I recently returned from Tete Province, Mozambique, where I helped to distribute bed nets and malaria medications to remote communities on the Zambezi River. I joined the adventurous and ambitious Roll Back Malaria Zambezi Expedition, a two-month voyage tracing Dr. David Livingstone’s trip down the river 150 years ago. The Zambezi Expedition aims to track successes and challenges of controlling malaria in six countries in malaria-endemic southern Africa: Angola, Namibia, Botswana, Zambia, Zimbabwe and Mozambique. I joined toward the end of the Expedition, during which crew members and medical teams have traveled more than 1,550 miles to deliver bed nets and medications to remote areas along the river, many of which are accessible only by boat.

We visited one village near the old colonial Boroma Mission, a few miles upstream from the city of Tete. Though we arrived only the evening before to tell the villagers that we would be coming to deliver bed nets, we found the entire village gathered, health cards in hand, early the next morning when we crossed the river from our campsite. They greeted us with impromptu singing and dancing, incorporating the sting of a mosquito’s bite and malaria’s fever and chills in their movements. One of the village women kept the crowd in gales of laughter as she mimed the mosquito’s treacherous path through the night to the sleeping victim. When we hung a bed net from a nearby tree to demonstrate how to use it, she crawled under it and pretended to sleep soundly and safely to illustrate the point.

The Zambezi Expedition’s goal is to show that coordinated action can force back the spread of malaria and help save millions of lives. As this visit showed, Africans along the Zambezi’s banks are eager to join in the fight against malaria—they have the energy, the drive and the dedication—all they need are the tools. The Expedition has drawn to a close, but the lessons of how international support and local implementation can and must go hand in hand are clear.

To learn more about the Roll Back Malaria Zambezi Expedition, go to
www.zambezi-expedition.org

-Emily Bergantino, Malaria No More

(Martin Edlund of Malaria No More joined President Bush’s on the Ghana portion of the president’s trip to Africa.)

It was a day of firsts for me. My first time meeting a sitting president. My first time racing through streets in a presidential motorcade. My first time seeing malaria education set to music.

President and Mrs. Bush made malaria a big focus of their stop in Ghana, where they were joined by American Idol Winner Jordin Sparks and Malaria No More. Sparks opened a noontime event at the U.S. Embassy with a Super Bowl-sized rendition of the national anthem that made the speakers whimper and moved patriotic listeners to tears.

President Bush took the mic to praise American Idol for raising $17 million for malaria during last year’s Idol Gives Back charity special and share some exciting news:

This spring, Fox and American Idol will once again appeal to viewers to help defeat malaria. On April 9th, the show will raise money to fight malaria in Africa and support other worthy causes in the second round of “Idol Gives Back.” Laura and I hope, and Jordin hopes, that America’s generosity will still pour forth, and we ask our fellow citizens to contribute to this worthy cause. (Applause.)

(Read the full transcript here, including the President’s shout out to Malaria No More.)

It was a short event – half hour all told – but plenty long for us to sweat through our suits in the soupy afternoon heat. “This reminds me of what it’s like to campaign in Texas in August,” quipped a glistening Commander in Chief. Still, he took the time to press the flesh with the hodge-podge audience of scruffy PeaceCorps volunteers, Ghanaian women in traditional dress, and Idol-loving tweens.

Lunch was served on the Embassy lawn flanked by mini-golf versions of the Capitol, the Lincoln Memorial, and the Washington Monument while the bar offered bottles of Schweppes tonic in a subtle (okay, probably unintended) homage to the days when the quinine in tonic was used to ward off malaria.

From there, we raced off to Maamobi Polyclinic on the outskirts of Accra where Jordin and Mrs. Bush were greeted by a traditional durbar—a Ghanaian community gathering complete with song, dance, and umbrella-wielding day-glo chiefs.

Jordin and Mrs. Bush did a bed net demonstration and kids sang a malaria song withwith mosquito-wing choreography. It’s what happens when well-intentioned public health professionals try their hand at pop song. Sample lyrics:

From home to home
From school to school
Children are saying
Give us treated bednets
To keep us protected
But if malaria attacks
For lack of protection
Give us early treatment
To save our lives

Somewhere Simon Cowell is scowling fiercely. For my part, I’ll stick with Jordin’s single “Tattoo” which I’m rocking on my (Product)Red iPod as I write this.

-Martin Edlund, Malaria No More

American Idol winner Jordin Sparks is sitting on the concrete floor of the airport here in Accra, Ghana thumbing away at her iPhone when she’s approached for her first autograph. “Of course,” she says, flashing the brillian smile that helped her to win over millions of Idol voters. She’s delighted and a bit surprised to be recognized so far from home.

Jordin has come to Ghana with Malaria No More to participate in the President’s trip to Africa and learn more about malaria, a disease which kills an estimated 900,000 Africans each year, mostly children and pregnant mothers.

Last year’s Idol Gives Back charity special raised $75 million for charities in American and Africa, including $17 million to fight malaria. Malaria No More used part of that money to protect 2 million moms and kids with insecticide treated bed nets in Angola, Madagascar, Mali, Uganda, and Zambia. The President and Mrs. Bush appeared on last year’s Idol Gives Back to thank viewers for their support. Now Jordin’s here to return the favor.

Today, she’ll appear alongside the First Couple at a series of events highlighting the US President’s Malaria Initiative, a $1.2 billion five-year program operating in 15 African countries and is just getting underway here in Ghana. She’ll do a bed net demonstration alongside Mrs. Bush at a malaria clinic on the impoverished fringes of Accra this afternoon. On the drive back from the rehearsal yesterday, our photographer, a cheery Ghanaian named Jeff, said that households in the area are stricken with 1 malaria case every month on average, a consequence of their windowless cinderblock homes and lack of bed nets. Malaria accounts for 22% of deaths among children under five here in Ghana and 44% of health clinic visits.

Tomorrow, we’ll head out into the field with a USAID rep named Bethanne to see the impact of malaria on rural communities and get a look at what they’re doing to fight back. Stay tuned. And if you’d like to help make a different, donate $10 for a bed net at www.MalariaNoMore.org.

-Martin Edlund, Communications Director, Malaria No More

Videos from the Gates Foundation’s Malaria Forum below.

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

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.

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…)

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.

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.

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.

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