 215 million
Coartem treatment courses at cost for public sector use in
malaria-endemic countries. A full treatment course for an
adult 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 100
pharmaceutical, academic, and endemic-country partners
in 38 countries.
PAGE TWO
IMMUNIZATION
GLOBAL COMMUNITY REDOUBLES
EFFORTS TO ERADICATE POLIO
Spurred by recent setbacks to the global cam-
paign to eradicate polio, the Bill and Melinda
Gates Foundation and Rotary International
are partnering with the Governments of Ger-
many and Great Britain to inject $635 million
into redoubling the effort.
The funds will be used to intensify vac-
cination campaigns in northern Nigeria and
northern India, which account for more than
80% of the remaining cases. The virus is also
active in Afghanistan and Pakistan.
In 1988, 166 national governments joined
forces with the World Health Organization
(WHO), Rotary International, the US Centers
for 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 since
been cut by 99% to about 1,625 cases a year
worldwide, in recent years numbers have
been rising again in parts of Nigeria and India
where vaccination campaigns have not been
effective.
BUILDING LOCAL CAPACITY
AFRICAN INITIATIVE LAUNCHED TO FUND LOCAL
HEALTH RESEARCH IN KENYA & MALAWI
Two new grant-giving bodies have been
launched in Kenya and Malawi to give local
stakeholders greater control over funding
for locally-developed strategies for health re-
search.
In Kenya, a new NGO, the Consortium for
National Health Research, will administer the
funds, and in Malawi activities will be under-
taken by the existing National Research Coun-
cil of Malawi.
The two new funding bodies were estab-
lished in collaboration with the Wellcome
Trust and the Department for International
Development (DFID) in the United Kingdom,
and with the International Development Re-
search Center in Canada.
The Wellcome Trust and DFID have agreed
to commit ₤10 million (approximately $14 mil-
lion) over the next five years to each country.
“Countries need to be able to develop and
implement their own research strategies to
meet their own priorities,” said Dr. Jimmy
Whitworth, Head of International Activities
A child receives the oral polio vaccine
The Gates Foundation will provide $255
million over the next five years and Rotary will
add $100 million. Britain has pledged $150
million and Germany will give $130 million.
The funding will support the Global Polio
Eradication Initiative through the purchase
of oral vaccine, the development of new vac-
cines and enhanced monitoring of and rapid
response to new outbreaks. In February, the
Gates Foundation announced it had bought
more than 100 million doses of oral vaccine in
Nigeria.
at the Wellcome Trust. “Through the Health
Research Capacity Strengthening Initiative
we aim to build the capacity of these African
countries to make their own grants according
to their own needs.”
“DFID’s focus is to ensure that research
makes a much greater impact on policy and
practice in our partner countries,” said Mr.
Graham Teskey, Head of Governance and So-
cial Development at DFID. “It is our hope that
the training fellowships, research grants, in-
stitutional grants and other forms of support,
which will be provided by this initiative, will
help counter the brain drain and attract young
bright African scientists and researchers back
to Africa to undertake high quality research.”
The initiative is the first time that interna-
tional donors have worked together to estab-
lish funding schemes planned and developed
locally. Other African countries such as Zam-
bia have expressed interest in developing simi-
lar schemes in their own countries.
GLOBAL HEALTH PROGRESS
DELEGATION VISITS
EAST AFRICA TO
EXPLORE PARTNERSHIPS
A delegation from Global Health Progress
(GHP), an initiative of the global research-
based bio-pharmaceutical industry, visited
Rwanda and Kenya in March to explore
strengthening public-private partnerships
with governments and NGOs in the region.
The 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 and
other health stakeholders to learn about ex-
isting public-private partnerships with phar-
maceutical companies and challenges on the
ground in Rwanda and Kenya, and to examine
how GHP can enhance and expand partner-
ships in the region.
While in Rwanda, GHP held a recep-
tion honoring Her Excellency Mrs. Jeannette
Kagame, Rwanda’s First Lady, and presented
her with a leadership award for her dedication
to improving access to HIV/AIDS care and
treatment for Rwandans. The award was ac-
cepted on her behalf by Minister of Health Dr.
Richard Sezibera.
To better learn about healthcare challenges
and to celebrate Mother and Child Health
Week in Rwanda, GHP hosted a roundtable
discussion on the successes and challenges of
maternal and child health in the country.
The delegation observed the ACCESS Proj-
ect, a US-based NGO dedicated to improving
the public health system in Rwanda, during its
second countrywide mass drug administration
campaign. Over four million Rwandan chil-
dren between the ages of five and 16 received
Mebendazol to combat intestinal worms and
over 100,000 received Praziquantel for the
parasitic disease schistosomiasis.
In Kenya, the delegation visited the African
Medical and Research Foundation (AMREF)
and the Johnson & Johnson Management De-
velopment Institute (MDI). MDI partners with
AMREF, the University of California at Los
Angeles and the Global Business Schools Net-
work to hold intensive management seminars
for leaders of AIDS service organizations.
GHP also held meetings with officials from
the Academic Model Providing Access to
Healthcare (AMPATH), a working model of
HIV preventive and treatment services in Ke-
nya.

REPLENISH AFRICA INITIATIVE
COCA-COLA COMMITS $30 MILLION
FOR CLEAN WATER IN AFRICA
The Coca-Cola Company announced on
March 16 that it would commit $30 million
between now and 2015 to providing access
to safe drinking water and sanitation to at
least two million people throughout Africa.
The initiative will not only benefit the com-
munities in which the soft drink company
operates but will also ensure a sustainable
water supply for both local business and
Coca-Cola.
The funding will be administered through
The Coca-Cola Foundation’s Replenish Af-
rica Initiative (RAIN) and implemented in
partnership with local communities in each
host country.
“No single organization can resolve Af-
rica’s development challenges, but together
with civic society, nongovernmental or-
ganizations and government we can make
a positive difference in the lives of people
who make up our communities,” said Mr.
William Asiko, President of The Coca-Cola
Foundation. “Having access to clean water
still remains a luxury, not a given, in large
parts of the continent. RAIN helps us both
fulfill our environmental goals while also
providing health benefits that will allow our
communities and our business to grow and
prosper.”
The strategy for achieving the goal in-
cludes three components:
■ Improving water efficiency by 20% by
2012;
■ Returning all water the company uses
for manufacturing processes to the environ-
ment at a level that supports aquatic life and
agriculture by the end of 2010; and
■ Expanding the company’s support of
healthy watersheds and sustainable com-
munity water programs to balance the water
used in its finished beverages.
The World Health Organization (WHO)
reports that more than 300 million Africans
lack access to safe drinking water, and mil-
lions die each year from preventable water-
borne illnesses.
“Africa’s water crisis threatens the health
of its population and, therefore, its prospects
for economic growth,” said Mr. Muhtar
Kent, President and CEO of the Coca-Cola
Company, which is the largest private sector
employer in Africa.
“Helping African communities tackle
PHOTO: OBI-AKPERI
their water challenges is an important prior-
ity for our company and our bottling part-
ners, and is an area where we can make a
positive and lasting impact,” he added.
The Coca-Cola Foundation currently
has water projects reaching about 300,000
people in 19 African countries. They in-
clude Angola, Côte d’Ivoire, Egypt, Ethiopia,
Ghana, Kenya, Mali, Malawi, Morocco, Mo-
zambique, Niger, Nigeria, Rwanda, Senegal,
South Africa, Tanzania, Tunisia, Uganda
and Zambia.
The Foundation has implemented over
130 programs in total in 32 countries across
Africa. Critical areas of focus have been wa-
ter, entrepreneurship, education and health.
In January, The Coca-Cola Company was
named the winner of the World Environ-
ment Center’s (WEC) Twenty-fifth Annual
Gold Medal for International Corporate
Achievement in Sustainable Development
for 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 an
amount of water equal to what it uses in all
of its beverages and their production,” was
cited by the independent international Gold
Medal jury as an exceptional demonstration
of leadership in sustainability.
The WEC Gold Medal Award will be pre-
sented to The Coca-Cola Company at the
25th Gold Medal Presentation Gala on May
8, 2009, at the National Building Museum in
Washington, DC. WEC is an independent
non-profit whose mission is to advance sus-
tainable development through the business
practices of its member companies in part-
nership with government and other stake-
holders.
PAGE THREE
HIV PREVENTION
PROMISING RESULTS
FOR WOMEN’S
MICROBICIDE GEL
A clinical trial involving more than 3,000
women in the US and southern Africa has
demonstrated the potential of a vaginal mi-
crobicide gel in helping women to protect
themselves against HIV infection.
Results from the trial, conducted between
February 2005 and September 2008, showed
that one 0.5% dose of the HPTN 035 microbi-
cide was 30% effective in preventing HIV from
attaching to cells in the genital tract.
“These findings provide the first signal
that a microbicide gel may be able to prevent
women from HIV infection,” said Dr. Salim
Abdool Karim, Professor of Epidemiology at
Columbia University Mailman School of Pub-
lic Health, Deputy Vice Chancellor at the Uni-
versity of KwaZulu-Natal and Director of the
Center for the AIDS Program of Research in
South Africa.
“Indeed, for the millions of women at risk
for HIV, especially young women in Africa,
there is now a glimmer of hope,” he said while
presenting the trial’s results in February at the
Conference on Retroviruses and Opportunis-
tic Infections (CROI) in Montreal, Canada.
The breakthrough could eventually enable
women to more effectively take control of
their health in an epidemic that in Africa dis-
proportionately affects them. While consistent
and correct use of male condoms is most ef-
fective in the prevention of HIV transmission,
their use remains beyond the control of most
African women.
Dr. Karim cautioned, however, that more
research was needed before the microbicide
was ready for widespread use.
In sub-Saharan Africa, the World Health
Organization (WHO) estimates that women
represent nearly 60% of adults living with HIV,
and in several southern African countries
young women are at least three times more
likely to be HIV-positive than young men.
Most women are infected with HIV through
sexual intercourse with an infected male part-
ner.
The six sites in Africa where the trial was
conducted were Durban and Hlabisa in South
Africa; Harare, Zimbabwe; Lusaka, Zambia;
and Blantyre and Lilongwe in Malawi.
The HPTN 035 trial is considered the first
successful clinical screening of a vaginal mi-
crobicide.
PAGE FOUR
BUSINESS OF HEALTH
AFRICAN ENTREPRENEURS PROMOTE
SUSTAINABLE SANITATION SOLUTIONS
Three social entrepreneurs from Africa were
in Washington, DC, in February to promote
their creative - and lucrative - solutions to
some of Africa’s most intractable sanitation
problems.
The three - Kenyan David Kuria, Nigerian
Joseph Adelegan and South African Trevor
Mulaudzi - have each identified a problem in
their communities and set about finding a so-
lution based on a business model rather than
turning to aid or public funding. Their innova-
tions are successfully changing social behavior
and improving public health, the environment
and the economy.
Toilet Malls
Mr. David Muria, an expert on environ-
mental sanitation, is making the toilet a hot
commodity in Kibera, one of Kenya’s largest
slums. “Why just do two quick things in the
toilet?” Mr. Muria wondered. His solution was
to found Eco-Tact, a company that builds toi-
let malls that provide shoe shines, food, phone
booths and other commercial services as well
as the usual facilities.
Founded in
2007, Eco-Tact toi-
let malls now serve
about 30,000 cus-
tomers a day. Each
complex, owned
locally as a fran-
chise, is equipped
with eight toilets, a
A toilet mall in Nairobi water kiosk, a baby
changing station and
gender separate showers.
By employing a franchise model, Eco-Tact
has ensured local involvement and sustainabil-
ity. Franchise owners can also increase income
by harvesting biogas from digesters of human
waste, urea from urine and compost from
sludge.
Mr. Kuria is collaborating with several
NGOs - Ashoka, Rotary International, the
Global Water Challenge and the Acumen
Fund - to extend the model to other African
countries.
Cows to Kilowatts
When Dr. Joseph Adelegan, a civil engi-
neer, observed a slaughterhouse in his native
Nigeria disposing daily of the manure of 1,000
slaughtered cows directly into a local river, he
LEADERS IN HEALTH
DR RICHARD SEZIBERA
MINISTER OF HEALTH, RWANDA
Dr. Richard Sezibera, who became
saw energy going to waste. Rwanda’s Minister of Health last Octo-
In response, he designed a bioreactor that di- ber, is a man committed to a prosper-
gests the waste into biogas to generate electric- ous, peaceful and healthy future for all
ity and produce cooking fuel. Local women’s Rwandans.
organizations sell the fuel at affordable prices As a Senior Adviser to President Paul
to the urban poor. Kagame and Presidential Special Envoy
The solid waste that to the Great Lakes Region from 2003
is left over makes to 2008, he has been a leading figure in
cheap and effective Rwanda’s remarkable renaissance follow-
fertilizer. ing the genocide of the 1990s.
Dubbed “Cows Now, he is bringing the same commit-
to Kilowatts” and ment to consolidating Rwanda’s position
“Power to the Poor,” as a leader in healthcare in Africa. Rwan-
the initiative also da has been lauded internationally as one
reduces the emis- A Cows to Kilowatts of the first African countries to meet the
sion of methane, a generator United Nations Millennium Develop-
potent greenhouse ment Goal of halting and beginning the
gas, and has improved the water quality of the reversal of the spread of HIV/AIDS and
communities that live downstream from the malaria.
slaughterhouse. In his first
In 2008, the Government of Nigeria began to months in office,
replicate Dr. Adelegan’s model at other slaugh- Dr. Sezibera has
terhouses in the country. He is now working promoted one
with other social entrepreneurs to take the ap- of Africa’s first
proach elsewhere in Africa. patients’ bills of
rights that lays
The Clean Shop out the rights of
Mr. Trevor Mulaudzi, a South African busi- all Rwandans,
Dr. Richard Sezibera
nessman and mining geologist, was shocked to regardless of
with Mr. Aurelian
see children skipping class to avoid using the gender, sexual
Agbenonothe, UN
school’s dirty and malfunctioning bathroom orientation, age,
Resident Coordinator,
facilities. religion, cultural
after the arrival in
He founded The Clean Shop, which offers belief or disabil-
March of the Prevnar
schools and large organizations sanitation ity, to access to
vaccine
services such as cleaning toilets and repairing healthcare and
plumbing as well as teaching students about choices regarding that care.
good hygiene. He has also been in the forefront of
Mr. Mulaudzi approaches the sanitation ensuring that Rwanda be the first Af-
problem as an educator rather than a cleaning rican country to procure the Prevnar
contractor and uses motivational techniques pneumococcal vaccine, which prevents
such as requiring meningitis and other diseases among
students to bring infants, donated by Wyeth Pharmaceu-
his or her own roll ticals. Rwanda is the first African coun-
of toilet paper as the try eligible under the Global Alliance for
“admission ticket” Vaccines and Immunization (GAVI) to
to the shiny new receive the drugs in 2009, based on its
restroom. The tech- national immunization programs.
nique builds a sense Dr. Sezibera holds a medical degree
of pride and owner- and a Masters in International Relations
ship by the users of from Georgetown University in Wash-
the facilities. ington, DC. He was Rwanda’s Ambassa-
Mr. Malaudzi in a “clean dor to Washington from 1999 to 2003.
shop”
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