IPN Health Blog

New study: larvicides better than bed-nets

A new study from Tanzania's Ifakara Health Institute has shown that larvicides can be just as effective as bed-nets, yet four times cheaper.

The study focussed on urban areas in Dar es Salaam, where larvicides are having a considerable effect in reducing malaria.

Malaria rates in children under five, the most vulnerable demographic to the disease, fell by 72 per cent following the application of larvicides.

One resident commented: "I can't tell the amount of mosquitoes we used to have here. They have helped us to do away with this nuisance."

March of Washingtons - website launched

With children in Africa particularly vulnerable to malaria, the quality of antimalarial drugs can literally be a matter of life and death.

Furthermore, as well as failing to treat patients, substandard drugs provoke drug resistant strands of disease.

Fortunately our friends at Africa Fighting Malaria are making huge strides with their March of Washingtons campaign.

For every $1 raised by the campaign, they provide safe, high quality antimalarial medicine to an African patient in need, and invest the rest in conducting quality control testing of antimalarial drugs in Africa.

The group have now launched a new website:

TO CHECK IT OUT, CLICK HERE

You can donate and / or sign up your organisation to the coalition.

Swine Flu not an excuse for blocking trade

Undoubtedly today's main health story concerns the outbreak of swine flu, suspected to have killed over a hundred people in Mexico.

Sadly this serious health concern is already being used to block perfectly legitimate trade.

News agency Bloomberg report that the Russian government has blocked all imports of meat from Mexico and some US states, while pork from other countries in the region (Guatemala, Honduras, the Dominican Republic, Columbia, Costa Rica, Cuba, Nicaragua, Panama, Salvador) is now also banned.

While this might seem reasonable at first, note that the World Health Organization clearly states that the virus cannot be transmitted through well-prepared food.

This document from the WHO confirms that the virus dies at 70 degrees celsius.

The Russian government's reactionary measures are the kind that imbed people in poverty throughout the world, furthering the spread of diseases like swine-flu.

As explained by Indur Goklany, free trade is crucial for economic growth and technological development, both of which combine to improve prosperity and health outcomes.

WHO getting closer on drug resistant malaria

The WHO issued a press release on Saturday, World Malaria Day, which at least showed they're starting to pay a little more attention to the role of counterfeit drugs in provoking drug resistance.

As we've mentioned before, counterfeits often contain too little active ingredient so that parasites survive and develop resistance to the drug.

The third paragraph of the press release states:

"Further jeopardizing ambitions to end the malaria threat ... is the wide availability of low-quality and counterfeit drugs in some countries of the Mekong region".

Absolutely correct, and exactly why the CFD has been highlighting the levels of drug resistance in the Mekong region, and the correlation with very high levels of counterfeit and substandard drugs.

The situation in the region isn't helped when taxes, tariffs and other duties block access to high quality drugs. The last comprehensive study of these levels found that Thailand's rates average out at 18.1 per cent, while Cambodia's stand at 13.5 per cent.

If governments persist in thwarting high quality drugs, substandard versions will continue to take their place.

Malaria: looking long term

As we’ve come to expect, World Malaria Day is preceded by a plethora of stories on how many billions of dollars are spent fighting the disease.

An accompanying chorus comes from actors, footballers and any grinning celebrity who wishes to tell the world how excited they are at the prospect of rich countries buying bed-nets for poor countries.

Thankfully one report with a more balanced outlook comes in today’s Financial Times. Author Andrew Jack notes that while malaria has attracted vast amounts of funds and attention, this will largely be pointless if the root causes are not addressed.

Malaria was until recently present throughout the world, yet now 108 countries can claim to be malaria-free, the article explains. In these countries the roots were tackled, mainly due to economic growth.

The article warns that the politicisation and sudden expansion of anti-malaria efforts can mean resources are “misspent while bringing unintended consequences.”

Bed-nets, for example, may not be a long term solution. If malaria persists, will wealthy governments simply continue to donate billions of dollars’ worth of more nets?

But most importantly, emphasis must be placed on measuring outcomes, rather than assuming inputs are automatically A Good Thing.

‘Too many groups hold themselves accountable by “process indicators” such as the number of nets delivered’, continues Jack, ‘rather than the ultimate impact they are having on mortality and morbidity.’

World Malaria Day always creates a lot of noise. Let’s make sure we see through the hype, and observe the most effective ways for people to overcome this curable disease.

UNAIDS wrong about local production

Exactly one month ago we reported on WHO head Margaret Chan’s somewhat confused pronouncement on the global economic crisis—and now her equivalent at fellow bureau UNAIDS (which shouldn’t really exist) has issued a similarly misguided rallying call.

Governments must somehow create profitable businesses

in Africa that make drugs for treating HIV / AIDS!

This is Michel Sidibé’s message, to paraphrase. In his own words, he wants to “facilitate a discussion around how we can build a business case.”

Good luck with this, Mr Sidibé. You’ll need it, because I’m struggling to think of a prosperous pan-continental industry that was planned and created by governments or the UN.

The most basic economic principles tell us that industries emerge organically due to sufficient demand and comparative advantage. Sufficient demand for HIV / AIDS drugs clearly exists in Africa—so why does only one African country produce their own drugs? That’s right, because there’s no comparative advantage.

There are all manner of reasons for this. In many African areas, for example, electricity supply can be erratic, making pharmaceutical product near-impossible.

Predictably, the UNAIDS head’s motivations are mixed. This isn’t just about AIDS, it’s “important politically” he says, and “important economically”, and “important for the integration of Africa in the global market.”

He’s wrong. African people need the freedom to trade in products and services where they hold comparative advantage, leading to prosperity and better health.

According to the article, Michel Sidibé  “expressed concern that the global financial crisis might hamper his efforts”. On this point alone let’s hope he’s right.

India’s innovation boom

Nearly four fifths of health services in India are provided privately, while recent years have seen some liberalisation of the industry. Barriers to investment have been reduced, and tax breaks offered for enterprises in smaller cities and rural areas.

The result? According to The Economist this week, an innovative boom of cost-cutting technologies that are improving the health of India’s middle- and low-income earners.

The process is aided by India’s economic boom, allowing more people to purchase health insurance.

The article includes many examples, such as Apollo Hospitals, who are opening new facilities in small and medium sized cities, saving costs for people who would otherwise have to travel to large cities.

LifeSpring Hospitals, meanwhile, offer maternity services, with normal deliveries available at a staggeringly frugal $40.

Furthermore, standards are often even higher than in wealthy countries. Nearly 60 per cent of Indian hospitals are using health-information technology, while the figure in the USA stands at a mere 20 per cent.

One American company who have switched to India said they did so in order to “escape over-regulation and the political power of the medical lobby.”

There's a lesson here: cut down regulation and enterprise will prosper. Thankfully India's patients are starting to reap the lesson's rewards.

Anti-corruption NGO steals 'aid' money

In a classic case of "if would be funny if it wasn't so tragic", an NGO set up to monitor recipients of Global Fund aid money in Uganda has itself been found guilty of siphoning off funds through gross corruption.

The Ugana Centre for Accountability was, as the name suggests, supposed to ensure that NGOs really spend donated money on improving the health of Ugandans suffering from TB, malaria or HIV / AIDs. However, Director Teddy Seezi Cheeye has now been convicted for stealing $56,000 of Global Fund money via this organisation.

Cheeye had previously worked for the government, as a director of the President's International Security Organisation. This acts as one further example of the rife corruption that often extends to the heart of government and healthcare services.