Campaign for Fighting Diseases Blog

World Malaria Day – the experts speak

More welcome publicity today for malaria, a disease which according to the WHO still kills more than a million people every year.

In the UK the BBC’s Today Programme featured Professor Chris Whitty, a trustee of the aid agency Merlin.

Professor Whitty made the point that conflicts can exacerbate effects of malaria. He explained that war typically causes a breakdown in health services and makes spraying (‘indoor residual spraying', IRS) far more difficult.

Asked whether global warming caused malaria and threatened to bring it back to Europe, Professor Whitty responded ‘I don’t think global warming would cause it … it’s not really because of global warming’.

This echoes the arguments provided by expert on insect-borne diseases Paul Reiter regarding the fallacy of global warming-induced malaria.

The BBC’s website also includes an article featuring contributors from Merlin. They make the same points about conflict causing a breakdown in health services, a decline in spraying and often resulting in large numbers of people being exposed to malaria near breeding sites. They also note the futility of bed-nets in such circumstances:

‘But nets don't work so well if, like many displaced people, you have no bed, and no home’

Note: If you want to listen, the interview was broadcast around 6:55am.

Let's talk about drugs on World Malaria Day

Over at The American, CFD contributor Dr Roger Bate has an interesting article for World Malaria Day. 

While he notes that increased funding and coordination amongst global agencies has improved the quality of malaria treatment, there are still many companies going against WHO advice and selling artemisinin monotherapies in Africa. These monotherapies raise the risk of the malarial parasite developing drug resistance.

Meanwhile, the suppliers of high quality artemisinin combination therapies are having their lives made difficult by the WHO's insistence on forecasting 'need' rather than actual demand.  WHO figures out how many people 'need' treatment in an ideal world, and these figures provide the basis upon which manufacturers produce the drugs.

The only problem is, 'need' is not the same as real demand: as a result of weak health infrastructure, only a fraction of the 'needed' drugs manufactured get to patients.  This results in a massive waste of drugs and loss of money, as for example when Novartis and Sanofi-Aventis had to destroy drugs that had been overproduced.  This undermines the incentives for companies to invest their precious capital in malaria drugs.

World Malaria Day is a good time to raise these issues.  Unless the economics are correct, the private  sector will lose interest in the disease, which will be a disaster for malaria sufferers everywhere.   

Soviet medicine rises from the grave

In ten days time, the World Health Organization's IGWG will get together to finalise its Plan of Action on IP and health.  When I last checked, talk of a 'Medical Research and Development Treaty' was still in the document.

Today my colleague Paul Howard (from the Manhattan Institute) and myself have an op-ed explaining why this treaty will actually undermine drug research. 

One would have thought the Soviet Union had provided ample evidence of why centralised planning can never work: yet twenty years on from the collapse of Soviet communism we find ourselves still having to explain why such ideas are bad.

Markets for organs?

Waiting lists and death are too often the outcomes for people suffering from End Stage Renal Disease (ESRD). Sadly, this familiar story occurs in virtually every country across the world.

In the US alone 73,000 people are waiting for a kidney donation and the waiting list is growing. Since 1999, 30,000 people have died whilst waiting for a kidney that never arrived.

These figures are reported by Benjamin E. Hippen, MD, a nephrologist (kidney expert), member of leading transplantation organisations and associate editor of the American Journal of Transplantation.

His report is available here and remarkably notes that Iran is the world’s only country to have eliminated waiting lists. This has been achieved via a kidney vendor program, made possible through the legalisation of kidney vending.

The program allows vendors to approach a not-for-profit body, Dialysis and Transplant Patients Association (DATPA), which matches them with recipients. Vendors are compensated by the government, receive health insurance and additional funds from either recipients or charities funding recipients. Vendors are assessed with non-remunerated donors and the operation vetoed if the vendor is found to be medically unsuitable.

Whilst noting problems within the system, Hippen notes that the involvement of an intermediary not-for-profit organisation and other means of legal framework mitigate concerns about organ donation.

This scheme could work in other countries which have organ shortages, thus reducing waiting lists, saving lives and eliminating illegal organ trafficking.

Malaria: bed-nets won’t ‘end killer disease’

Last night Prime Minister Gordon Brown pledged Britain would supply 20 million bed-nets to aid the fight against malaria.

Appearing on U.S. show ‘American Idol’, he urged governments and donors to supply aid for 120 million bed-nets to be supplied to malaria-hit countries.

Is this the best way to deal with malaria and thus should governments be channelling vast amounts of aid at bed-nets? Are bed-nets really the way to ‘end this killer disease’?

Research suggests not. In Chapter 6 of ‘Fighting the Diseases of Poverty’* authors such as Jason Urbach from Africa Fighting Malaria argue there are far more effective means of fighting malaria.

UN-led programmes against malaria have failed due to the withdrawal of DDT for indoor residual spraying and are overstating the value of bed-nets. Bed-nets require regular retreatment, do not guarantee protection and are often simply not used.

Furthermore, a chapter in a report from the Civil Society Coalition of Climate Change (pages 28-36) examines the causes of malaria and means of prevention.

The chapter is written by Paul Reiter, Director of the Insects and Infectious Diseases Unit of the Institut Pasteur and global consultant on insect-borne diseases. Reiter covers the conditions in which malaria thrives, mainly relating to agricultural and economic development (rather than, as often misconceived, climate change).

* Fighting the Diseases of Poverty can be purchased here.