This Just In

Videos from the Gates Foundation’s Malaria Forum below.

See Bill Gates’ first post on the ONE Blog here.

An Audacious Goal

This week in Seattle, an extraordinary group of people – scientists, policymakers, and advocates – came together for three days to discuss what can be done to stop malaria. Melinda and I issued a challenge to those attending the meeting. We asked them to begin charting a course to eradicate malaria – not just to control or reduce it, but to work toward a time when no one on earth is infected with malaria, and no mosquitoes carry the disease.

Today, malaria kills more than one million people every year, most of them children in Africa. That’s the equivalent of losing every student in the New York City public school system in one year.

We know that eradicating malaria is an audacious goal. But advances in science and medicine, new political commitments, and the dedication of people like you have given the world an historic opportunity to conquer malaria. It won’t be easy and it won’t happen quickly, but I’m optimistic that we can make this disease history.

At the forum in Seattle, Melinda and I called on the U.S. presidential candidates to commit to expand the President’s Malaria Initiative, a great program started by President Bush. I hope you will join us in asking all of the candidates to make this pledge and keep the fight against malaria on the national agenda.

I am confident that together, we can produce the energy, compassion, and commitment needed to win the fight against malaria.

-Bill Gates

*** To view a webcast of the Seattle malaria forum, visit www.kaisernetwork.org/healthcast/malariaforum2007. For more information about how you can help fight malaria, visit ONE.org.

Make New Friends But Keep the Old

Malaria is capturing the public imagination, bringing a range of new partners that would have seemed unthinkable only a few years ago.

In the last year, tens of thousands Americans — from elementary school students to Fortune 500 companies — have donated money for lifesaving bed nets through the Nothing But Nets and Malaria No More campaigns; American Idol educated 27 million viewers about the disease through its Idol Gives Back charity special; Major League Soccer, the NBA, and the WNBA have joined the ranks, naming malaria as a key public cause; faith groups like the United Methodist Church and Saddleback Church have carried the message to their congregations, in America and around the world.

I caught up with Major League Soccer star Diego Gutierrez, a midfielder for the Chicago Fire and panelist on the “New Partners” session here at the Gates Malaria Forum, to discuss the work he and his wife Ginna are doing to spread the word about malaria through the Nothing But Nets campaign.

What attracted you to this cause Diego?

The sheer numbers of mortalities grabbed my attention. I was challenged by a friend to read some literature and become educated about the subject. After doing so, I couldn’t not act. I want to utilize my platform as a professional athlete to get the message out there. I decided to get involved and get the league involved.

What response do you get when you talk to people about malaria?

We’re seeing unbelievable response from multinational companies down to elementary schools; at every level the response has been phenomenal. It’s a simple message and a profound message that with so little money you can actually save lives. It’s very appealing to the American public and to all age groups. It’s a message not too hard to sell.

(more…)

Show Me The Money

Malaria funding has increased some 300% in the last three years. Between donor funding (~$1 billion), spending by endemic countries and their citizens (~$600 million), and R&D ($400 million), total spending amounts to just under $2 billion a year.

So how much do we need to meet the challenge of malaria?

A recent World Health Organization (WHO) study concluded that it would cost $1.7 billion to $2.2 billion per year over ten years to meet the 80% coverage targets in Africa. Worldwide the figure is $3.8 billion to $4.2 billion/year.

Yesterday at the Gates Malaria Forum, the Boston Consulting Group (BCG) presented a somewhat different set of estimates: $7 billion per year worldwide.

This seemingly vast difference boils down to a few simple assumptions.

First, the BCG study includes a much bigger population than the WHO’s: 3.3 billion people as opposed to 1.9 billion. BCG covers 107 countries (vs. the to 80 for the WHO) and assumes much larger at-risk populations in countries like India, China, and Pakistan.

Second, the BCG study includes $600 million a year for R&D to develop new anti-malaria tools including, eventually, a vaccine. The WHO looks only at the expense of rapidly scaling up current tools.

Having said all that, the two agree as often as not, particularly when it comes to Africa. The BCG estimate for Africa is in the neighborhood of $2 billion to $3 billion per year, just like the WHO’s.

This is a very reasonable number for tackling malaria on the continent where 90% of the more than 1 million annual deaths from malaria occur. Now that’s something we can all agree on.

-Martin Edlund, Malaria No More

Tuesday to Thursday this week, Malaria No More’s Martin Edlund is live blogging on the ONE Blog from the Gates Foundation’s Malaria Forum in Seattle. Malaria No More’s mission is simple: no more deaths from malaria. Learn more and help prevent a million child deaths this year by donating a $10 bed net at www.MalariaNoMore.org.

Hunt for a Malaria Vaccine

A malaria vaccine is the Holy Grail of the medical research world—one of its most tantalizing and allusive prizes.

Time and again scientists have been on the brink of success only to have their hopes publicly and painfully dashed. The height of false hope, perhaps, was in 1984 when the NY Times ran the headline “Malaria Vaccine is Near.”

Researchers were so confident they’d cracked the code that they tested the vaccine on themselves just before flying to a conference where they expected to declare victory. They came down with malaria symptoms the morning after they landed.

The vaccine community is beginning to hope again, cautiously. The Gates Malaria Forum highlighted an important step forward for RTS,S, the world’s most clinically advanced malaria vaccine candidate.

A joint project between GlaxoSmithKline and the Gates-funded Malaria Vaccine Initiative, RTS,S works in two ways. First, it prepares the defense mechanisms of a person to recognize and respond to the malaria parasite before it encounters the genuine article. Second, it helps t-cells attack the parasite as it emerges from the liver (the first stop in the body where it multiplies some 40,000X) and begins to infiltrate red blood cells.

In 2004, RTS,S was shown to provide greater than 50% protection against infection in children 1-to-4 years old. The new study finds that among children under one, the vaccine provides 65% protection against new infections over three months.

This is significant because children 18 months and younger bear a disproportionate burden from the disease: 30% to 50% of the severe disease and deaths occur in that age group. Until now, it was unknown whether the vaccine could help shield them from malaria.

Assuming Phase III trials go as planned next year, RTS,S could be on the market by 2011. But it challenges the traditional understanding of how a malaria vaccine might work. Typically, a successful vaccine is understood to provide 90% to 100% protection. With its lower efficacy rate, RTS,S wouldn’t be a silver bullet. But it would be a powerful and welcome tool in the fight against malaria.

-Martin Edlund, Malaria No More

Tuesday to Thursday this week, Malaria No More’s Martin Edlund is live blogging on the ONE Blog from the Gates Foundation’s Malaria Forum in Seattle. Malaria No More’s mission is simple: no more deaths from malaria. Learn more and help prevent a million child deaths this year by donating a $10 bed net at www.MalariaNoMore.org.

Eradication is Not a Four-Letter Word

The “e-word,” as eradication is nervously known in the malaria community, is highly contagious. At the Gates Malaria Forum it’s spreading by the hour.

Following the significant progress in the UNICEF report released yesterday and the results reported by countries like Zambia and Ethiopia, the conversation has quickly turned to whether eradication is possible and when.

The word took center stage at a Q+A last night. “I think whether it’s the E-word or whatever you want to achieve, the issue is in your desire,” said Minister Tedros of Ethiopia. “If we really are committed to it, we can do it. So I go for the E-word, whether elimination or eradication.”

Melinda Gates took up the challenge head-on in her portion of the keynote this morning: “Any goal short of eradicating malaria is accepting malaria; it is making peace with malaria; it’s rich countries saying: ‘We don’t need to eradicate malaria around the world as long as we’ve eliminated malaria in our own countries.’ That’s just unacceptable.”

She described a “multi-pronged approach” to achieve it, using current tools to dramatically drive down the number of cases, and new tools – including a vaccine – to “totally stop transmission, and end the disease.”

“What is the most repeated failure in all of global health?” Asked Bill Gates to open his keynote remarks. “It could well be the commitment to eradicate malaria.”

Yet he didn’t shrink from the challenge. “We should declare the goal of eradicating malaria because with enough time we can eradicate malaria.” (Bill Gates will lay out his case for why eradication is possible on a future post on this blog.)

By now, the “E-word” has developed into a full-blown epidemic. Margaret Chan, head of the World Health Organization, ended the session with a bracing call to action. “As we are talking here children are dying every minute, and we are still struggling with whether malaria elimination can be done.

“In order to take big steps forward in global public health, we need leaders to make big ambitious goals,” she said. “So come one let’s be brave. I’d like to thank both of you for taking that bold step forward and challenging us. I for one pledge the WHO’s commitment to move forward, and I dare you to come along with us.”

-Martin Edlund, Malaria No More

Tuesday to Thursday this week, Malaria No More’s Martin Edlund is live blogging on the ONE Blog from the Gates Foundation’s Malaria Forum in Seattle. Malaria No More’s mission is simple: no more deaths from malaria. Learn more and help prevent a million child deaths this year by donating a $10 bed net at www.MalariaNoMore.org.

People We’ve Met At the Gates Malaria Forum

ONE is here at the Bill & Melinda Gates Foundation’s Malaria Forum to speak with the many experts who have gathered. Among the people we’ve been lucky enough to talk to are:

Suprotik Basu, who is the Public Health Specialist for the World Bank’s Malaria Control Booster Program. Mr. Basu spoke via video to ONE’s members, telling us that there is a lot to be excited about the world’s efforts to combat malaria.

ONE also spoke with Dr. Christian Loucq, who is the Director of the PATH Malaria Vaccine Initiative. Dr. Loucq made a very exciting announcement the day the Malaria Forum began: PATH is developing a malaria vaccine that is performing extremely well in early testing.

Oliver Sabot, Director of the Clinton Foundation Malaria Control Team, took some time to share some of the exciting work they are doing on the ground in Zambia and elsewhere. Here Oliver is showing us some of the literature they distribute with medicine to treat Malaria. This guide is easy to understand, as its printed in the native language and also includes pictoral instructions for those unable to read.

We are speaking with more experts later and we’ll be sure to fill you in on their inspiring work too!

-Kimberly Cadena

A Tipping Point for Malaria?

Malaria control is moving so quickly that any snapshot of progress is necessarily a blur.

This is certainly true of the new UNICEF report “Malaria & Children: Progress in intervention coverage,” released today at the Gates Foundation Malaria Forum.

It shows that malaria control efforts have turned a corner, setting the stage for dramatic gains in the next few years—and that the rate of change is accelerating.

It’s a tale of two reports, really. The first draws on data from 2005 household surveys across sub-Saharan Africa, which feels like a lifetime ago. In 16 of the 20 African countries where data was available, insecticide-treated net (ITN) coverage at least tripled between 2000 and 2005. Still, only 26% of households in sub-Saharan Africa owned a mosquito net of any kind at the time of the survey—well below global targets.

Medicine is likewsie a mixed bag. Most African governments overhauled their drug policies by 2005 to prioritize effective new Artemisinin-based combination therapies (ACTs) over chloroquine, which was producing drug-resistannce. But the percentage of children treated in Africa actually decreased between 2000 and 2005 (from 41 percent to 34 percent), reflecting the higher cost of ACTs.

The second report, living between the same covers as the first one, tells a far more inspiring story, reflecting the dramatic strides since 2005. Here, all signs point in the same direction.

Funding for malaria control has risen substantially over the past few years. (more…)

Zambia Leads the Way

Tuesday to Thursday this week, Malaria No More’s Martin Edlund is live blogging from the Gates Foundation’s Malaria Forum in Seattle.

Perhaps no country in sub-Saharan Africa is being quite so closely scrutinized as Zambia. Landlocked and malaria endemic, it is an ideal proving ground for what’s possible in malaria control.

It’s difficult to exaggerate the role malaria plays in daily life in the country. Nearly 20 percent of Zambian children do’’t reach their 5th birthday, and malaria is the single biggest reason why. There are 4 million reported malaria cases in the country each year, and an estimated 50,000 deaths due to the disease.

Roadside billboards warn about the threat of malaria on the way to and from the airport; Boy Scout troops get merit badges for their knowledge of the disease. In some provinces, as many as 1/3 of all children are sick with the disease at any one time.

But these alarming stats only make the country’s recent turnaround all the more impressive.

Zambia will distribute 3 million insecticide-treated nets by the end of year, putting it on track to reach its goal of 80% coverage by 2008; 62% of pregnant women received preventative treatment nationwide; and indoor residual spraying (IRS) of insecticides has reached 85% coverage in 15 target districts, protecting 250,000 structures (or 1.5 million people).

Part of what sets Zambia apart is the quality of its data. Thanks to its partnership with the Gates-funded MACEPA project, Zambia is able to go beyond mere distribution figures to measure real impact.

Minister Chituwo shared some of the results at the opening session of the Gates Forum. Children 5 and under living in households with two or more mosquito nets had 38% fewer cases of fever, 51% less malaria infection, and 30% less severe anemia than those in houses without mosquito nets or IRS, he reported. “Immediately we have been able to see the numbers of children in hospitals declining.”

Far from satisfied, Minister Chituwo challenged the Gates audience to go further. “If these results are showing success, it is a matter of aiming higher,” he said. “80 percent [coverage] by 2008, with the help we are having surely we can do better. Why not 100 percent?”

-Martin Edlund, Malaria No More

Malaria No More’s mission is simple: no more deaths from malaria. Learn more and help prevent a million child deaths this year by donating a $10 bed net at www.MalariaNoMore.org.

Rolling Out the Red Carpet

Seattle is welcoming malaria notables with fanfare usually reserved for movie stars. In fact, they’re hardly distinguishing between the two.

A cover article in today’s Seattle Times calls the Gates Malaria Forum malaria’s “Oscars,” its “Woodstock.” “This is probably as competitive a ticket as the Bruce Springsteen concert,” one fortunate attendee is quoted as saying. (Read the full text here.)

Here come some of the malaria A-listers now. As the conference gets underway, it’s worth knowing who they (and the institutions they represent) are…

• Rear Admiral Tim Ziemer is the head of the U.S. President’s Malaria Initiative (PMI), a $1.2 billion five-year initiative to control malaria. Looking dashing in work boots still caked with red dirt, he is just back from one of the 15 African countries where PMI is working to cut malaria deaths by half. By the end of 2007, the program expects to reach 30 million people with lifesaving malaria prevention and treatment.
• Chairman of the Board of the Global Fund to Fight AIDS, TB, and Malaria, Rajat Gupta, comes from the private sector as a senior partner worldwide of McKinsey & Company. The Global Fund was created by the world’s wealthiest countries in 2002 and currently provides 2/3rds of all funding for malaria prevention and treatment programs worldwide — almost $3 billion since 2002.
• And the click of cameras can only mean, yes, it’s Minister Tedros Adhanom Ghebreyesus, the Minister of Health from Ethiopia. Minister Tedros is a rising star in malaria circles thanks to his country’s aggressive distribution of nearly 20 million bed nets over the past two years. As recently as 2003, Ethiopia trailed its neighbors with only five percent of households owning a single bed net. Today, it is fast-approaching an unprecedented goal: providing two long-lasting insecticide-treated nets for all households in malaria-endemic areas.

And with that, the orchestra is warming up and the conference is getting underway. Let us send you inside…

-Martin Edlund, Malaria No More

Malaria No More’s mission is simple: no more deaths from malaria. Learn more and help prevent a million child deaths this year by donating a $10 bed net at www.MalariaNoMore.org.