Researchers at the Johns Hopkins Malaria Research Institute have for the first time produced a malarial protein (Pfs48/45) in the proper conformation and quantity to generate a significant immune response in mice and non-human primates for use in a potential transmission-blocking vaccine. Antibodies induced by Pfs48/45 protein vaccine effectively blocked the sexual development of the malaria-causing parasite, Plasmodium, as it grows within the mosquito. Sexual development is a critical step in the parasite’s life cycle and necessary for continued transmission of malaria from mosquitoes to humans.

“Development of a successful transmission-blocking vaccine is an essential step in efforts to control the global spread of malaria. In our study, we demonstrate the relative ease of expression and induction of potent transmission-blocking antibodies in mice and non-human primates. This approach provides a compelling rationale and basis for testing a transmission-blocking vaccine in humans,” said Nirbhay Kumar, PhD, senior author of the study and professor in Johns Hopkins Bloomberg School of Public Health’s W. Harry Feinstone Department of Molecular Microbiology and Immunology.

For the study, the research team expressed full-length Pfs48/45 in E. coli bacteria to produce the vaccine. Previous attempts to fully express the protein had not been successful. The vaccine was first given to mice in the laboratory. The vaccine was also tested in non-human primates (Olive baboons) in Kenya with similar results. According to the study, a single-dose vaccine provided a 93 percent transmission-blocking immune response, reaching greater than 98 percent after a booster given several months later.

“This is an exciting beginning to what might become an important tool in the arsenal for malaria control and progressive elimination of malaria transmission,” said Kumar. There is no animal reservoir for human malaria and in that regard it is possible to gradually reduce malaria transmission to a point of almost eradication. However, Kumar cautioned that more research is needed to achieve that goal. For one, similar research efforts are needed to reduce transmission of Plasmodium vivax, another major human malaria parasite.

Malaria affects greater than 500 million people worldwide and is estimated to kill over one million people each year, most of whom are children living in Africa.

The study is published in the July 22 edition of the journal PLoS One. In addition to Kumar, “A Potent Malaria Transmission-Blocking Vaccine Based on Condon Harmonized Full Length Pfs48/45 Expressed in E. Coli” was published by Debabani Roy Chowdhury, a postdoctoral fellow of the Johns Hopkins Bloomberg School of Public Health; Evelina Angov of the U.S. Military Malaria Vaccine Program; and Thomas Kariuki of the Institute of Primate Research in Nairobi, Kenya.

The research was supported by grants from the National Institutes of Health and the Johns Hopkins Malaria Research Institute.

“Let’s use some Atlanta drug money,” said Facundo M. Fernández, a chemistry professor, as he picked out a limp, ratty dollar bill from his wallet and handed it to one of his graduate students.

Minutes later, after running the bill through the laboratory’s high-tech machinery, the chemists had found what they were looking for: traces of cocaine.

Dr. Fernández, a professor at the Georgia Institute of Technology, said that the demonstration, which he repeated with other bills provided by a reporter, showed both how pervasive cocaine was in the United States and how sensitive his machines were.

They can instantly identify the chemical makeup of food, drugs and just about anything placed in front of their stainless-steel aperture. The uses of the machines, known as mass spectrometers, are manifold — the federal Department of Homeland Security has commissioned Dr. Fernández to study whether the technology can help sniff for explosives at airports.

But Dr. Fernández’s main focus is counterfeit pharmaceutical drugs, especially in poorer countries, where government regulation is weak. He is part of an informal group of researchers and government officials spanning Africa, Asia and the United States who have teamed up with Interpol, the international police agency, to use cutting-edge technology in tracking fake drugs that claim to treat malaria. Counterfeit malaria drugs are of particular concern because of the scale and severity of the disease — it kills more than 2,000 children a day in Africa alone — and fears that fake or substandard malaria drugs are aggravating a growing problem of drug resistance.

For years, scientists have been able to analyze the ingredients of a pill or capsule using mass spectrometers, which identify chemicals by measuring molecular weights. But the overall process was time-consuming, taking about an hour per sample.

A scientific breakthrough in 2005 added an “ion gun” to the machines and allowed Dr. Fernández to check hundreds of pills a day. A technician simply holds the sample — a pill, dog food or a dollar bill, for example — up to the machine, which emits a jet of helium gas and captures a minute amount of the material, instantly identifying its component parts.

Contrary to the common belief that counterfeit drugs are just sugar pills, Dr. Fernández said, most fakes have some level of active ingredient. Many contain the cheap and readily available pain reliever paracetamol, which might temporarily soothe some symptoms but will not fight the underlying disease.

Sometimes researchers find harmful or very unexpected chemicals. Once, when analyzing what was suspected to be a counterfeit antimalarial pill, his team discovered traces of sildenafil, the main ingredient in the anti-impotency drug Viagra.

“We feel like detectives,” said Dr. Fernández, who is from Argentina. “You never know what you’re going to find.”

The counterfeit drug business has become increasingly attractive for criminal syndicates; the profit potential is vast, yet the punishment for those caught is typically much less severe than for illegal drugs like cocaine, law enforcement officials say.

This is especially true in Asia, where many countries impose the death penalty for trafficking heroin, Ecstasy or even marijuana but where combating counterfeit drugs is not a priority.

Three years ago, the World Health Organization estimated that as many as one in four pharmaceutical drugs sold in the developing world were counterfeit. It is impossible to know the exact level, but there is general agreement that the level of fake drugs is “unacceptably high,” in the words of the organization…

Story continues at: http://www.nytimes.com/2009/07/21/science/21coun.html?_r=1&hp

A few years ago University of California, Berkeley, professor Daniel Fletcher challenged the undergraduate students in his optics and microscopy course to develop an instrument using only a cell phone and a few objective lenses. It was not until after the project began that Fletcher and the students realized they had created a powerful yet inexpensive instrument that could potentially be used to test for diseases common in developing countries, such as malaria, sickle-cell anemia and tuberculosis.

These diseases in particular have wreaked havoc in Africa. In 2003 in the 10 African countries with available data, 11,875,108 people had malaria, according to the World Health Organization (WHO). Approximately 300,000 infants are born in Africa each year with sickle- cell anemia, and tuberculosis is the leading killer of people with HIV and in 2007 alone infected an estimated 1.9 million people in sub-Saharan Africa.

Financial limitations prevent the diagnosis and treatment of these diseases. According to Dina Sigano, a research scientist who has volunteered at missionary hospitals in Kpele Tsiko, Togo, in west Africa and Andhra Pradesh in India, "Getting functioning equipment like the light microscopes needed to identify malaria is a challenge. " Laboratory-grade versions cost thousands of dollars, and Sigano notes that once equipment is purchased there is no money to maintain and repair it.

Fletcher and his colleagues believe that their device, which they call the CellScope, will provide an inexpensive alternative to the microscopes. The group made a removable adapter that fits over the camera lens on a standard Nokia N73 cell phone. David Breslauer, lead author on the study published in PLoS One, demonstrates the adapter in a video on the university’s Web site. It comprises inexpensive standard microscope eyepieces and objective lenses, along with high-power LEDs, which illuminate the object.

To determine the usefulness of the CellScope, the group obtained and analyzed samples from patients confirmed to have malaria and sickle-cell anemia. Petri dishes containing each sample were clipped onto the end of the adaptor and magnified by the lenses. The phone’s camera captured the enlarged images of the cells. The malaria-infected blood cells had turned blue with the addition of Giemsa stain and could clearly be seen on the cell phone screen; the irregular crescent moon–shaped sickle cells were easy to spot, as well.

Testing for tuberculosis was trickier. Currently, the best method is to stain cells with a dye that will fluoresce when the pathogen is present and use a fluorescent microscope—a variation of the light microscope— to see the glow. Such microscopes, however, cost tens of thousands of dollars.

While developing the CellScope, Brelauer’s group noticed that blue light-emitting diodes provide enough light to trigger this fluorescence. The discovery, he says, "was somewhat serendipitous. It so happened that we were working on this at the same time that LED technology started becoming affordable." The researchers added blue LEDs to the adapter, at a cost of about $10 each, and each diode lasts about 50,000 hours, according to Breslauer. The group even had room to add filters, which are used in fluorescent microscopes to block extraneous light from contaminating the image…

Story continues at: http://www.scientificamerican.com/article.cfm?id=cell-phone-adapter-becomes-microscope&page=2

The South African Research Ethics Training Initiative, SARETI, is a joint project by the University of KwaZulu-Natal, the University of Pretoria, faculty from Johns Hopkins University, and the Fogarty International Center of the US National Institutes of Health to offer advanced learning in health research ethics. The programme is aimed at scientists, health professionals, members of ethics review committees, public health personnel, social scientists, philosophers, ethicists, health journalists, lawyers, and other professionals whose work impacts on health.

SARETI is an African programme in health research ethics that offers modular, academic and practical learning. Trainees develop the expertise required to ensure that health research in Africa has the welfare of individuals and of communities as its primary focus. SARETI offers Masters programmes (MPH and M Soc Sci with majors in health research ethics), to 3-6 month self-funded Fellowships for senior professionals, to one-week intensive short courses.

SARETI announces the availability of scholarships that offer full financial support for two Masters degree trainees in 2010. These scholarships are available to professionals involved in health research ethics and health research and who are resident in Africa. (Scholarships for short courses / non-degree programme are not available for 2010, but self-funded students are welcome to apply for these programmes or particular modules.)

Applications for the 2010 Masters programme (which starts in January 2010) are invited. The closing date for applications is 21st August 2009. For further information and application forms, see SARETI’s website: http://www.up.ac.za/sareti or contact:

Mrs Carla Pettit, School of Psychology, Faculty of Humanities, Development and Social Sciences, University of KwaZulu-Natal; Private Bag XO1; Scottsville 3209; Pietermaritzburg; South Africa; Tel: +27-33-260-6162; Fax: +27 33 260 5809; E-mail: pettitc@ukzn.ac.za 

OR

Ms Faith Seme, School of Medicine, Faculty of Health Sciences, University of Pretoria, PO Box 667, Pretoria, 0001, South Africa; Tel: +27 12 354 1002; Fax: +27 12 354 1367; Email: faith.seme@up.ac.za

Gaia Luoni Prize 2009 Euro 10.000,00

Deadline for applications: 27 July 2009

The Gaia Luoni Fund was created within the framework of activities of the Istituto Pasteur-Fondazione Cenci Bolognetti in memory of Dr. Gaia Luoni, a young researcher prematurely passed away.

The Fund, a donation by Gaia Luoni’s family, finances the Gaia Luoni Prize of 10.000,00 Euros awarded annually to support leading young researchers who made an outstanding contribution to the field of Genetics of malaria

Applications for The Gaia Luoni Prize 2009

·         Applicants must have received a University degree not earlier than 27 July 2003;

·         On line submissions and/or paper submissions signed in original by the applicant must be sent to the Istituto Pasteur-Fondazione Cenci Bolognetti (address given below) by July 27 2009;

·         Applicants must include: (i) a curriculum vitae; (ii) an official certificate of their University degree, and documentationattesting if they received a PhD (if available); (iii) a scientific project in the relevant field (max 20.000 characters);(iv) a list of publications; (v) any other information or document useful for the evaluation of their training andachievements

·         The Prize will be assigned following evaluation by an international Committee nominated by the Istituto Pasteur-Fondazione Cenci Bolognetti. The decision of the Committee is definitive, and its report will be notified to Gaia Luoni’sfamily as well as to other contributors to the fund.

·         The Gaia Luoni Prize 2009 will be presented to the awardee on the occasion of the Istituto Pasteur Science Days that willbe held in Rome on October 9 th and 10 th 2009 on Liver development and disease.

·         The awardee is requested to aknowledge the contribution of the Gaia Luoni Prize in any publications relevant to theproject carried out.

Postal address:

Istituto Pasteur-Fondazione Cenci Bolognetti Sapienza Università di Roma,

P.le Aldo Moro, 5 - 00185 Roma (Italy) E-mail address: pasteurcenci@uniroma1.it 

Chowdhury DR, Angov E, Kariuki T, Kumar N. A potent malaria transmission blocking vaccine based on codon harmonized full length Pfs48/45 expressed in Escherichia coli. PLoS One. 2009 Jul 22;4(7):e6352.

Malaria caused by Plasmodium falciparum is responsible for nearly 1 million deaths annually. Although much progress has been made in the recent past, the development of a safe, effective and affordable malaria vaccine has remained a challenge. A vaccine targeting sexual stages of the parasite will not only reduce malaria transmission by female Anopheles mosquitoes, but also reduce the spread of parasites able to evade immunity elicited by vaccines targeting pre-erythrocytic and erythrocytic asexual stages...

John PA Lusingu , Samwel Gesase , Salum Msham , Filbert Francis , Martha Lemnge , Misago Seth , Samwel Sembuche , Acleus Rutta , Daniel Minja , Method D Segeja , Samuel Bosomprah , Simon Cousens , Ramadhani Noor , Roma Chilengi  and Pierre Druilhe. Satisfactory safety and immunogenicity of MSP3 malaria vaccine candidate in Tanzanian children aged 12-24 months. Malaria Journal 2009, 8:163doi:10.1186/1475-2875-8-163

Development and deployment of an effective malaria vaccine would complement existing malaria control measures. A blood stage malaria vaccine candidate, Merozoite Surface Protein-3 (MSP3), produced as a long synthetic peptide, has been shown to be safe in non-immune and semi-immune adults. A phase Ib dose-escalating study was conducted to assess the vaccine’s safety and immunogenicity in children aged 12 to 24 months in Korogwe, Tanzania…

Dickert N, Wendler D. Ancillary care obligations of medical researchers. AMA. 2009 Jul 22;302(4):424-8

An investigator planning a study in Africa of the prevalence of pulmonary hypertension in children with severe malaria anticipates that she and her team will encounter significant unmet health needs during the course of the study. She recognizes that study procedures, particularly echocardiography, may identify and diagnose conditions that are not treatable within the local health system due to resource constraints. Aware that some of these needs may be serious, as well as difficult and costly to treat, she asks the bioethics consultation service for assistance in determining the extent to which she as an investigator has a responsibility to provide clinical care for conditions that she finds while conducting the study…

Bruno P Mmbando , Method D Segeja , Hamisi A Msangeni , Samwel H Sembuche , Deus S Ishengoma , Misago D Seth , Filbert Francis , Acleus S Rutta , Mathias L Kamugisha  and Martha M Lemnge.  Epidemiology of malaria in an area prepared for clinical trials in Korogwe, north-eastern Tanzania. Malaria Journal 2009, 8:165doi:10.1186/1475-2875-8-165

Site preparation is a pre-requesite in conducting malaria vaccines trials. This study was conducted in 12 villages to determine malariometric indices and associated risk factors, during long and short rainy seasons, in an area with varying malaria transmission intensities in Korogwe district, Tanzania. Four villages had passive case detection (PCD) of fever system using village health workers…

Matee MI, Manyando C, Ndumbe PM, Corrah T, Jaoko WG, Kitua AY, Ambene HP, Ndounga M, Zijenah L, Ofori-Adjei D, Agwale S, Shongwe S, Nyirenda T, Makanga M.  European and Developing Countries Clinical Trials Partnership (EDCTP): the path towards a true partnership. BMC Public Health. 2009 Jul 20;9(1):249.

European and Developing Countries Clinical Trials Partnership (EDCTP) was founded in 2003 by the European Parliament and Council. It is a partnership of 14 European Union (EU) member states, Norway, Switzerland, and Developing Countries, formed to fund acceleration of new clinical trial interventions to fight the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS), malaria and tuberculosis (TB) in the sub-Saharan African region. EDCTP seeks to be synergistic with other funding bodies supporting research on these diseases...

The Wellcome Trust, the largest charity in the United Kingdom, has pledged £30 million (US$50 million) to support health research at more than 50 African institutions.

The charity unveiled the grant package on 2 July. The money will be channelled through seven new international and pan-African consortia, each led by an African research institution, and spread across 18 countries on the continent.

It will be used to revamp laboratories, to train laboratory personnel and to fund grants. The trust hopes that the consortia will develop into thriving research communities that benefit public health by methods such as reducing infectious diseases and improving sanitation. Better-equipped labs and improved career prospects for researchers should also help to stem the brain drain of Africa’s most able scientists.

"It is essential that the best and brightest researchers have access to training opportunities and career pathways in their home countries," says Mark Walport, director of the trust. "There is no use training excellent researchers in Africa unless a first class environment is also available in which they can develop their careers and pursue their research."

There are already many programmes that target higher education and research in Africa. Between 2000 and 2008, the Partnership for Higher Education in Africa, financed by American charitable organizations, put $337 million into research and education initiatives in nine African countries.

And the Nelson Mandela Institute in East London, South Africa, is spearheading an effort to raise $5 billion to establish centres of excellence in science and technology across sub-Saharan Africa. The first such institution, the African University of Science and Technology in Abuja, Nigeria, opened its doors in 2008, and there are plans to create centres in Burkina Faso, Tanzania and South Africa.

Donor dependence

"There are other collaborations and networks, but the lack of research capacity is a huge problem and it’s going to take more than one initiative to achieve this," says Jimmy Whitworth, head of international activities at the Wellcome Trust.

Damtew Teferra, the Africa and Middle East director of the Ford Foundation’s International Fellowship Program, based in New York, points out that African research is still heavily dependant on external funding of this kind. "In most African countries, the amount of money put aside for research is peanuts; 70-80% of research depends on external donors," he says.

One of the consortia receiving Wellcome Trust funding, the Research Institute for Infectious Diseases of Poverty (IIDP), involves six African institutions, and particularly focuses on malaria. Researchers and students should benefit because each of the partner institutions has different areas of expertise, says Margaret Gyapong, director of the Dodowa Health Research Centre in Ghana and chair of the consortium. "The University of Bamako in Mali specializes in genome research and lab work, and here in Ghana we focus on social science and field-based work," she says.

But more partners means that each institution receives a smaller portion of the funding. Most of the roughly $2 million allotted to Gyapong’s consortium will be used to fund PhDs and postdoctoral training.

Gyapong says The Wellcome Trust grant is a good start, but even more funding will be needed to make her research network competitive. For example, "we had to cut our plan for IT support", she says. "And currently I am sitting here with no internet access."

Scientists at Seattle Biomedical Research Institute announced Monday they’ve made progress toward developing a malaria vaccine using a weakened form of the malaria parasite.

Dr. Stefan Kappe, lead researcher for the institute’s malaria program, said he has found a way to genetically engineer malaria-causing parasites and that his test vaccine has proved 100 percent effective in trials on rats and mice. Kappe said his lab will start testing the vaccine on human volunteers early next year.

The announcement came during a conference in Seattle organized by We Work for Health, a network of life-sciences business in Washington state created in April.

As part of a public literacy campaign, the organization Monday released a report about 119 new medicines being developed by companies with a presence in Washington.

The event at Seattle Biomedical Research Institute on Westlake Avenue North brought together not only scientists and business people, but also Gov. Chris Gregoire and other political figures. Several people made presentations during the event.

"I want to showcase this kind of stuff [medical research] because of its power to inspire us as a population," said Lee Huntsman, one of several co-chairs for We Work for Health and a longtime bioengineering researcher at the University of Washington, where he served as interim president for about 2 ½ years.

Huntsman said he wants people to realize that the state has become a key player in the fields of biotechnology and biomedicine. He wants to give the public an opportunity to share in the delight of that progress, he said.

Gregoire emphasized the need for research to be done collaboratively.

"It’s not about one scientist or one facility or one state or one nation, it’s about all of us working together," she said.

The conference was a snapshot of the efforts to realize that goal, said Gregoire.

A breast-cancer survivor, Gregoire developed the $1 billion Life Sciences Discovery Fund in 2005. The goal of the state-sponsored initiative is to put Washington at the forefront of health research.

Money spent on medical research ultimately has a big impact in reducing health-care costs, said Ken Johnson, senior vice president of communications for Pharmaceutical Research and Manufacturers of America.

For every dollar spent on medicine, he said, the country saves $6 to $7 in health-care costs. That’s why it’s important to support efforts like Kappe’s, he said.

Kappe’s presentation covered his team’s malaria research, which is funded by the Bill & Melinda Gates Foundation.

Malaria, one of the world’s deadliest diseases, is often transmitted by mosquitoes. Kappe said it kills more than 6 million people a year — close to the population of Washington.

With varying success over the years, scientists have attempted to use parts of the malaria-causing parasite as a vaccine. So far, the best vaccine protects against malaria only 30 to 50 percent of the time.

So Kappe, who wants to find the magic bullet, has figured out a way to "copy and paste" into the genes of the parasites. By directing electricity into its DNA, he can pop out the gene that allows the parasite to develop inside a host’s liver. He then replaces that gene with a neutral piece of DNA, he said.

Malaria-causing parasites usually develop inside the liver for about seven days before they can get into the bloodstream and cause disease, Kappe explained. Without the ability to progress past the liver, the parasite is harmless.

Kappe said he hopes the vaccine will prove 100 percent effective in humans.

"We want to eradicate malaria," he said. "We want to get rid of it totally."

Just about one-third of people seeking malaria treatment in Kenya received the recommended artemisinin-based combination therapies (ACTs) and some people are being treated with ineffective drugs like chloroquine, which was phased out almost 10 years ago, according to the recently launched 2007 Kenya Malaria Indicator Survey – the country’s "first ever comprehensive malaria study," the Daily Nation reports (Gathura/Cheboi, 6/30).

Elizabeth Juma, the head of the Division for Malaria Control in the Ministry of Public Health and Sanitation, said the survey focused on children younger than age five because of their vulnerability to the transmission of malaria, Capital News reports. (Karong’o, 6/30).

The survey also found that prescription drugs were being sold over the counter, and it calls on the Pharmacy and Poisons Board to ensure medicines are regulated, according to the Daily Nation. The report also recommends that children presenting with fever be tested for malaria and treated accordingly, "which is bound to raise debate given that most health clinics do not have the facilities and equipment to undertake such tests," writes the Daily Nation (6/30).

According to Capital News, "[t]he report further indicated that at least 61 percent of Kenyan children do not sleep under Insecticide Treated Nets (ITNs), which are recommended for preventing malaria spread." Juma said efforts to promote the use of bed nets must be scaled up (6/30).

Kenya Broadcasting Corporation reports that Kenya National Bureau of Statistics Director Anthony Kilele said the country needs to increase ITN usage by pregnant women to reach a 60 percent coverage target. "The survey results indicate that areas where two mass net distribution campaigns were conducted reported a higher ITN usage among children under five than areas in which there were no such campaigns," he said.

Kikele also said the survey showed that up to 30 percent of outpatient health facility visits and 19 percent of admissions to health facilities in Kenya are due to malaria (Kamau/KNA, 6/30). "The delay in releasing the report was blamed on the post 2007 election crisis," Capital News writes (6/30).

Deadline for submission of letters of intent: 30 July 2009

Since its creation, the Multilateral Initiative on Malaria (MIM) Secretariat has rotated from United Kingdom, USA, Sweden and to Africa in 2006. The African Malaria Network Trust (AMANET) in Tanzania is currently hosted the MIM Secretariat for a 5 year period.

In order to be able to face the new challenges arisen by its move to Africa, the MIM secretariat has revised its strategic plan for being more engaged in the coordination of research activities in Africa and to work hand-to-hand with African researchers; as example by being involved in the coordination of the Central Africa Network of Excellence supported by EDCTP or by strengthening collaboration with African networks, institutions and research groups.

With many players in the field of research capacity building/strengthening and taking into account that each organization needs visibility for its own survival, it becomes crucial for MIM to clearly identify its niche. MIM can be viewed as a unique alliance that has given African scientists in African institutions, a voice and an opportunity to build capacity and contribute to new knowledge while setting their own research agenda.

From January 2011, the secretariat will move from Tanzania to another institution. In keeping with the tradition of engaging partners openly and transparently in advancing the MIM agenda, we invite applications for hosting the next MIM Secretariat.

Who can apply?

•              Organizations/institutions or agencies in Sub-Saharan Africa involved with malaria research, research funding and research capacity strengthening in malaria endemic countries.

•              An alliance of organizations and/or institutions from Sub-Saharan Africa and a Northern partner by preparing a joint application.

Applications have to be submitted by the institution from the South.

Candidates will be required to give details on the following:

1)    Willingness and ability to support the Secretariat functions

2)    Proposed activities to be carried out by the Secretariat over a 3 to 5 year period.

3)    Joint application:  role of each institution in the partnership for supporting the MIM secretariat

4)    Proposed budget for the Secretariat and its activities

5)    Demonstrated ability to fund the Secretariat budget

6)    Information regarding capacity to maintain the communications, including easy email access

7)    Demonstrate organization/institute/agency has good organizational capacity

8)    Demonstrate organization/institute/agency has strong scientific capacity

Duties and Responsibilities of the MIM Secretariat

Established in 1997, MIM is an alliance of organizations and individuals, and four autonomous constituents which comprise the MIM Secretariat, MIM at WHO/TDR (MIM/TDR), MIM Communications (MIMCom, at the US National Library of Medicine) and Malaria Research Reference Reagent Resource Center (MR4, at the American Type Culture Collection) for the promotion of capacity development through collaboration to undertake malaria research that lead to the control of the disease in Africa.

The new Secretariat will decide to what level they will fund Secretariat activities. It is expected that core support will be provided for administrative costs and salaries of personnel, the organization and financial support of one MIM Pan-African Conference, as well as support for raising funds from other sources. In addition to core functions, it is expected that the Secretariat will also strengthen malaria research capacity in endemic regions by organizing workshops and training opportunities on topics including grant writing, peer review, writing scientific papers, making presentations, and developing leadership skills; promote research and networking, and be involved in coordination of research activities with African researchers.

Budget for MIM Activities

Financial support of the next Secretariat would be expected to come from the host organization (or collective). The MIM Secretariat also raises financial support to co-fund workshops and other activities it organizes. Funds for the MR4 program are from NIAID at the US National Institutes of Health (NIH). Funds for MIMCom are from the National Library of Medicine (NLM) at the NIH and from the local recipient programs or their Northern sponsors. Funds for the MIM/TDR program are from a variety of sources The MIM Secretariat helps convene funders to raise support for various MIM activities (such as MIM/TDR), but the parties responsible for the various MIM activities are responsible for fund raising for those activities in conjunction with the Secretariat. The MIM Secretariat also helps in identifying new funding opportunities and partners for MIM. MIM Secretariat is fully responsible for funds related to effective functioning of the MIM Secretariat. Other programs such as MR4, MIM/TDR, and MIMCom, have a decentralized decision-making and fund-raising structure, but they all work to support broad goals of MIM. All research grant decisions are made by the MIM/TDR Task Force. MR4 has a Scientific Advisory Board (SAB) to decide on workshop funding etc. The MIM Secretariat and MIMCom identify priorities and related funding decisions through broad but informal consultative mechanisms.

Transfer of Duties

To aid the transfer of knowledge and enable the Secretariat to become functional as soon as possible after the transfer, it is recommended that there is a period of overlap with a coordinator from the newly elected Secretariat working with the current Secretariat for 2-5 months.

Mechanism of voting

The previous MIM Secretariat at Fogarty International Center developed a voting mechanism to ensure that the transfer of the Secretariat was conducted in a fair and transparent manner. It was decided that a group of representatives of the funding partners and international organizations, and an equal number of malaria research institutes in Africa will be represented as voting members. The voting members are identified based on their significant and direct involvement with MIM, through major support of:

•              MIM Conferences,

•              Workshops

•              Programs (including MIMSec, MIM/TDR, MR4 and MIMCom)

•              In-country activities

•              Collaboration/partnerships with MIM

There will be one vote per donor or international organization, and one vote per country for malaria research institutes either in Africa or the North. The voting members from the malaria research institutions in Africa will have had to be significantly involved in MIM, such as:

•              Being the host institution to a MIM/TDR Task Force member or principal investigator,

•              Being a recipient of other MIM support (MIMSec, MIMCom, and/or MR4),

•              Having hosted a MIM Conference or workshop.

In the event which there is more than one research institute per country, it will be left to the representatives of these institutes to decide together on the vote of their country. The votes will be cast by email to the MIM Secretariat.

How to apply

This is two step process.  Successful letters of intent will be encouraged to submit full proposal (deadline 15 September 2009).  Please send your letter of intent by 30 July 2009. We strongly encourage you to discuss candidature requirements with the secretariat before submitting your application.

MIM Secretariat
Hosted by African Malaria Network Trust
PO Box 33207, Dar-Es-Salaam, Tanzania
Phone: +255 (0)22 2700018
Fax: +255 (0)22 2700380

Email : francine.ntoumi@amanet-trust.org
Website: www.mimalaria.org

Childs DZ, Boots M. The interaction of seasonal forcing and immunity and the resonance dynamics of malaria. J R Soc Interface. 2009 Jul 1.

Theory has emphasized the importance of both intrinsic factors such as host immunity and extrinsic drivers such as climate in determining disease dynamics. In particular, seasonality may lead to multi-annual cycles in prevalence, but the likelihood of this depends on the role of acquired immunity. Some diseases including malaria have immunity that falls between the classic susceptible-infectious-removed and susceptible-infectious-susceptible models. Here, we investigate the general conditions promoting the subharmonic resonance behaviour that may lead to multi-annual cycles in a general malaria dynamical model...

Tasman H, Soewono E, Sidarto KA, Syafruddin D, Rogers WO. A model for transmission of partial resistance to anti-malarial drugs Int J Math Biosci Eng. 2009 Jul;6(3):649-61

Anti-malarial drug resistance has been identified in many regions for a long time. In this paper we formulate a mathematical model of the spread of anti-malarial drug resistance in the population. The model is suitable for malarial situations in developing countries. We consider the sensitive and resistant strains of malaria. There are two basic reproduction ratios corresponding to the strains. If the ratios corresponding to the infections of the sensitive and resistant strains are not equal and they are greater than one, then there exist two endemic non-coexistent equilibria. In the case where the two ratios are equal and they are greater than one, the coexistence of the sensitive and resistant strains exist in the population…

Tarning J, McGready R, Lindegardh N, Ashley EA, Pimanpanarak M, Kamanikom B, Annerberg A, Day NP, Stepniewska K, Singhasivanon P, White NJ, Nosten F. Population pharmacokinetics of lumefantrine in pregnant women treated with artemether-lumefantrine for uncomplicated P. falciparum malaria. Antimicrob Agents Chemother. 2009 Jun 29

Artemether-lumefantrine has become one of the most widely used antimalarial drugs in the world. The objective of this study was to determine the population pharmacokinetic properties of lumefantrine in pregnant women with uncomplicated multi-drug resistant P. falciparum malaria on the North Western border of Thailand. Karen pregnant women (n=103) with P. falciparum malaria in the 2(nd) and 3(rd) trimesters of pregnancy were treated with artemether-lumefantrine (80/480 mg) twice daily for three days…

Mpimbaza A, Staedke SG, Ndeezi G, Byarugaba J, Rosenthal PJ. Predictors of anti-convulsant treatment failure in children presenting with malaria and prolonged seizures in Kampala, Uganda. Malar J. 2009 Jun 29;8(1):145

In endemic areas, falciparum malaria remains the leading cause of seizures in children presenting to emergency departments. In addition, seizures in malaria have been shown to increase morbidity and mortality in these patients. The management of seizures in malaria is sometimes complicated by the refractory nature of these seizures to readily available anti-convulsants. The objective of this study was to determine predictors of anti-convulsant treatment failure and seizure recurrence after initial control among children with malaria. METHODS: In a previous study, the efficacy and safety of buccal midazolam was compared to that of rectal diazepam in the treatment of prolonged seizures in children aged three months to 12 years in Kampala, Uganda…

Dillip A, Hetzel MW, Gosoniu D, Kessy F, Lengeler C, Mayumana I, Mshana C, Mshinda H, Schulze A, Makemba A, Pfeiffer C, Weiss MG, Obrist B. Socio-cultural factors explaining timely and appropriate use of health facilities for degedege in south-eastern Tanzania. Malar J. 2009 Jun 29;8(1):144.

Convulsions is one of the key signs of severe malaria among children under five years of age, potentially leading to serious complications or death. Several studies of care-seeking behaviour have revealed that local illness concepts linked to convulsions (referred to as degedege in Tanzanian Kiswahili) called for traditional treatment practices while modern treatment was preferred for common fevers. However, recent studies found that even children with convulsions were first brought to health facilities. This study integrated ethnographic and public health approaches in order to investigate this seemingly contradictory evidence...

Stewart L, Gosling R, Griffin J, Gesase S, Campo J, Hashim R, Masika P, Mosha J, Bousema T, Shekalaghe S, Cook J, Corran P, Ghani A, Riley EM, Drakeley C. Rapid assessment of malaria transmission using age-specific sero-conversion rates. PLoS One. 2009 Jun 29;4(6):e6083.

Malaria transmission intensity is a crucial determinant of malarial disease burden and its measurement can help to define health priorities. Rapid, local estimates of transmission are required to focus resources better but current entomological and parasitological methods for estimating transmission intensity are limited in this respect. An alternative is determination of antimalarial antibody age-specific sero-prevalence to estimate sero-conversion rates (SCR), which have been shown to correlate with transmission intensity. This study evaluated SCR generated from samples collected from health facility attendees as a tool for a rapid assessment of malaria transmission intensity...

Deadline for submission of letters of intent: 30 July 2009

Since its creation, the Multilateral Initiative on Malaria (MIM) Secretariat has rotated from United Kingdom, USA, Sweden and to Africa in 2006. The African Malaria Network Trust (AMANET) in Tanzania is currently hosted the MIM Secretariat for a 5 year period.

In order to be able to face the new challenges arisen by its move to Africa, the MIM secretariat has revised its strategic plan for being more engaged in the coordination of research activities in Africa and to work hand-to-hand with African researchers; as example by being involved in the coordination of the Central Africa Network of Excellence supported by EDCTP or by strengthening collaboration with African networks, institutions and research groups.

With many players in the field of research capacity building/strengthening and taking into account that each organization needs visibility for its own survival, it becomes crucial for MIM to clearly identify its niche. MIM can be viewed as a unique alliance that has given African scientists in African institutions, a voice and an opportunity to build capacity and contribute to new knowledge while setting their own research agenda.

From January 2011, the secretariat will move from Tanzania to another institution. In keeping with the tradition of engaging partners openly and transparently in advancing the MIM agenda, we invite applications for hosting the next MIM Secretariat.

Who can apply?

•              Organizations/institutions or agencies in Sub-Saharan Africa involved with malaria research, research funding and research capacity strengthening in malaria endemic countries.

•              An alliance of organizations and/or institutions from Sub-Saharan Africa and a Northern partner by preparing a joint application.

Applications have to be submitted by the institution from the South.

Candidates will be required to give details on the following:

1)    Willingness and ability to support the Secretariat functions

2)    Proposed activities to be carried out by the Secretariat over a 3 to 5 year period.

3)    Joint application:  role of each institution in the partnership for supporting the MIM secretariat

4)    Proposed budget for the Secretariat and its activities

5)    Demonstrated ability to fund the Secretariat budget

6)    Information regarding capacity to maintain the communications, including easy email access

7)    Demonstrate organization/institute/agency has good organizational capacity

8)    Demonstrate organization/institute/agency has strong scientific capacity

Duties and Responsibilities of the MIM Secretariat

Established in 1997, MIM is an alliance of organizations and individuals, and four autonomous constituents which comprise the MIM Secretariat, MIM at WHO/TDR (MIM/TDR), MIM Communications (MIMCom, at the US National Library of Medicine) and Malaria Research Reference Reagent Resource Center (MR4, at the American Type Culture Collection) for the promotion of capacity development through collaboration to undertake malaria research that lead to the control of the disease in Africa.

The new Secretariat will decide to what level they will fund Secretariat activities. It is expected that core support will be provided for administrative costs and salaries of personnel, the organization and financial support of one MIM Pan-African Conference, as well as support for raising funds from other sources. In addition to core functions, it is expected that the Secretariat will also strengthen malaria research capacity in endemic regions by organizing workshops and training opportunities on topics including grant writing, peer review, writing scientific papers, making presentations, and developing leadership skills; promote research and networking, and be involved in coordination of research activities with African researchers.

Budget for MIM Activities

Financial support of the next Secretariat would be expected to come from the host organization (or collective). The MIM Secretariat also raises financial support to co-fund workshops and other activities it organizes. Funds for the MR4 program are from NIAID at the US National Institutes of Health (NIH). Funds for MIMCom are from the National Library of Medicine (NLM) at the NIH and from the local recipient programs or their Northern sponsors. Funds for the MIM/TDR program are from a variety of sources The MIM Secretariat helps convene funders to raise support for various MIM activities (such as MIM/TDR), but the parties responsible for the various MIM activities are responsible for fund raising for those activities in conjunction with the Secretariat. The MIM Secretariat also helps in identifying new funding opportunities and partners for MIM. MIM Secretariat is fully responsible for funds related to effective functioning of the MIM Secretariat. Other programs such as MR4, MIM/TDR, and MIMCom, have a decentralized decision-making and fund-raising structure, but they all work to support broad goals of MIM. All research grant decisions are made by the MIM/TDR Task Force. MR4 has a Scientific Advisory Board (SAB) to decide on workshop funding etc. The MIM Secretariat and MIMCom identify priorities and related funding decisions through broad but informal consultative mechanisms.

Transfer of Duties

To aid the transfer of knowledge and enable the Secretariat to become functional as soon as possible after the transfer, it is recommended that there is a period of overlap with a coordinator from the newly elected Secretariat working with the current Secretariat for 2-5 months.

Mechanism of voting

The previous MIM Secretariat at Fogarty International Center developed a voting mechanism to ensure that the transfer of the Secretariat was conducted in a fair and transparent manner. It was decided that a group of representatives of the funding partners and international organizations, and an equal number of malaria research institutes in Africa will be represented as voting members. The voting members are identified based on their significant and direct involvement with MIM, through major support of:

•              MIM Conferences,

•              Workshops

•              Programs (including MIMSec, MIM/TDR, MR4 and MIMCom)

•              In-country activities

•              Collaboration/partnerships with MIM

There will be one vote per donor or international organization, and one vote per country for malaria research institutes either in Africa or the North. The voting members from the malaria research institutions in Africa will have had to be significantly involved in MIM, such as:

•              Being the host institution to a MIM/TDR Task Force member or principal investigator,

•              Being a recipient of other MIM support (MIMSec, MIMCom, and/or MR4),

•              Having hosted a MIM Conference or workshop.

In the event which there is more than one research institute per country, it will be left to the representatives of these institutes to decide together on the vote of their country. The votes will be cast by email to the MIM Secretariat.

How to apply

This is two step process.  Successful letters of intent will be encouraged to submit full proposal (deadline 15 September 2009).  Please send your letter of intent by 30 July 2009. We strongly encourage you to discuss candidature requirements with the secretariat before submitting your application.

MIM Secretariat

Hosted by African Malaria Network Trust

PO Box 33207, Dar-Es-Salaam, Tanzania

Phone: +255 (0)22 2700018

Fax: +255 (0)22 2700380

Email : francine.ntoumi@amanet-trust.org

Website: www.mimalaria.org

Early Bird Registration Extended to June 30, 2009

Deadline for early bird registration for the Fifth MIM Pan-African Malaria Conference has been extended from 31 May 2009 to 30 June 2009. The Conference will be held on 2-6 November 2009 at the Kenyatta International Conference Centre (KICC) in Nairobi, Kenya.

If you are not registered, visit www.mimalaria.org/pamc or click this link to get started:  Registration. 

Accommodation

The Organizing Committee for the Fifth MIM Pan-African Malaria Conference has appointed AfricaPoint as the official agent to secure hotel and accommodation booking for conference participants. Africa Point is one of the leading online travel agents in Africa, offering travel services to all top destinations in the continent.

Africa Point has negotiated special rates for participants coming to the MIM in a number of Nairobi hotels, ranging from budget to 5-star, in vicinity of the conference venue.  If you wish to take advantage of the special rates then follow this link (www.africapoint.com/pamc) for online booking. Hotel reservations for sponsored participants will be made by the organizing committee.

International scientists say they have found the first evidence of resistance to the world’s most effective drug for treating malaria.

They say the trend in western Cambodia has to be urgently contained because full-blown resistance would be a global health catastrophe.

Drugs are taking longer to clear blood of malaria parasites than before.

This is an early warning sign of emerging resistance to a disease which kills a million people every year.

Until now the most effective drug cleared all malaria parasites from the blood within two or three days but in recent trials this took up to four or five days.

The BBC’s Jill McGivering, reporting from Cambodia, says it is unclear why the region has become a nursery for the resistance - but the local public health system is weak, and the use of anti-malaria drugs is not properly controlled.

Drug defence

The artemesinin family of drugs is the world’s front-line defence against the most prevalent and deadly form of malaria.

Two teams of scientists, working on separate clinical trials, have reported seeing the disturbing evidence that the drugs are becoming much less effective.

There is particular concern because previous generations of malaria drugs have been undermined by resistance which started in this way, in this part of the world, our correspondent reports.

The World Health Organization warned in 2006 there was a possibility the malaria parasite could develop a resistance to artemesinin drugs, and that there was particular concern about a decreased sensitivity to the drug being seen in South East Asia.

It urged drug firms to stop selling artemesinin on its own to in order to prevent resistance building up.

Early results from two studies by US and UK teams have both revealed the early stages of resistance.

Between a third and a half of patients in the US study saw delayed clearance of the malaria parasite.

In the UK study, patients in the Cambodia arm of the trial took almost twice as long to clear the parasite as a comparison group in Thailand.

Professor Nick Day, director of the Mahidol-Oxford Tropical Medicine Research Unit which is carrying out the UK study, said: "Twice in the past, South East Asia has made a gift, unwittingly, of drug resistant parasites to the rest of the world, in particular to Africa," he said.

"That’s the problem. We’ve had chloroquine and SP (sulfadoxine pyrimethamine) resistance, both of which have caused major loss of life in Africa," he said in reference to earlier generation anti-malarial drugs.

"If the same thing happens again, the spread of a resistant parasite from Asia to Africa, that will have devastating consequences for malaria control," he said.

Health systems

Cambodia has long been a laboratory for malaria investigators and a nursery of anti-malaria drug resistance.

Alongside a weak public health system and poorly-controlled drug use, there are many fake drugs, produced by international criminals.

These fakes often contain a small amount of the real drug to fool tests, which can also help to fuel resistance.

Those working to control malaria are calling for urgent action to contain this emerging resistance.

If it strengthens and spreads, they warn, many millions of lives will be at risk. About half the world’s population faces exposure to the disease.

Story from BBC NEWS:

http://news.bbc.co.uk/go/pr/fr/-/2/hi/asia-pacific/8073118.stm

Published: 2009/05/29 03:36:25 GMT

Researchers based in Gabon and France report the discovery of a new malaria agent infecting chimpanzees in Central Africa. This new species, named Plasmodium gaboni, is a close relative of the most virulent human agent P. falciparum; it is described in an article published May 29 in the open-access journal PLoS Pathogens.

P. falciparum is the major human malaria agent responsible for one to three million deaths annually. In 2002, the publication of the genome of P. falciparum generated new hopes in the fight against this deadly disease, by the opportunities it offered to discover new drug targets. However, the lack of known related genomes has limited the development of comparative genomics according to the study’s researchers from Centre International de Recherches Médicales de Franceville, Centre National de la Recherche Scientifique, and l’Institut de Recherche pour le Développement.

To investigate the diversity of Plasmodium parasites circulating in chimpanzees in Africa, the team collected blood from 19 wild-borne animals kept as pets by villagers in Gabon. Two were found infected by a Plasmodium parasite. The sequencing of the parasite’s whole mitochondrial genome revealed that it belonged to a previously undescribed species of Plasmodium, closely related to P. falciparum. Sequencing of the nuclear genome of this new agent should further the understanding of genomic adaptations of P. falciparum to humans and thus help discover new potential drug targets.

The development of comparative genomics to further understanding of P. falciparum has been hindered by a lack of knowledge of closely related species’ genomes. Only one species, P. reichenowi, infecting chimpanzees, was previously known as a sister lineage of P. falciparum. Additional information on related species has thus been needed, making the discovery of P. gaboni an important step forward in exploring a possible relationship for malaria between chimpanzees and humans.

The world’s most advanced malaria vaccine entered its final phase of pre-approval testing yesterday in Bagamoyo, Tanzania, raising hopes that the drug could be licensed for widespread use by 2012.

On 26 May, five infants aged 5–17 months were inoculated with GlaxoSmithKline (GSK)’s RTS,S vaccine. In the coming months, the study will become the largest ever trial of a malaria vaccine candidate, involving 16,000 children under the age of two at eleven sites in seven African countries.

Investigators hope that the phase III trials will show that RTS,S prevents at least half of the infants and young children who are vaccinated from developing the symptoms of malaria, and that the protection will last for several years. Even a partially effective vaccine is sorely needed. Most of the one million people killed every year by malaria are children under the age of 5 in sub-Saharan Africa, the World Health Organization says.

"This vaccine has the potential to save hundreds of thousands of lives," says Salim Abdulla, principal investigator of the Tanzanian trial. "It’s an amazing feeling to be a part of [this trial]."

Long, long road

It has taken researchers more than two decades to nurture RTS,S through to its third phase — the final stage of development before the drug is sent for regulatory approval. GSK and its partner, the Malaria Vaccine Initiative which is funded through the Bill & Melinda Gates Foundation, say they have invested more than US$400 million in the project.

The drug is a combination vaccine, which fuses fragments of a protein from the malaria parasite with a surface antigen from the hepatitis B virus. "Several other approaches have shown scientific promise," says Vasee Moorthy, a medical officer who works on malaria vaccines at the World Health Organization’s Initiative for Vaccine Research. "But only RTS,S has reached phase III trials."

After promising safety and efficacy trials that involved a few thousand children, phase III trials had been scheduled for April 2009 in Lambaréné, Gabon. But the country’s newly appointed minister of health, Idriss Ngari, requested more time to review documents before finalizing his decision, explains Christian Loucq, director of the Malaria Vaccine Initiative.

If all goes well, the vaccine could be submitted for regulatory review by 2011 and on the market by 2012. The Malaria Vaccine Initiative says it is working with organizations that fund vaccines, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccine and Immunizations, to ensure that RTS,S will be affordable if it reaches the market.

"The cost to African babies and mothers is going to be nil," says Loucq. "That is very clear."

Deadline for Applications: 15 June 2009

http://www.amanet-trust.org/ext/calls/third_call_for_capacity_strengthening_20090521.html

Download pdf [50kb]

Background and justification

There are intensified global efforts towards malaria control in the world and particularly in Africa. The main strategy is to use together several effective interventions for treatment and prevention. The search for malaria vaccine has in the last decade gained an increased impetus. The success of vaccination against other communicable diseases is convincing enough to increase our attention and capacities towards the search for an effective malaria vaccine.

Overall, there are several malaria vaccine candidate molecules at various stages in the development pipeline. A few of these having reached clinical testing stages, which of necessity require to be tested in malaria endemic African populations – since this is where the burden of disease is greatest. There are yet very few African-led and African owned institutions with the capacity and technical ability to undertake malaria vaccine trials. Although some have now successfully conducted studies at Phase Ib – IIb, they remain too few in numbers to handle the multiple evaluations options inherent in the development of vaccines. Additional sites are being required to provide varied epidemiological profiles of malaria transmission and enable series of tests such as with age de-escalation towards and including the target populations. In recognition of these challenges, the African Malaria Network Trust (AMANET) has since 2004, endeavored to support holistic development of selected African institutions to build their capabilities for the necessary trials of candidate malaria vaccines.

Call for Applications

This is the third AMANET call intended to assist additional two African malaria research institutions to develop capacity for conducting malaria vaccine trials at phase Ib and possibly IIb where applicable. This grant which may last 1-3 years should allow a research institution which is strategically placed, but is incapacitated by infrastructural weaknesses, inadequate skilled personnel, lack of equipment, or/and including inadequate epidemiological characterization of their potential field sites, to attain the requisite capacities. The institution will be expected to undertake such activities to upgrade itself, together with wholesome characterization of its intended field sites.

Interested institutions should submit a detailed up to three pages letter of intent. The letter should outline expected objectives and a plan to meet these objectives within the life of such a project. It is important to show how limiting weaknesses will be overcome through this grant i.e. technical human resources, poor infrastructure, essential equipments, functioning of scientific and ethical review bodies, capacity to care for research participants, etc. In addition to the above considerations, applying institutions must clearly demonstrate; i) the existence of national commitment to their development, such as within the framework of the Ministry of Health in their country, and ii) that it is both African- led and  owned.   

Only applications submitted by institutional heads/leaders will be considered.

How to apply

Completed applications with the above requirements must be sent by e-mail and received at the AMANET secretariat by 15th June 2009.

All applications must be directed to:

The Managing Trustee,

African Malaria Network Trust (AMANET),

302 Ring Street, Off Garden Road, Mikocheni A,

P.O Box 33207,

Dar es Salaam,  Tanzania.

  E-mail: info@amanet-trust.org

Tel: + 255-22-2700018, Fax: + 255-22-2700380.

Short listed institutions will be requested to submit a detailed proposal by 31st   July 2009.

Analyst Contrat avec IMEA, Paris

IDENTIFICATION DU POSTE

Fonction : Analyste de données biologiques. Liaisons hiérarchiques : - Pr Jacques Le Bras, CNR Palu, Parasitologie, Bichat & EA209 Univ Paris Descartes, - Dr Sandrine Houzé, CNR Paludisme & Parasitologie, GH Bichat - C.Bernard. Liaisons fonctionnelles : - Dr David Hughes, Wellcome Trust Centre For Human Genetics Univ. Oxford. - Pr France Mentré, Biostatistics Unit UMR 738 INSERM - Univ Paris Diderot. Durée du poste : Contrat sur mission de 4 ans établi par une fondation médicale (salaire brut annuel 26 400 €). Poste à pourvoir dès maintenant.

MISSIONS ET RESPONSABILITES

Fonction : Organisation et analyse de données biologiques (in vitro) dans le contexte d’un réseau de surveillance mondiale de la résistance aux antipaludiques

Missions : Dans le cadre d’un projet international de surveillance de l’efficacité des médicaments du paludisme, l’analyste aura en charge le transfert de données depuis l’appareil d’analyse vers la base de données et la validation des données de relations dose-effet par,

·         comparaison des méthodes de mesure des relations dose-effet,

·         confrontation à des contrôles de qualité,

·         comparaison inter laboratoires,

·         étude de la stabilité dans le temps des indicateurs de qualité.

Dans un deuxième temps, il participera à la formation/supervision d’analystes de futurs centres experts en Asie et en Afrique. Niveau de responsabilité dans la structure :

·         collaborer avec le responsable et l’ingénieur d’assurance qualité pour l’établissement des normes de saisie et de validation et la mise en place de standards et la planification des études/comparaisons,

·         assurer la validation des analyses réalisées par des techniciens,

·         collaborer avec l’équipe IT d’Oxford pour la création d’une base de données en ligne,

·         établir des rapports de validation des données pour l’assurance qualité.

COMPETENCES ET QUALITES REQUISES

Compétences professionnelles requises : ■ Niveau Bac +3 +5, ■ Connaissances en biologie et/ou pharmacologie souhaitées, ■ Maîtrise de l’outil informatique (base de données, création de routine/macro), ■ Connaissance de l’outil statistique appliqué à des données biologiques, ■ Très bonne maîtrise de l’anglais. Qualités requises : ■ Capacité d’initiative et autonomie, ■ Sens de l’organisation, ■ Qualités personnelles et relationnelles et goût pour le travail en équipe, ■ Rigueur, ■ Curiosité.

____________________________________________________________

REF : IMEA1201/2008 Location : Institut Médecine Epidémiologie Appliquées, IMEA, Paris Department : IMEA Fondation Position : Biological data manager chargé(e) de mission Duration : Temporary mission of 4 years Beginning date : Currently available Main objective Management and analysis of biological data (in vitro) in the context of a global surveillance network of antimalarial resistance

Missions

The recruited person will be in charge, within the Centre National de Reference du Paludisme (http://www.imea.fr/imea-recherche/imea-rba-chimiosenspalu.php), of all data management regarding in vitro testing standards of WWARN (http://www.wwarn.org/home/modules/in-vitro-module.php), including data transfer from analytic devices to a database and validation of biological data.

Other responsibilities will be data analysis in : • validation processes: control of dose-effect curves parameters and controls on reference clones, • inter laboratories comparisons, • assessment of stability of quality indicators upon time, • collaborating with avec Oxford IT team to create a data base.

He/She will work in close relationship with a QAQC engineer and with the data managers of WWARN, including, in the early period, design of norms of data management and setting up standards and planning comparison studies. From 2010, visits to expert labs would be planned as to share experience and maintain common SOPs.

Brut annual salary € 26,400.

Cultural background : • Scientific formation with biological and/or pharmacological knowledge appreciated, • Experience in database management, • Knowledge of statistical tools dedicated to biological data, • Fluency in French/English

Aptitude : • Team work ability • Scientific rigour • Relationship skill • Autonomy and initiative

Candidacy (curriculum vitae, letter of motivation) must be addressed to : Jacques LE BRAS Direction Scientifique - IMEA, Faculté de Médecine Paris Diderot 16 rue Henri Huchard - 75018 PARIS CEDEX 18 Tél. : 33 1 40 25 78 99 - E-mail : jacques.lebras@wwarn.org

The Fifth MIM Pan-African Malaria Conference will be held 2-6 November 2009 in Nairobi, Kenya.

The Conference Organizing Committee is still accepting requests for exhibitions.

Over 1500 participants are expected at this year’s conference and many of them disseminate exhibitor information and materials to their staff and colleagues. Besides sharing your work with others, your participation will put you in contact with malaria researchers and control experts from malaria endemic countries in Africa, Asia, and Latin America and the Caribbean, as well as malaria scientists, administrators, and representatives from private foundations, governments and international organizations from all over the world.

Exhibits will be located in an area that will provide you with excellent access to Conference participants. The exhibition (and poster) area will be open between 1000-1700hrs Monday through Friday. Participants will be encouraged to visit exhibits and posters, with all refreshment breaks set up in the exhibit area to encourage delegates to meet with exhibition personnel and discuss their products and services.

Exhibition booths measuring three (3) square metres will be set up. The booths will be equipped with a sign board, two seats, a power source and a skirted table to display your information. Exhibitors are expected to decorate their own stands.

A single exhibition booth/space costs USD 1300.

To book a space, fill in and submit the Exhibition Space Request Form available at the MIM Conference website.

More information available at www.mimalaria.org/pamc

The Organizing Committee for the Fifth MIM Pan-African Malaria Conference has appointed AfricaPoint as the official agent to secure hotel and accommodation booking for conference participants. Africa Point is one of the leading online travel agents in Africa, offering travel services to all top destinations in the continent.

Africa Point has negotiated special rates for participants coming to the MIM in a number of Nairobi hotels, ranging from budget to 5-star, in vicinity of the conference venue; Kenyatta International Conference Centre.

If you wish to take advantage of the special rates then follow this link (www.africapoint.com/pamc) for online booking.

Hotel reservations for sponsored participants will be made by the organizing committee.

A convention named « INFECTIOPOLE SUD », situated in Marseille, Nice and Montpellier (France) is opening 8 PhD positions and 9 post-doc positions starting autumn 2009. The research field is on infectious diseases and tropical medicine. We would like to welcome people from developing countries.

For more information: www.infectiopolesud.com

Didier RAOULT    

Le Président

didier.raoult@gmail.com

Yolande OBADIA

La Directrice

On 25 April 2009, the Multilateral Initiative (MIM) Secretariat joined the malaria endemic countries and the world in commemorating World Malaria Day. 

World Malaria Day 2009 had a message of hope. That malaria is beatable, and we are slowly gaining the upper hand in fighting malaria. Remember this disease has been with us from times immemorial. But malaria has been eradicated in some parts of the world. Africa why not, the debate is on the table. 

From its humble beginning in 1997, MIM has been actively involved in building research capacity among malaria institutions and researchers in Africa. This growing alumnus of “MIM researchers” is now playing major role in researching, developing and deploying effective malaria interventions in Africa. So our mission is to facilitate African participation in the development of effective control tools and sustain research capacity of malaria endemic countries in Africa. That sounds like a very ambitious goal, but if we have to count out malaria, we have got to be ambitious. 

From 2-6 November this year, the eve of the first milestone in malaria reduction as per the Global Strategic Plan 2005-2015, MIM we will be organizing the largest malaria conference in Africa, and probably world.  We are calling on all stakeholders to converge in Nairobi to churn out the way forward, and strategize on next steps. 

Thank you everyone for your hard work and dedication in this long and painful battle to win over malaria

Francine Ntoumi

MIM Secretariat Coordinator

On this World Malaria Day, the international community commits itself to eliminate malaria as a major global public health problem. RBM Partners and country representatives announce new ambitious initiatives to achieve universal coverage with malaria control tools in the countdown to 2010, to reach near-zero deaths by 2015 and begin to tackle malaria elimination in more countries. On World Malaria Day 2009, we rally for a single purpose: to show our political support to the Global Malaria Action Plan and to commit with vigour to its rapid and universal implementation.

View Video statement of Prof Coll-Seck

Read the RBM Statement in English, in French

Joint Statement on the Occasion of World Malaria Day 2009 by H.E. the Secretary General of the Organization of Islamic Conference (OIC), Prof Dr. Ekmeleddin Ihsanoglu and The Executive Director of the Roll Back Malaria (RBM) Partnership, Prof Awa Marie Coll-Seck in English

Joint Statement on the Occasion of World Malaria Day 2009 by the UN High Commissioner for Refugees (UNHCR), António Guterres and The Executive Director of the Roll Back Malaria (RBM) Partnership, Prof Awa Marie Coll-Seck in English

RBM World Malaria Day Press Release in English, in French

25 April 2009, Dar Es salaam, Tanzania

Indeed, the World Malaria Day is here to remind us of the intolerable burden and the task ahead of us in addressing the malaria challenge. A hundred years ago the malaria problem encompassed all tropical countries. Today more than 80 percent of the global malaria burden is restricted to Sub-Saharan Africa, with an overwhelming human toll among children and pregnant women. In Africa, malaria and poverty have almost become synonymous, with a growth penalty of up to 1.3% in some countries. 

Malaria Day is the time to assess progress being made in the fight against this debacle. We know that we are yet to win the war but the battle against malaria is being won gradually but surely. In 2008, World Malaria Report showed that more than 25 countries have managed to decrease malaria deaths by half. The report noted considerable progress in scaling up distribution and the use of insecticide-treated nets; many countries changed their malaria drug policies to the more effective arteminisin combined therapy, and funding increased more than ever.

The world is also responding! Today more players are in the field and major milestones have been recorded in the search for efficacious interventions including malaria vaccines. Malaria eradication is now back on the agenda. As the theme for this year’s World Malaria Day goes, and if all stakeholders continue to play their part, we are poised to “count malaria out” from Africa, and the World.

The African Malaria Network Trust (AMANET) believes that strong African leadership and stewardship in malaria prevention, control and eventual eradication is needed. AMANET is leading Africa in the search for effective and affordable interventions by strengthening capacities and enabling active participation of African malaria research institutions in this crucially important endeavour. The reality of malaria is intimately appreciated by African health researchers and scientists. We must harness this special intimacy and experience to develop more effective tools against malaria.

AMANET takes a holistic approach in capacity strengthening for malaria research and development (R&D). AMANET is providing support to the Centre de National Recherche et de Formation sur le Paludisme (CNRFP) in Burkina Faso, the National Institute for Medical Research (NIMR) Tanga Centre in Tanzania, the Tropical Diseases Research Centre (TDRC) in  Zambia and Makerere University in Uganda for upgrading of infrastructure and facilities essential for effective conduct of critical malaria research. AMANET invests in the long-term development of African research capacity through support for long and short term training of personnel at the selected institutions; strengthening malaria research institutions in health research ethics to ensure that sound ethical practice is integral part of the conduct of these clinical trials.

AMANET is currently sponsoring trials of candidate malaria vaccines Merozoite Surface Protein-3 Long Synthetic Peptide (MSP3-LSP) and GMZ2.  AMANET is the first and currently the only African organization to assume sponsor role as far as malaria vaccine trials are concerned. Progress was made in the last year to launch a phase IIb trial of the candidate malaria vaccine MSP3-LSP at the Malaria Research Training Center (MRTC) in Bamako, Mali, drawing closer to real pivotal studies. AMANET will continue ardent collaboration with partners and institutions to create effective malaria vaccine trial networks among African institutions. And with the currently effective interventions, an effective malaria vaccine will add an irreversible assault on the malaria burden and ensure early knock out of malaria.

About AMANET

AMANET is not for profit capacity strengthening African institution committed to ensure that Africans are enabled to steward the fight against malaria through efficient and product oriented approaches. AMANET is registered as a Trust in the United Republic of Tanzania.

≠≠≠

For further information contact

Dr Charles Wanga | Communications Officer

African Malaria Network Trust | 302 Ring Street, Off Rose Garden Road, Mikocheni A

PO Box 33207, Dar es salaam

Tanzania | Tel: +255 22 2700018 Fax: +255 22 2700380

Email: clwanga@amanet-trust.org   

The Lancet is publishing two Comments to coincide with this year’s World Malaria Day (25 April). In the first of these Comments, Sir Richard Feachem and Allison Phillips, University of California San Francisco (UCSF) Global Health Group, discuss the rapid progress made in malaria control and elimination in the past two years - and their optimism for the future.

The strategy of Roll Back Malaria (a UN organisation) is in three parts - achieve low transmission and mortality in the 61 tropical countries with the highest malaria burden; progressive elimination from the endemic margins to gradually shrink the ’malaria map’; and research into vaccines, drugs and other interventions. The first part has seen a massive scale-up in antimalaria programmes, with Global Fund round 7 approving US$1 billion and round 8 pledging a staggering $2.9 billion. The US President’s Malaria Initiative and The World Bank’s Booster programme have scaled-up operations in the malaria heartland, and substantial malaria reductions have been achieved in, for example, Brazil, India, and Zambia. Private sector investment is increasing in places such as Angola, Nigeria and Ghana.

While part two (elimination) received little support two years ago, today 39 countries have set ambitious, yet attainable elimination strategies. Recent advice in two novel documents produced by the Malaria Elimination Group (part of UCSF Global Health Group) will assist all those involved in decision making for this second part. Regarding the third part, malaria research has continued to flourish. The Malaria Eradication Research Agenda (MalERA), has been recently launched and is developing a comprehensive research agenda to further malaria technologies.

In addition to this promising progress, a surge of NGO and civil-society activity in malaria has seen several organisations spring into existence, eg, Malaria No More, which has already raised over $37 million. Ray Chambers has been appointed as the UN Secretary-General’s special envoy on malaria, and the US has followed the UK by setting up a non-party-political parliamentary group for malaria.

The authors say: "The challenge now is the implementation gap between political commitment, ambition, and availability of funds, and the capacity at ground level to do the work that needs to be done."

They conclude: "Overall, we have many reasons to be optimistic. Except for those countries that are politically dysfunctional or suffering major conflicts, the 61 malaria control countries in the heartland will make great progress in reducing death and sickness from malaria over the next 10 years. Meanwhile, many of the 39 malaria-elimination countries will successfully get rid of malaria, and the malaria gap will be substantially shrunk. Also, if the pace of malaria research continues, we can expect a first vaccine, important therapeutic advances, and further progress in the development of sensitive and specific point-of-treatment diagnostic tests. All this will move us forward towards a malaria-free world in the middle of the 21st century."

The second Comment discusses in detail the progress towards a vaccine, and is written by Dr Vasee Moorthy, John Radcliffe Hospital, Oxford, and University of Oxford, UK, and colleagues. The authors refer to two recent studies, by Bejon and Abdulla and their respective colleagues, that represent important steps toward a malaria vaccine. They say that these developments are ’driving commitments to research and development of a second-generation vaccine with a target efficacy of 80%, as outlined as a goal for 2025 in the strategic framework of the Malaria Vaccine Technology Roadmap’, so long as funding and commitment are provided.

They add: "Areas of controversy remain in the design and analysis of malaria-vaccine trials, including whether primary attention should be focused on any delay in the first episode of malaria after vaccination, whether any second or subsequent episodes should be evaluated, or whether a better measure of effect might be in the proportion of children who have had no attack of malaria by some defined time after vaccination. These and related issues have been the subject of recent WHO consultations."

Sir Richard Feachem and Allison Phillips, University of California San Francisco (UCSF) Global Health Group)

A new study, carried out in primary care units in Zanzibar and published in this week’s issue of PLoS Medicine, evaluates the impact of rapid malaria tests on prescribing practice and clinical outcomes. The findings suggest that routine use of such tests may reduce the number of people who are inappropriately given antimalarial drugs.

Currently, malaria in sub-Saharan Africa tends to be diagnosed on the basis of symptoms alone (i.e. fever). However, such symptoms are not very accurate and overuse of antimalarial drugs, such as artemisinin combination therapy, for individuals whose fever is actually caused by another disease may result in increased resistance to the drugs, in increased cost, and delayed treatment for the relevant condition. However, tests for malaria now exist which can be quickly carried out even in settings where a well-resourced laboratory is not available. One of these, Paracheck, was tested in this study by Anders Björkman and colleagues.

The study took place in four primary health care units in Zanzibar, where malaria is generally considered endemic. In the study, each unit alternated between weeks when "normal" clinical diagnosis guided treatment, and weeks when clinical diagnosis plus use of the rapid test were used to guide treatment. Study nurses, who were responsible for implementing the study and carrying out treatment, were encouraged to rely on the rapid diagnostic tests during weeks when these were used. 1,887 patients were included in the study (1,047 were children aged under five). The researchers found that during weeks when rapid test-aided diagnosis was in place, there was a statistically significantly lower prescription of antimalarial treatment (36% of patients in the rapid test category, compared to 85% in the clinical diagnosis category). Prescription of antibiotics was also higher in the group of patients receiving rapid tests (37%, compared to 27% in the group receiving clinical diagnosis). This finding suggests that use of rapid diagnostic tests resulted in non-malarial causes of symptoms being considered and treated.

Encouragingly, the researchers found a lower rate of reattendance due to perceived lack of cure in the group who received a rapid test – 2.5% compared to 4.9% in clinical diagnosis alone.

The findings are in contrast to the results of other trials in which use of rapid diagnostic tests has not led to a reduction in inappropriate prescribing. Studies carried out in Zambia and Tanzania have suggested that healthcare workers may often give antimalarials even when a rapid test suggests the patient does not have malaria. Although the findings from this study in Zanzibar are encouraging, further work will be needed before it is clear that they can be generalized to other types of settings in sub-Saharan Africa, where training for healthcare practitioners, and practice may be very different.

###

Funding: This study was funded by MSF Spain, WHO-AFRO, Italian Co-operation and Zanzibar Malaria Control Programme. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Citation: Msellem MI, Ma°rtensson A, Rotllant G, Bhattarai A, Stro¨mberg J, et al. (2009) Influence of Rapid Malaria Diagnostic Tests on Treatment and Health Outcome in Fever Patients, Zanzibar—A Crossover Validation Study. PLoS Med 6(4): e1000070. doi:10.1371/journal.pmed.1000070

Deadline for applications: 5 May 2009

A leading non-profit organization, headquartered in Washington DC, is seeking a Project Director for a major malaria control and prevention project. The project is global with an emphasis on countries in sub-Saharan Africa where malaria is most prevalent. The Project Director must be a globally respected leader in the malaria community, with significant experience in malaria control management. He/she must have both the technical and management skills required to lead this project, providing vision, leadership, and direction.

Candidates with only the following qualifications should apply:

·         Recognized global leader in the malaria field in the prevention and control of malaria in developing countries and in capacity building.

·         Extensive developing country field experience (minimum of five years) in designing and implementing ITN related activities in malaria control programs.

·         At least 10 to 15 years of senior level experience managing large, complex projects in the developing world.

·         Experience interacting with developing country governments, multilateral and bilateral funding and technical organizations, civil society representatives, and senior level government officials. Experience working on USAID contracts a plus.

·         Substantial experience (at least five years) in supervising technical, management and support staff, and ability to work with diverse international teams.

·         A Master’s degree or higher, with a strong preference in public health and/or management.

·         Effective English oral and written communications skills and fluency in at least one of the following languages: French, Spanish, Portuguese.

·         Ability to travel up to 30% of the time for project oversight purposes.

Please send cover letter and resume to publichealthrecruiting@yahoo.com by May 5, 2009. Due to the volume of respondents we regret that only those selected for an interview will be contacted.

Deadline for applications: 4 May 2009

Ref: reference NH02

There has been a recent resurgence of interest in medical entomology research and renewed international recognition of the public health potential of vector control. The development of emerging technologies for controlling malaria vector mosquitoes in Africa, whilst additionally strengthening relevant endemic country research capacity is essential for successful malaria elimination.

We are looking for a post doctoral researcher, preferably with experience of conducting field research in tropical countries to provide essential supervision, support and mentorship required by post-graduate students who will undertake field research at the Ifakara Health Institute (IHI) in Tanzania www.ihi.or.tz . The successful candidate will act as a project leader of an international collaboration to investigate the control of adult African malaria vectors with spatially repellent compounds and insecticides. A relevant doctorate or equivalent, strong scientific and research training skills, as well as adaptability and ability to work in a team is essential. Experience with entomology, epidemiology, international health, challenging conditions and team leadership desirable but not essential. The post is available for 3 years.

The appointment will be made on the LSHTM National Research Fellow scale with a starting salary between £31,738 - £36,533 per annum depending on qualifications and experience.  Additional overseas allowances and benefits will be provided as appropriate.

For further particulars and an application form, please contact The Personnel Office, LSHTM, (telephone 020 7927 2203 (24 hour answer phone) or e-mail personnel@lshtm.ac.uk), quoting reference NH02.  Only applications in the format outlined in the recruitment pack will be considered. Applicants are encouraged to contact Sarah Moore (email: smoore@ihi.or.tz) or Nigel Hill (email: nigel.hill@lshtm.ac.uk)  for informal discussions.

The London School of Hygiene & Tropical Medicine is committed to being an equal opportunities employer

Following Monday`s release of a new global map on malaria, the government has expressed hope that Tanzania will triumph over the killer disease in six years` time.

The map shows Tanzania as one of sub-Saharan African countries with the highest prevalence of malaria and is one of the latest initiatives in rolling back the disease.

Health and Social Welfare deputy minister Aisha Kigoda said on Tuesday that the release of the map would enhance Tanzania`s fight against malaria ``with more knowledge about the disease and its prevalence across the country so that we can kick it out by 2015``.

``The map will be of use to health workers, policymakers, researchers and other players in the war on malaria. It will help them in more easily identifying the places worst hit and thus enable them to focus on them faster,`` she added.

She described the map as a good thing to the country and the donor community, elaborating: ``All these could use it to know exactly where the problem lies so that appropriate support or assistance can be directed to the most disadvantaged areas.``

Malaria is the ninth most significant cause of death and disability globally and is among the leading killers of under-fives and expectant mothers in Tanzania.

It also contributes to one of the highest infant and maternal mortality rates in the world.

The map was done by a multinational team of over 200 researchers, funded by the UK`s Wellcome Trust and released under the Malaria Atlas Project.

``The maps also show that almost all populations at medium and high levels of risk live in sub-Saharan Africa where the disease, death and disability burdens from malaria remain high,`` noted a Wellcome Trust statement.

Accompanying study results show that 70 per cent of the 2.4 billion people at some risk of infection with the malaria parasite live in areas of unstable or low endemic risk, where the technical obstacles to control of the disease are relatively small.

They further show that obstacles to malaria control mainly stretch from lack of knowledge about the disease, poor access to medical care and treatment.

``The map published today is the first in an annual series, which will help monitor and evaluate progress towards international targets for control and elimination,`` Dr Simon Hay, lead researcher who manages the project from the Department of Zoology at the UK`s University of Oxford, said.

Prof Bob Snow from the University of Oxford and the Kenyan Medical Research Institute, who heads the MAP group in Kenya, meanwhile explained that charting the future success of international efforts to control and eliminate malaria ``requires a map of the present-day situation which, when systematically updated, will indicate the progress achieved in ten, twenty and thirty years` time``.

Rather than guessing what`s happened, he said, the MAP`s intention has been ``to record, model and map developments, giving donors and national governments an evidence-based perspective on what their investments have achieved``.

Most of the international support for malaria-endemic countries is coordinated and dispersed by the Global Fund for Aids, Tuberculosis and Malaria.

The new map has been welcomed by its Executive Director, Prof Michel Kazatchkine, who noted: ``We need to increase the information available to us and to our donors to demonstrate that investing in malaria control does indeed reduce the numbers of people at risk worldwide.``

``With this kind of information, we can reassure donors by graphically showing progress and highlight where further investments are most needed,`` he pointed out.

The National Malaria Control Programme says Tanzania has between 16 and 18 million cases of malaria occurring each year and ending in more than 100,000 deaths.

Malaria accounts for some 30 per cent of the country`s disease burden, with some 35 per cent of deaths occurring at hospitals.

Statistics show that 37 per cent of the deaths are of children aged below five years, while pregnant women account for 25 per cent of maternal deaths.

The government has set 2015 as the target to eradicate the disease, which eats up 3.4 per cent of the gross domestic product

Français: http://www.edctp.org/Communique_de_presse.593.0.html

Putting the well-being of African study participants first: Gabon establishes national ethics committee

The Hague, 26 March 2009 - As the number of health research conducted in sub-Saharan Africa increases, so does the need for improved review of the ethical and scientific rigour of these trials. As we work on increasing the quality of research, we should also work on ensuring the safety of research participants. The recently established National Bioethics Committee of Gabon, which was established with the help of a grant from the European and Developing Countries Clinical Trials Partnership (EDCTP), is an example of the progress made to safeguard the well-being of African study participants.

The newly formed National Bioethics Committee for research of Gabon currently comprises 19 members that represent the three main Gabonese research institutes (USS Libreville, URM Lambarene and CIRMF Franceville), as well as relevant Gabonese hospitals and ministries. This initiative was started with the help of an EDCTP grant, training support from the Vienna School of Clinical Research, the Government of the Republic of Gabon and a committed team of Gabonese nationals. Consequently, with complementary support of other partners including WHO, UNESCO, AMANET and the Institut Pasteur of Dakar the Committee was officially established.

The committee is now operational and anticipates starting reviewing protocols for clinical trials soon. Negotiations are currently underway to include the committee in UNESCO’s Global Ethics Observatory Database. Inclusion in this database means that not only the Committee has proven able to assess research, but that is also able to advise on ethical problems, formulate recommendations and foster debate, education and public awareness.

Why every country must have a National Ethics Committee

All clinical trials involving human participants must be reviewed and approved by a competent and independent research ethics committee. The research ethics committee must ensure that all studies are conducted in accordance with international ethics codes and guidelines. The ultimate goal of ethical review is that the dignity, rights, safety and wellbeing of research participants are protected.

In many African countries, ethics review capacity needs to be strengthened. Inadequate training, limited infrastructural facilities and lack of funding remain a big challenge. As the number of clinical trials conducted in Africa is growing, so is the requirement to empower the countries of Africa to conduct their own safety reviews of those trials. Currently, a number of organisations such as EDCTP, WHO, UNESCO, AMANET, COHRED and others are working hand-in-hand to help those countries to create and strengthen their institutional and National Bioethics Committees.

EDCTP strengthening of ethics committees in Africa

EDCTP is involved in the assessment of the ethics and regulatory environment of the countries where EDCTP-funded trials will be conducted and provides support in these areas. The ultimate aim is to reinforce the African ethics and regulatory environment in the long term. EDCTP has funded research ethics committees in Zimbabwe, Ghana, Malawi, Nigeria, Uganda and Gabon and is working hand-in-hand with COHRED to map ethics and regulatory capacity in Africa and with the World Health Organization (WHO) to strengthen the National Regulatory framework.

About EDCTP

EDCTP aims through research integration to accelerate the development of new or improved drugs, vaccines, diagnostics and microbicides against HIV/AIDS, malaria and tuberculosis, with a focus on phase II and III clinical trials in sub-Saharan Africa.

EDCTP supports integrated multicentre projects which combine clinical trials, capacity building and networking. The aim of integrating these three activities is to ensure that the developed capacity is utilised to successfully conduct the clinical trials in a sustainable way.

EDCTP is currently part of the European Commission’s Sixth Framework Programme (FP6) for research and technological development, the European Union’s main instrument for funding research in Europe.

The basis of EDCTP is partnership. It unites 14 participating European Union (EU) member states plus Norway and Switzerland with sub-Saharan African countries. The partnership helps EU Member States to integrate and coordinate their own national research and development programmes and form partnerships with their African counterparts.

___

Note to the editor

For more information please contact:

Ilona van den Brink

EDCTP Communications Officer

media[at]edctp.org

+31 70 349 44 22

Scientists have created the most detailed global maps of malaria prevalence ever compiled. Their goal is to generate the maps annually so they can better fight the disease by tracking progress in malaria intervention efforts.

For the Malaria Atlas Project, the scientists collected data from over 8,000 surveys and used them to develop maps for 2007. According to a Q&A in Nature News with Simon Hay, one of the scientists working on the project at the University of Oxford, UK, next year’s maps will be based on over 13,000 surveys. You can download maps for any country from their website, something that Hay said "has never been done before."

The group spent two years compiling and modeling data across the entire globe down to a 5-by-5 kilometer resolution, which required about a month of computing time. This involved combining data from all the different surveys--information gathered at many different times and in different places.

Next years maps might not take so long. Hay says that Amazon will work with the group and has opened a free credit line of $12,000 dollars of computing time on their systems. "We intend to make it easy for scientists and policy-makers to see which areas are making progress and which are not," said Hay, who was surprised by the low level of prevalence in countries like Kenya and Tanzania, and at the higher prevalence in west Africa.

From the Nature News article:

Look at the Americas. Almost all the 40 million people there at risk of malaria are living in areas where transmission is below 5%. So technically the obstacles to malaria elimination in the region are low. It’s not rocket science; it says that if you can roll out prevention measures, you know they will work, so it’s purely a question of resources and logistics, nothing else. We can say the same for vast swathes of Central and South East Asia, although there are pockets of higher transmission areas such as Myanmar and lowlands of Papua New Guinea which are going to require more effort. The maps should of course be valuable guides in those efforts.

Even in Africa, where you have some 660 million people at risk, some 100 million live in areas where the maps show prevalence of less than 5%, so again there are excellent prospects for eliminating malaria from these areas, such as the northern extent of the Sahara, and the Horn of Africa. Again it’s the logistical obstacles that will be the rate-limiting step.

The paper was published online today in the journal PLoS Medicine.

Scientists from Germany today reported a major advance toward opening the doors of a carbohydrate-based medicine chest for the 21st Century. Much more than just potatoes and pasta, these carbohydrates may form the basis of revolutionary new vaccines and drugs to battle malaria, HIV, and a bevy of other diseases.

Speaking at the 237th National Meeting of the American Chemical Society, Peter H. Seeberger, Ph.D., described development of an automated carbohydrate synthesizer, a device that builds these intricate molecules in a few hours — rather than the months or years required with existing technology.

"Our automated synthesizer is now the fastest method to make complex carbohydrates," says Seeberger, principal investigator for the research. "There are currently no competitive methods available. Today, if people working in biology run into a problem related to carbohydrates, they usually drop it because there are no tools available. They can’t buy anything from a catalogue. It becomes a royal pain in the neck."

Scientists trying to synthesize DNA and protein-based molecules experienced a similar pain-in-the neck decades ago, until the invention of automated DNA and protein synthesizers. These devices helped kick start a revolution in genetics and proteomics. The carbohydrate synthesizer may do the same thing for the emerging fields of glycochemistry and glycobiology — named for carbohydrate sugar chains known as "glycans."

In 2001, Seeberger and colleagues reported the design of a prototype synthesizer. Revealed for the first time at the ACS National Meeting, the latest version is now fully automated, much faster, and can be operated by a non-expert, says Seeberger. Developed at the Swiss Federal Institute of Technology in Zurich, the instrument produces significant quantities of carbohydrate molecules that were nearly inaccessible until now.

Carbohydrates are tough molecules to build because of their complicated, branched structure. So instead of trying to build carbohydrates from scratch, scientists today use molecules isolated from nature, a painstaking process that could take months.

"We make things chemically that people used to isolate," explains Seeberger. "The automated synthesizer puts single sugars, the building blocks of carbohydrates, together like beads on a string."

Carbohydrates play crucial roles in the immune system, especially in the body’s defenses against disease-causing viruses and bacteria. Most of these microbes have unique carbohydrate markers on their surfaces. The immune system recognizes these carbohydrates as foreign material, and creates antibodies that launch an immune response to battle the infection.

"Vaccines ’educate’ the immune system to recognize a specific molecule on the surface of infectious organisms," explains Seeberger. "The synthesizer allows us to make not one but many carbohydrate structures from a particular organism and test those to see if they protect against the microbe. Synthetic carbohydrates that show promising protective qualities then may become the basis for new vaccines.

In a recent finding, the team discovered a carbohydrate on the surface of the malaria parasite P. falciparum that enables the parasite to infect human red blood cells, thus solving a long-standing mystery about how infection happens.

Seeberger’s group used the carbohydrate synthesizer to develop a malaria vaccine. Clinical trials for the vaccine are scheduled for 2010 in Mozambique and Tanzania. Its unique "anti-disease" mechanism makes it the only vaccine of its kind, he says.

"To my knowledge, ours is the first attempt at an anti-disease vaccine. It doesn’t actually kill the malarial parasite; it blocks its toxic action. You create antibodies against the sugar structure, and these antibodies block the carbohydrate toxin from leading to inflammation and anemia, the hallmarks of malarial infection," says Seeberger.

He explained that they will pair the carbohydrate vaccine with a traditional, protein-based one to create a "conjugate vaccine," which is best suited to immunize the most vulnerable group of potential malaria victims — children under the age of two.

The malaria vaccine is only one of almost a dozen vaccines from Seeberger’s lab headed for clinical trials. Carbohydrate-based vaccines could target some of today’s most serious infectious diseases, including antibiotic-resistant infections and HIV.

Seeberger is commercializing the carbohydrate synthesizer through his start-up company, Ancora Pharmaceuticals, based in Medford, Mass. Looking ahead, Seeberger discussed the other major obstacle facing carbohy¬¬¬drate research.

"In the area of glycobiology, there are two technological hurdles right now. One is to get access to molecules, which we have now addressed. The second one is sequencing. If you look at the human genome project, or genomics and proteomics, sequencing and synthesis were always the key issues," says Seeberger.

Seeberger saw firsthand the profound effect that automated DNA synthesizers had on genetics and biotechnology. His doctoral advisor, Marvin H. Caruthers, Ph.D., of the University of Colorado, helped develop the first model in 1980.

"We hope that we have the same effect on carbohydrate research," says Seeberger.

Summary of the Training Programme

The Special Programme for Research and Training in Tropical Diseases (TDR) invites researchers, living and working in the developing countries, to apply for one of ten 12-month career development fellowships on Clinical Research & Development at selected pharmaceutical companies and related institutions globally. The goal is to develop human resources to promote high quality R&D in the disease endemic countries (DEC) in the areas of project management, regulatory compliance and good practices. It is expected that qualified professional will be able to enhance DEC product development capacity on diagnostics, drugs and vaccines against infectious diseases that disproportionately impact low income countries. The programme will train individuals in situ with relevant partners in order to develop specialized skills not readily taught in academic centres, including inter alia R&D project management, regulatory compliance and good practices. Upon completing their fellowships, the individuals are expected to return to their home institutes and assume a leading role and become valuable resources in the global effort on R&D for neglected infectious diseases.

The proposed training programme extends TDR’s work in empowering DEC scientists to lead, manage and direct vaccine trials against AIDS/HIV, malaria, tuberculosis and other neglected tropical diseases and is based on a successful model developed between GlaxoSmithKline Biologicals (GSK) and TDR over the past eight years.

TDR reserves the right to propose candidates to specific locations for training based on their field of interest and opportunities available among partners. Although all companies are expected to provide the trainees with good exposure to general technical and managerial principles of R&D practices, individual programmes will be established within each company according to ongoing activities. A list of potential host organizations will be provided to successful candidates.

Alumni Network and post-training opportunities

An electronic alumni network will be organized and a meeting of past and current fellows will be held annually. The meetings will last three days each at the end of each programme year and will be held in locations other than Geneva. A vibrant alumni network will greatly contribute to the long-term sustainability of the programme by providing a forum for ongoing communication, better interaction and linkage building.

A follow-up grant will be made available to successful trainees to provide an additional opportunity for interaction with their peers and development of individual interests after completing the period of training. Applications for these funds must be proposed as an integral part of a personal development programme (PDP) and institutional programme that clearly documents the career development plans for the fellows. There would also be opportunity to attend an annual scientific meeting such as the one for the American Society for Tropical Medicine and Hygiene or the Royal Society of Tropical Medicine and Hygiene.

Eligibility

Applications are requested from developing country nationals working or involved in the Ministries of Health, academic or research institutions. Preference will be given to candidates under 35 years holding an MD or PhD degree with clinical and research experience in infectious diseases. Candidates will be computer literate and able to demonstrate fluency in English. Other languages, especially French, are an asset. Candidates must be able to demonstrate how the training programme will be put to use upon return to their home institute and country. Prior international experience is an asset.

Application

The application should be sent in electronic format (Word, PDF or RTF only) to RCStraining@who.int (no application form is required). Reference letters must be scanned and attached electronically. The following information should be provided:

1.      Full name with the family name underlined.

2.      Date of birth, sex and nationality (copy of information page of passport or other identification document may be requested at a later date).

3.      Name, address, telephone number, fax number and e-mail address of institution where the applicant is employed.

4.      Telephone number for personnel contact and possible interview (if not the same as institutional telephone number above #4) must be included.

5.      Educational qualifications, including place of study and graduation date (transcripts and copies of qualifications are not required but may be requested later).

6.      A brief description of the applicant’s current post and of the post held immediately before.

7.      A description (1 page maximum) of the applicant’s current work/research interests including disease(s) interest.

8.      A brief description of how the applicant, if selected, plans to apply the acquired skills and knowledge after returning to his home country/institution.

9.      A list of the applicant’s publications and other abstracts or presentations.

10.   A letter of recommendation from two senior scientists/professors that includes their address, telephone numbers, fax numbers and e-mail addresses. Please scan and include these with the application.

11.   An endorsement from the Director of the applicant’s home institution testifying to the ability of the applicant to undertake successfully the training proposed and certifying that the applicant, if selected, will be granted a leave of absence. The Director should also indicate how the proposed training will strengthen the institution’s capability to conduct clinical research upon the return of the trainee.

12.   Applicants from countries requiring national endorsement should submit their applications through proper government channels. A copy of all applications should be sent to the WHO Representative’s Office in their home country for information purposes.

All applications must be received at RCStraining@who.int by 15 April 2009

For further information:

Steven Wayling

Research Networks Manager

Special Programme for Research and Training in Tropical Diseases

World Health Organization

1211 Geneva 27

Switzerland

Telephone: (41-22) 791-3909 Fax: (41-22) 791-4854

E-mail: waylings@who.int

Candidates closely matching the eligibility criteria will be contacted to arrange a telephone interview in May and final candidates may have a face to face interview in Geneva.

Applicants will be informed of the outcome in June 2009.

Training will begin by mutual consent as soon as possible.

Abrams ET, Meshnick SR. Malaria during pregnancy in endemic areas: A lens for examining maternal-fetal conflict. Am J Hum Biol. 2009 Mar 25.

Most of our knowledge about maternal-fetal conflict derives from the battle over scarce nutritional resources. How do other stressors like infectious diseases alter the maternal-fetal relationship? In this article, we use the example of malaria infection during pregnancy to explore the altered maternal-fetal relationship in the presence of an infectious disease. While adults living in regions endemic to Plasmodium falciparum malaria are generally immune, pregnant women experience significantly more frequent and severe infections...

Parquet V, Briolant S, Torrentino-Madamet M, Henry M, Almeras L, Amalvict R, Baret E, Fusaï T, Rogier C, Pradines B. Atorvastatin is a Promising Partner for Antimalarial Drugs in Treatment of Plasmodium falciparum Malaria Antimicrob Agents Chemother. 2009 Mar 23

Atorvastatin (AVA) is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor. AVA exposure resulted in reduced in vitro growth of 22 P. falciparum strains with IC50s ranging from 2.5 microM to 10.8 microM. A significant positive correlation was found between the strains’ responses to AVA and mefloquine (r = 0.553; P = 0.008)…

Nielsen MA, Pinto VV, Resende M, Dahlbäck M, Ditlev SB, Theander TG, Salanti A. Induction of adhesion-inhibitory antibodies against placental Plasmodium falciparum parasites using single domains of VAR2CSA. Infect Immun. 2009 Mar 23.

In endemic areas pregnancy associated malaria (PAM) is an important cause of maternal anaemia, stillbirth and delivery of low birth weight children. The syndrome is precipitated by the accumulation of Plasmodium falciparum infected erythrocytes (IE) in the placenta mediated through an interaction between a parasite protein expressed on erythrocytes named VAR2CSA and chondroitin sulphate A (CSA) on syncytiotrophoblasts. VAR2CSA is a large polymorphic protein consisting of six Duffy-Binding-like (DBL) domains and with current constraints on recombinant protein production it is not possible to produce entire VAR2CSA recombinant proteins…

Mizuno Y, Kato Y, Kudo K, Kano S. First case of treatment failure of artemether-lumefantrine in a Japanese traveler with imported falciparum malaria. Jpn J Infect Dis. 2009 Mar;62(2):139-41

Artemether-lumefantrine, a tablet formulation of these respective antimalarial compounds, has been developed for the treatment of patients with drug-resistant malaria worldwide. Many studies have shown that it is most effective of the antimalarial compounds in shortening the fever and parasite clearance times. However, several treatment failures have been reported. These failures are believed to be a consequence of poor bioavailability of the lumefantrine component when ingested without fatty food. This paper reports the first case of such treatment failure of imported malaria in Japan in a 58-year-old Japanese man who showed recrudescence of Plasmodium falciparum after treatment with artemether-lumefantrine …

Ramphul U, Boase T, Bass C, Okedi LM, Donnelly MJ, Müller P. Insecticide resistance and its association with target-site mutations in natural populations of Anopheles gambiae from eastern Uganda. Trans R Soc Trop Med Hyg. 2009 Mar 18

Insecticide resistance in Anopheles gambiae threatens the success of malaria vector control programmes in sub-Saharan Africa. In order to manage insecticide resistance successfully, it is essential to assess continuously the target mosquito population. Here, we collected baseline information on the distribution and prevalence of insecticide resistance and its association with target-site mutations in eastern Uganda. Anopheles gambiae s.l. adults were raised from wild-caught larvae sampled from two ecologically distinct breeding sites and exposed to WHO discriminating concentrations of DDT, permethrin, deltamethrin, bendiocarb and malathion. Survival rates to DDT were as high as 85.4%, alongside significant resistance levels to permethrin (38.5%), reduced susceptibility to deltamethrin, but full susceptibility to bendiocarb and malathion...

Goodman C, Kachur SP, Abdulla S, Bloland P, Mills A. Concentration and drug prices in the retail market for malaria treatment in rural Tanzania. Health Econ. 2009 Mar 19.

The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three districts in Tanzania. We developed methods for investigating market definition, sales volumes and concentration, and used these to explore the relationship between antimalarial retail prices and competition...

Sirima SB, Tiono AB, Gansane A, Diarra A, Ouedraogo A, Konate AT, Kiechel JR, Morgan CC, Olliaro PL, Taylor WR. The efficacy and safety of a new fixed-dose combination of amodiaquine and artesunate in young African children with acute uncomplicated Plasmodium falciparum. Malar J. 2009 Mar 16;8(1):48

Artesunate (AS) plus amodiaquine (AQ) is one artemisinin-based combination (ACT) recommended by the WHO for treating Plasmodium falciparum malaria. Fixed-dose AS/AQ is new, but its safety and efficacy are hitherto untested...

Recently, the World Health Organization (WHO) announced that the emergence of parasites, along the Thai-Cambodia border, that are resistant to the medicine artemisinin could seriously undermine global malaria control.

The recent shift from drugs that were failing to the highly effective artemisinin-based combination therapies allowed great progress in fighting malaria, one of the world’s major killers.

More than one million people die of malaria each year, mostly in Africa. The disease poses a risk to half of the world’s population, according to the World Health Organization

Now, along the Thai-Cambodian border, researchers have discovered a malaria parasite that is resistant to the most effective anti-malaria medicine. 

Colonel Gray Heppner is a key researcher on malaria and Deputy Commander at the Walter Reed Research Institute in Maryland. He says if drug resistance spreads, the number of yearly deaths could double.

"And it’s not just the death toll, it is the number of people who are chronically ill because we can’t cure them," Heppner said. "So if you can imagine all the people that are chronically ill with malaria today. And some estimates are that there are a half a billion people that have a recognized episode of malaria every year. And if you think about doubling this, well it puts an incredible burden in a society."

The recent news in a report by U.S. Army researcher Mark Fukuda, published in the New England Journal of Medicine, shows that some malaria parasites are resistant to artemisinin.

"The artemisinins are the most rapidly effective medicine that has ever been invented for malaria," he said.

"Artemisia" is a plant. Its derivatives are known as artemisinins. The Chinese have used the plant for centuries against fever.

But a few decades ago, when malaria parasites became immune to chloroquine and other medications, artemisinin became the world’s great hope. 

In the last decade, malaria control programs have also included insecticide-treated bed nets - to shield against mosquitos that carry the parasites. The nets and artemisinins have helped lower infection rates in many countries, mostly in Africa.

For the moment, there is no replacement for artemisinin-based drugs.  

The Walter Reed Institute has been working to develop a vaccine against malaria as well as new medicines. 

Colonel Peter Weina, who specializes in tropical diseases, and specifically malaria, led the U.S. Army’s effort to develop a drug against the most severe form of malaria. "Intravenous Artesunate" has not yet received final approval, but is now being use in certain cases. 

"We have our formulation available on compassionate use here in the U.S. and recently in Canada. We have donated several hundred vials to clinical trials that are being done in Africa with some of our partner groups," Dr. Weina said.

But this drug is also derived from artemisinin. 

"There was an assumption and there was a hope and there was a prayer that resistance to artemisinin would never happen," he said.

Research to find new medications against malaria continue.

"Out of every 5,000 compounds that show promise," Dr. Weina said. "Only one of them statistically will make it to being a drug that is useful."

The World Health Organization and the Bill and Melinda Gates Foundation have launched a multi-million dollar campaign to control the spread of the artemisinin resistant parasite.

But as Dr. Weina says, malaria is a disease of poverty. It thrives in areas lacking hygiene and resources. And it will be with us for years.

Urgent measures are being taken by the WHO along the Thai-Cambodia border in response to the first signs of resistance to the antimalarial wonder drug artemisinin.

Fears about a full outbreak of the resistant malaria are so great that US$22.5 million will be spent on high-quality drugs and bednets for affected provinces, as well as research and improved case management.

"Before, we were warning people that there could be an emergence of artemisinin resistance. Now there is artemisinin resistance … the tone [of our warning] has changed," Pascal Ringwald, malaria coordinator at the WHO, told SciDev.Net.

The WHO has been concerned since 2005, when artemisinin effectiveness at the border was found to be deficient. 

Many people in the area have been using artemisinin alone, rather than in artemisinin combination therapies (ACTs) as recommended. Using artemisinin alone encourages the parasite to adapt to, and eventually overcome, the activity of the single drug.

The WHO is unsure what has triggered the resistance and some of the money will fund research to address this issue.

"There are some gaps in our knowledge," says Ringwald. "For instance, we do not know yet what is the [genetic] mutation that occurs in parasites with regards to artemisinin resistance."

"Many people talk about elimination and eradication, and ACTs are one of the effective weapons we have. We have not yet lost this weapon but we’re detecting a problem — it’s like a car that cannot reach maximum speed." ACTs are effective in more than 90 per cent of cases but we will "completely lose this weapon" if resistance spreads, he adds.

The most important preventative measure, says the WHO, is using combination therapies. Countries must ban the use of artemisinin monotherapies, and ensure that only good-quality drugs are used. Vector control must also be strengthened; ensuring that coverage with bednets and hammock nets. 

This is not the first time that resistance to antimalarial drugs has occurred along the Thai-Cambodia border — resistance to chloroquine developed in the 1950s, followed by sulfadoxine-pyrimethamine and mefloquine.

Ringwald says the current outbreak of resistance has been detected early enough, but without action a serious problem could emerge.

"At this stage, the chances of success depend on whether or not the resistance has already spread beyond the border. If it is limited to [the border city] Pailin and the Pailin area, the chances of success are very high. If not … we can’t begin to imagine how big a problem it will be."

The funds, given by the Bill and Melinda Gates Foundation, were announced by the WHO last week (25 February).

A separate group published a paper in PLoS ONE last week (23 February) providing evidence of "small but significant increases in parasite tolerance" to artemisinin on the Thai-Myanmar border. The authors advocate close monitoring to check for the emergence of resistance.

The means by which most deadly malaria parasites are detected and killed by the mosquitoes that carry them is revealed for the first time in research published today (5 March) in Science Express. The discovery could help researchers find a way to block transmission of the disease from mosquitoes to humans.

Mosquitoes become infected with malaria when they feed on the blood of an infected person. Young malaria parasites then grow and develop inside the mosquito for two weeks. New human infections occur when these parasites are ’injected’ with the insect’s saliva during the mosquito’s next blood meal.

However, most of the malaria parasites are killed by the mosquito’s immune system as soon as they enter the insect’s bloodstream, with only one or two slipping through the net and going on to divide, multiply, and infect people.

The new study shows exactly how the mosquito’s immune system kicks in to kill 80 - 90 percent of the parasites. The researchers discovered that the parasites are detected by a pair of proteins called LRIM1 and APL1C which belong to the mosquito’s infection surveillance system. These two ’intruder detection’ proteins then activate a third protein in the mosquito’s blood called TEP1, which seeks out the parasitic invader, binds to its surface and orchestrates its destruction by punching holes in its cell membrane.

The Imperial College London team behind the new discovery say this knowledge could be used to develop new genetic or chemical techniques to improve on the mosquito’s natural detection success rate, so that 100 percent of the parasites can be killed inside the mosquito, preventing transmission of the disease from insects to people.

Dr George Christophides from Imperial’s Department of Life Sciences comments: "Mosquitoes are known as the ’bad guys’ that spread malaria, but these insects are unwilling carriers of the disease, whose immune systems try to fight it, just like ours do. Now that we know exactly how their immune system attacks malaria parasites, we need to work out how a small number of parasites manage to evade detection by this system. Only a few manage to get past the mosquito’s defences, but that’s all that’s needed for the disease to be transmitted to humans.

"If we can figure out how some parasites manage to sneak through undetected, hopefully we can find a way to bolster the mosquito’s defences to catch them all."

The research, which was funded by the Wellcome Trust, the Biotechnology and Biological Sciences Research Council (BBSRC), and the National Institute of Allergy and Infectious Diseases of the U.S. National Institutes of Health, was carried out in the laboratory using a model parasite which causes malaria in rodents.

Half the global population are at risk of contracting malaria and up to half a billion new infections are recorded every year. Between one and three million people die from malaria every year - the majority of fatalities are children living in sub-Saharan Africa.

Apart from malaria, mosquitoes also spread other serious infectious diseases such as dengue and yellow fever, filariasis and various encephalitides. Dr Christophides and his colleagues at Imperial also discovered that LRIM1 and APL1C belong to a family of infection detection proteins that appear to be specific to mosquitoes. The researchers believe that proteins in this family may play a role in defence against these other infections too, and are currently investigating how these proteins function during mosquito infection with dangerous human pathogens.

Health ministers from eight countries in the Southern African Development Community this week held a Malaria Elimination Ministerial Meeting in the Namibian capital of Windhoek to develop a cross-border approach for eliminating malaria in the region, New Era reports.

The project will involve four "front-line" countries -- Botswana, Namibia, South Africa and Swaziland -- and four "second-line" countries -- Angola, Mozambique, Zambia and Zimbabwe -- that are located on the northern border of the front-line countries. Namibian Prime Minister Nahas Angula said the project, also called "Elimination 8," aims to eliminate malaria first from the front-line countries, which would then contribute to malaria elimination in the second-line countries. He added that the success of the project will depend on the extent of partnership among the countries involved.

According to New Era, the World Health Organization identified the four front-line countries because they have low malaria transmission rates and other favorable climatic and epidemiological conditions. The project will operate under the belief that intensifying malaria control in low-burden countries will result in malaria elimination up to the northern border of the front-line countries, which will then propel the neighboring second-line countries to advance malaria elimination initiatives. Richard Kamwi, Namibia’s minister of health and social services, said reducing malaria transmission in the front-line countries would provide a foundation for malaria elimination in the region. He added that neighboring countries with high malaria burdens are critical in elimination strategies because malaria vectors can travel between national borders. "Malaria is a challenge that knows no borders, and therefore must be tackled with similar strategies that equally know no borders," Kamwi said. He added, "When we consider the movement of our people across borders and the import and export of cases, we appreciate the imperative of cross-border collaboration and of a regional approach to elimination."

According to Angula, eliminating malaria in southern Africa will contribute to child development, improve productivity and growth, and increase the use of resources for development in the region. In addition, malaria elimination could lead to an increase in foreign investment and tourism, he said. Despite the economic downturn, Angula encouraged the participating countries to maintain their malaria intervention programs. "Let us seriously consider the positive financial and economic implications of malaria elimination for our region," he said, adding, "It is an investment with very high returns." According to New Era, previous cross-border initiatives, such as the Lubombo Spatial Development Initiative between South Africa and Swaziland, have helped reduce malaria prevalence in targeted areas. The Southern Africa region decided to undertake its cross-border initiative following the 2007 launch of the African Union’s Africa Malaria Elimination Campaign. According to New Era, officials from SADC, WHO, the Roll Back Malaria Partnership, the World Bank, UNICEF and other international agencies attended the ministerial meeting in Windhoek.

Although progress has been made towards reducing malaria deaths, currently around 1 million a year, to near zero by the end of 2015, the international community needs to intensify its efforts to reach the goal, stressed a new United Nations report published today.

The report noted that over 40 per cent of the population in sub-Saharan Africa now has access to long-lasting insecticide-treated mosquito nets (LLINs), compared to 10 per cent in 2005.

The figures indicate a considerable leap in the number of people benefiting from the protective cover of the nets in the continent, which accounts for over 90 per cent of all malaria deaths.

Secretary-General Ban Ki-moon’s target of providing universal malaria control coverage by the end of 2010 to all endemic African countries is within sight, according to the report, with the distribution to date of more than 140 million mosquito nets, protecting nearly 300 million people in the region.

“At this moment, we can point to definite indicators of progress, with data revealing that LLINs now have been distributed to more than 40 per cent of the population in endemic African nations,” said Ray Chambers, the Secretary-General’s Special Envoy for Malaria.

“This signifies perhaps the most encouraging development in a year that featured many noteworthy accomplishments,” added Mr. Chambers, in a press release announcing the launch of the report.

Mr. Chambers’ report noted that in 2008 the African Union Summit strengthened its commitment to malaria control and malaria-endemic countries, and submitted an aggressive set of proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which responded with a record $1.57 billion donation.

The report, which also underscores last year’s announcement that the world can reach near-zero deaths from malaria by 2015, stressed that while malaria-related objectives are within sight, a failure to increase momentum will result in falling short of objectives.

“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,” warned Mr. Chambers.

He emphasized that the international community needs to exert the “same thought and energy that guided LLINs in 2008” to support other essential interventions, such as treatment in public health facilities, the provision of rapid diagnostic tests and the production of an adequate number of anti-malarial medicines, in particular artemisinin-based combination therapies (ACTs).

Deadline for applications: 15 April 2009

www.amanet-trust.org

The European Malaria Vaccine Initiative (EMVI) has an exciting career opportunity for a Physician, Epidemiologist or Public Health specialist to join the organisation on a three-year full time position as GMZ2 Clinical Trials Associate.  This position is within an EDCTP funded 5-year project which is coordinated by The African Malaria Network Trust (AMANET) based in Tanzania.

Duties and Areas of Responsibility:

·         To assist the Director, Clinical and Regulatory Affairs (DCRA) in the coordination and conduct of Phase I/IIb clinical trials of the GMZ2 candidate vaccine.

·         To assist the DCRA in formulating the detailed work plan of activity and proposing allocation of tasks and resources to the clinical trial sites.

·         To identify and discuss potential difficulties and barriers associated with achieving the set tasks

·         To plan and organise monthly meetings and TC’s with the PI’s of the clinical trial sites.

·         To highlight and present any difficult issues those need the attention of the Project Steering Committee.

·         To assist in the technical/administrative reporting of the progress of the work plan to the DCRA.

Qualifications:

·         MD

·         Post-graduate degree in Public Health, Epidemiology, Immunology or Clinical Research would be an asset.

·         Fluency in English is mandatory, French would be a plus.

Experience:

·         Three to five years experience in clinical development at the level of Clinical Research Assistant, or Clinical Research Physician.

·         Extensive training in ICH GCP guidelines will be a plus.

·         Experience in the conduct of malaria vaccine clinical trials will be an asset.

·         Knowledge of Microsoft Project, Microsoft Office and Microsoft Access is desirable.

Competencies:

1.    Planning and Organising: Proven ability to be able to plan and manage clinical trials. Ability to work within deadlines.

2.    Respect of Diversity: Good interpersonal skills; Demonstrated ability to work in multicultural and multi-ethnic environment and to maintain effective working relations with people of different national and cultural backgrounds.

Conditions of Appointment

·         Contract period will be three years, available from April 2009 with a possibility of extension.  A probationary period of six months will apply.

·         Attractive salary conditions to be offered.

·         Successful applicants will be based in Copenhagen.

·         Extensive traveling in Africa, and to a lesser extent in Europe is to be expected.

Deadline for applications:  15 April 2009

Applications should be sent by email to:

Dr. Odile Leroy Executive Director European Malaria Vaccine Initiative C/o Statum Serum Institut (SSI) Artillerivej 5 DK-2300 Copenhagen S Denmark

Secretariat email: ji@ssi.dk Cc: ebi@ssi.dk

For further information, please contact:

Dr Egeruan Babatunde Imoukhuede, Director of Clinical and Regulatory Affairs Tel.: +44 208 674 8318 Email: ebi@ssi.dk

Master International (M2) d’Entomologie médicale et vétérinaire  /  International Master (M2) in medical and veterinary Entomology

Promotion 2009-2010 : 2ème appel à candidature  /  Year 2009-2010: 2nd call for student application

(Date de clôture des pré-incriptions : 31 mars 2009)  /   (Dead line for preregistration : March 31st, 2009)

La quatrième promotion du Master International d’Entomologie médicale et vétérinaire (MIE) débutera en septembre 2009 au Bénin (Afrique de l’Ouest). Les étudiants souhaitant participer à cette formation universitaire doivent impérativement s’inscrire sur le site Internet du MIE : www.miemv.org à la rubrique « pré-inscription» avant le 31 mars 2009, date au delà de laquelle cette rubrique ne sera plus en ligne.

Les étudiants dont la candidature est administrativement recevable seront avertis par courrier électronique au plus tard le 15 avril 2009. Ils devront soumettre en ligne avant le 15 mai 2009 un dossier définitif de candidature. Ces dossiers définitifs de candidature seront examinés en juin 2009 par le Comité Pédagogique et Technique du MIE. Les candidats retenus seront informés par courrier électronique début août 2009.

Pour plus de renseignements sur le MIE, nous vous invitons à consulter notre site, ou à contacter le Secrétariat Scientifique et Administratif du MIE.

Pour le Secrétariat du MIE Le Coordonnateur Dr Thierry BALDET

---------------------

The fourth year of the International Master Degree in medical and veterinary Entomology (IME) will begin in September 2009 in Benin (West Africa). Students interested in this academic training are urged to register online at www.miemv.org, item “pre-registration", no latter than March 31st, 2009. This deadline is unalterable and will be strictly complied with.

Students that meet the first administrative requirements will be informed by email by April 15th, 2009 at the latest. At that point, students will have until May 15th, 2009 to submit online a final application. Final applications will be assessed in June 2009 by the Pedagogic and Technical Committee of the IME. Selected candidates will be notified by email in early August 2009.

For further information on the IME, we kindly ask you to check our website, or contact the IME Scientific and Administrative Secretary’s office.

IME Secretary’s Office

The Coordinator Dr Thierry BALDET

Deadline for applications: 30 April 2009

As part of our ongoing research program examining malaria transmission and immunity in highland Kenya, the University of Minnesota, USA (UMN), in collaboration with the Kenya Medical Research Institute (KEMRI), Maseno University, Kenya, and Moi University, Kenya, and through a grant from the Fogarty International Center of US National Institutes of Health, is pleased to announce training opportunities for one Postdoctoral Fellow (Epidemiology) and two PhD Students (one each Epidemiology and Biostatistics).

The Fellow and Students will assist in the following research areas, which are supported by a vast collection of geo-spatial, climactic, and entomologic data:

1.    Determine the effect of P. falciparum transmission on antigen-specific immunity and associated protection from infection.

2.    Identify antigen-specific immune responses protective against P. falciparum disease.

3.    Elucidate the relationship of parasite genotypes to P. falciparum disease.

These opportunities are specifically designed to include multi-disciplinary training in epidemiology, biostatistics, immunology/molecular biology, entomology, and clinical research. Appointments will be for 3 years for Postdoctoral Fellow and 5 years for PhD Students. Positions will be based primarily at the campuses of UMN-KEMRI, Maseno Univserity and Moi University in western Kenya (Kisumu), however opportunities for training at UMN in the USA will also be available.

Qualifications (Note: Candidates must be nationals of an African country):

1.    Postdoctoral Fellowship (Epidemiology): PhD degree in epidemiology, biostatistics, or related discipline. Must possess a good publication record. Experience in clinical trials or field epidemiology studies required. Experience in malaria research preferred but not required.

2.    PhD Student (Epidemiology): BSc degree with a minimum award of an upper second class and MSc degree in epidemiology, biostatistics, mathematics, or related discipline.

3.    PhD Student (Biostatistics): BSc degree with a minimum award of an upper second class and MSc degree in biostatistics, mathematics, epidemiology or related discipline. Coursework in mathematics must include multivariable calculus, linear algebra, applied statistics, and computer programming. GRE scores of 550 (verbal), 650 (quantitative) required.

Application Procedures:

Interested applicants should email a letter of interest stating the position to which you

are applying, along with a CV, copies of degree certificates, and three letters of

recommendation from academic referees to:

Dr. Gregory S. Noland

Project Manager

UMN/KEMRI Malaria Project

PO Box 1578  Kisumu, Kenya

nolan103@umn.edu.

Cheraghali AM, Idries AM. Availability, affordability, and prescribing pattern of medicines in Sudan. Pharm World Sci. 2009 Mar 5.

…The survey followed the WHO guidelines for monitoring and assessing the pharmaceutical situation in countries. For this survey, a total of 36 public health facilities selected from the six geographic areas were identified…The survey confirmed the good availability and acceptable affordability of essential medicines in the public health centers and private pharmacies. Despite acceptable stocking of the medicines in these facilities, storage quality of medicines was low...

Njuguna J, Muita J, Mundia G. Malaria morbidity and temperature variation in a low risk Kenyan district: a case of overdiagnosis?

The Deadline for Abstract Submission to the Fifth MIM Pan-African Malaria Conference is Right Here: March 1, 2009.

Have you registered? Are you planning to submit your abstract to one of the largest meeting worldwide entirely devoted to malaria research and control? It’s never too late. Visit www.mimalaria.org/pamc for more information, online registration and abstract submission. Or go directly to the online registration system to submit your abstract: http://www.regonline.co.uk/Checkin.asp?EventId=625453

Remember, it is possible to submit your abstract now and pay for registration fees later. If you don’t have a credit card, choose the second option: payment by wire transfer. This will allow you to continue with the process and submit your abstract on time; just remember to write down details on how to send money by wire transfer.

If you are already started and have not completed your registration, log on to the registration system then click “Already Registered”. Then enter the email address used for the registration and password. On the page that opens there are several links including viewing the receipts etc.  At the bottom there is a section for editing your information. Click Personal Information, and then go to the “Abstract Submission” section to upload your abstract.

Central African Institutions with coordination from the Multilateral Initiative on Malaria secretariat have been awarded a three million euros grant by the European and Developing Countries Clinical Trials Partnership (EDCTP) for establishing a Central Africa Network on Tuberculosis, HIV/AIDS and Malaria for the Conduct of Clinical Trials (CANTAM). The network involves following partners; in Cameroon-University of Buea, University of Yaoundé1, Centre International de Référence Chantal Biya, and the Organisation de Coordination pour la lutte Contre les Endémies en Afrique Centrale (OCEAC) ; in Congo-University Marie Ngouabi and Centre d’Etudes des Ressources Végétales ; in Gabon- The Medical Research Unit of the Albert Schweitzer Hospital; in Tanzania-Multilateral Initiative of Malaria (The Project Coordinator) and in Germany-The University of Tübingen.

With this grant, CANTAM will develop human resources skills such as good clinical and laboratory practice (GCP and GLP), health research ethics, required to conduct clinical trials including writing clinical trial protocols to guide such trials. The network will also strengthen laboratories in the region to enable them to perform relevant tests for HIV/AIDS and malaria clinical research; strengthen ethical review boards and regulatory authorities where they are weak or absent and establish effective community liaison at each site and identify new study cohorts in villages and towns for future clinical trials on HIV/AIDS and malaria.

As project coordinator, the MIM Secretariat Coordinator will be working hand in hand with participating research institutions in this network in Central Africa, with guidance and political goodwill from the OCEAC. Ever since the MIM Secretariat moved to Africa, the challenge has been to see MIM playing active role in coordinating both health research and the researchers themselves, especially in the Central African corridor which has not been very well  covered.

MIM Secretariat is looking forward to playing major role in networking African researchers, setting up specific and cross-cutting disease training programmes and sharing resources and information.

A new study suggests that one of the most important malaria drugs, artemether-lumefantrine, may remain potent well after its shelf-life was thought to expire. The study, published in the Malaria Journal, says the drug used in artemisinin-based therapy could possibly be used years after its listed expiration date.

In Washington, Richard Tren, director of Africa Fighting Malaria, says, "The drugs that were effective against malaria over the past few decades…have become resistant. The malaria parasite is extremely effective at resisting our attempts to kill it off. And so the new…malaria drugs are these artemisinin combination therapies that are based on an ancient Chinese herbal remedy and then combined with a different drug that has a different mode of action. And by combining the two drugs, you reduce the probability that the parasite will become resistant."

The thinking has been that these newer malaria drugs probably could only be used for up to two years before becoming ineffective. Tren says, "This goes back…(to) when these drugs were first developed and formulated as a combination therapy. The drug regulators gave it a two-year shelf life because we simply didn’t know how long it lasts."

Setting a limited shelf life helps protects patients. Tren says, "They do this for good reason. They want to make sure that the drugs we’re getting out there are safe and effective. But now we’ve been using these drugs in some countries for five or six years, sometimes even longer. And it seems though from our initial studies that the drugs are much more stable, that they could last well beyond two years."

There’s a call for a more in-depth study of the malaria drugs to determine their true expiration date. Such a study could be done by the US Food and Drug Administration or Swissmedic. Tren says the preliminary study was based on 70 samples that were officially out of date. Tests using thin-layer chromatography and Raman spectrometry indicated nearly all were still effective. Some of the samples were out of date by as much as 58 months.

Malaria is not only one of the most common diseases in Tanzania it is also a major killer. Although a lot of emphasis has been placed on fighting the HIV/Aids pandemic, more efforts are required to eradicate malaria.

Malaria is a preventable disease. Experience has shown that, when adequate preventive measures are applied, the prevalence of malaria infections can be greatly lowered.

Zanzibar, which has over the years scaled efforts to combat and prevent the spread of malaria, could be safely cited as a success story.

Official reports show that Zanzibar had done so with financial support from the Global Fund Against Aids, Tuberculosis and Malaria (GFATM) and resources from other partners like the President`s Malaria Initiative.

The Isles` strategy was based on the spraying of homes and fumigating mosquito-breeding grounds, and its success is slowly becoming an international case study on effectively fighting malaria.

This experiment has proved that malaria prevention is lots more effective than treatment, given the fact that mosquitoes carrying malaria parasites have developed resistance to insecticides while the parasites have developed resistance to anti-malaria drugs.

This experience has made Tanzania adopt different anti-malaria drugs from time to time.

As recently as early this week, the Health and Social Welfare minister launched a new anti-malaria drug for under-fives which is a combination of Arthmether and Lumefrantine.

Despite the introduction of these methods of treatment, the fact remains that most Tanzanians still suffer from the disease, President Jakaya Kikwete`s dream by last September being that the country would eradicate malaria by 2015.

African countries met on April 25, 2000 and signed the Abuja Declaration, committing their countries to helping cut malaria deaths in Africa by half by 2010.

This shows that African governments, without exception, are committed to kicking malaria out of the continent.

Nevertheless, this resolve would be useless unless it is accompanied by effective strategies whose projects pass the value for money gauge.

We have spent a lot of money fighting malaria, including popularising the use of mosquito nets, yet the disease keeps claiming victims in large numbers.

It is high time we reviewed our approach by seeking to slash the jugular vein, which means destroying mosquito-breeding grounds.

We are not suggesting that treated mosquito nets are useless, only that greater emphasis should be put on destroying breeding grounds and spraying residences, as has been done in Zanzibar.

The fight against malaria also requires a joint war as well as an effective regional strategy.

The transmission of malaria knows no borders, and hence the need for African countries to confront the killer disease more seriously and better equipped.

Malaria is wreaking havoc all over the globe, with Africa most seriously hit.

It is reported on authority that the disease claims an annual one million lives across the globe, most victims being under-fives.

This is enough reason for African leaders to use global forums to call for the pooling of international resources - both human and material - so that this disease is indeed eliminated. It is a war we must fight to win.

The global financial crisis may soon make external funding much harder to get, warns Linda Nordling.

In the face of the global financial crisis, African scientists should start applying for funding while there is still some going around.

Foreign funding is important for African science. It pays for much of the best of it — for example, testing the PRO 2000 gel which recently gave hope to women wanting to protect themselves against HIV infection (see Microbicide hope at last, say researchers).

It is also important in re-building universities and research communities on the continent — although the ensuing dependence on overseas donors remains controversial.

A decline in external funding would have seemed far-fetched a few years ago when donors were falling over one another to pledge support for African science. But with the global financial crisis, things are looking less rosy.

Will science suffer?

In October 2008, Kenyan anthropologist Richard Leakey said that the financial crisis would be "just devastating" to science. Not only will companies and governments have less money to spend on research and development (R&D), but philanthropists and aid agencies are also likely to cut back support, he said.

According to Leakey, the decline would start to be felt this year. But while funding is likely to become a bit tighter, the effect this year may be a lot less than imagined.

Foundations that finance their grants through interest paid on assets held in global financial markets have been hit hard, but many are not making immediate funding cuts. For example the Bill and Melinda Gates Foundation, which saw its total assets shrink by 20 per cent last year, is still planning to increase its payouts in 2009.

If this means eroding the foundation’s asset base more quickly than planned, so be it, wrote Bill Gates in a January staff letter, saying: "The goal of our foundation is to make investments whose payback to society is very high rather than to pay out the minimum to make the endowment last as long as possible".

Other US charities, including members of the Partnership for Higher Education in Africa, are taking a similar line. They too deny that spending will fall in 2009, although a spokesman for the Carnegie Corporation said that beyond the end of its financial year in September, things are as yet unclear.

Others have brought out the scissors. The Wellcome Trust, a UK medical charity, saw its assets drop from £15.1 billion in September 2007 to £13.1bn the following year. The weakness of sterling is an additional headache, making international projects, including those in Africa, more expensive to fund. The trust says it will pay out £590 million in grants this year — a £30m cut from 2007/08. The result will be tougher competition for funding, it says.

Government promises

But if the charity sector is facing a lean year, it is far from clear how the financial crisis will affect governmental aid agencies. Before the credit crunch, many of them promised to increase their spending on science in Africa.

On paper, at least, most remain committed. Ivan Lewis, the UK’s minister for international development, recently reiterated a pledge to spend 0.7 per cent of gross domestic product (GDP) on development aid by 2013. And the Canadian International Development Agency says it’s on target to double aid to Africa by 2011.

But many doubt such claims. Having dragged their feet in times of plenty, they ask, how likely are government aid agencies to keep their promises in hard times?

Even if aid budgets grow, they may not go to science. The crisis — which Trevor Manuel, South Africa’s finance minister, says will hit developing countries hard — could increase the need for humanitarian aid like food and healthcare. This could in turn starve less pressing projects like university reform.

Lean times ahead

Meanwhile, on the ground, research institutes are digging in for tough times ahead. "With countries facing GDP decline we are planning more conservatively," says Liz Ogutu, resource mobilisation officer for the International Livestock Research Institute.

Projects that are in the middle of their funding cycle, such as the Millennium Science Initiative in Uganda, don’t have cause to worry — yet. But it will no doubt be tough for programmes looking to replace grants that are nearly ended — such as the African Mathematics Millennium Science Initiative which has a Mellon Foundation grant ending this year.

Still, there is a silver lining for African researchers who are confident competing against overseas teams for funding. The ’crisis package’ signed into law by President Barack Obama earlier this month (February) features a hefty biomedical research funding boost. The money will be distributed by the US National Institutes of Health, which gives many grants to African researchers on the continent.

There is political pressure for the stimulus package to be spent inside the United States. But "traditionally, science funding has been relatively immune from ’Buy American’ pressures that affect other types of spending like government procurement or transportation projects", says Kei Koizumi, R&D budget analyst for the American Association for the Advancement of Science.

All things considered, 2009 seems unlikely to bring the devastation Richard Leakey predicted. But it may only be a temporary respite. All funders and recipients interviewed for this column said that how much damage the financial crisis causes will depend on how long it lasts. The major funders could probably weather it for a year — maybe two. But if it lasts longer than that, all bets will be off.

Linda Nordling is former editor of Research Africa.

Bate R, Tren R, Hess K, Attaran A. Physical and chemical stability of expired fixed dose combination artemether-lumefantrine in uncontrolled tropical conditions. Malar J. 2009 Feb 25;8(1):33.

New artemisinin combination therapies pose difficulties of implementation in developing and tropical settings because they have a short shelf-life (two years) relative to the medicines they replace. This limits the reliability and cost of treatment, and the acceptability of this treatment to health care workers. A multi-pronged investigation was made into the chemical and physical stability of fixed dose combination artemether-lumefantrine (FDC-ALU) stored under heterogeneous, uncontrolled African conditions, to probe if a shelf-life extension might be possible...

Phillips A, Bassett P, Szeki S, Newman S, Pasvol G. Risk Factors for Severe Disease in Adults with Falciparum Malaria. Clin Infect Dis. 2009 Feb 25.

Over a 16-year period, we conducted a clinical study of malaria acquired worldwide in adults from malaria-nonendemic countries, to determine risk factors for severe Plasmodium falciparum malaria…

Gesase S, Gosling RD, Hashim R, Ord R, Naidoo I, Madebe R, Mosha JF, Joho A, Mandia V, Mrema H, Mapunda E, Savael Z, Lemnge M, Mosha FW, Greenwood B, Roper C, Chandramohan D. High resistance of Plasmodium falciparum to sulphadoxine/pyrimethamine in northern Tanzania and the emergence of dhps resistance mutation at Codon 581. PLoS ONE. 2009;4(2):e4569

Sulphadoxine-pyrimethamine (SP) a widely used treatment for uncomplicated malaria and recommended for intermittent preventive treatment of malaria in pregnancy, is being investigated for intermittent preventive treatment of malaria in infants (IPTi). High levels of drug resistance to SP have been reported from north-eastern Tanzania associated with mutations in parasite genes. This study compared the in vivo efficacy of SP in symptomatic 6-59 month children with uncomplicated malaria and in asymptomatic 2-10 month old infants…

Ibrahim ML, Steenkeste N, Khim N, Adam HH, Konate L, Coppee JY, Ariey F, Duchemin JB. Field-based evidence of fast and global increase of Plasmodium falciparum drug-resistance by DNA-microarrays and PCR/RFLP in Niger. Malar J. 2009 Feb 23;8(1):32

Over the last years, significant progress has been made in the comprehension of the molecular mechanism of malaria resistance to drugs. Together with in vivo tests, the molecular monitoring is now part of the survey strategy of the Plasmodium sensitivity. Currently, DNA-microarray analysis allows the simultaneous study of many single nucleotide polymorphisms (SNP) of Plasmodium isolates. In December 2005, the International Federation of the Red Cross distributed two million three hundred thousand long-lasting insecticide nets to pregnant women and mothers of under five years children in the whole Niger. Then, Niger adopted artemisinin-based combination therapy as first-line treatment…

Lehmann T, Hume JC, Licht M, Burns CS, Wollenberg K, Simard F, Ribeiro JM. Molecular evolution of immune genes in the malaria mosquito Anopheles gambiae. PLoS ONE. 2009;4(2):e4549.

As pathogens that circumvent the host immune response are favoured by selection, so are host alleles that reduce parasite load. Such evolutionary processes leave their signature on the genes involved. Deciphering modes of selection operating on immune genes might reveal the nature of host-pathogen interactions and factors that govern susceptibility in host populations. Such understanding would have important public health implications...

Afolabi BM, Sofola OT, Fatunmbi BS, Komakech W, Okoh F, Saliu O, Otsemobor P, Oresanya OB, Amajoh CN, Fasiku D, Jalingo I. Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria - Niger Delta and Sahel Savannah. Malar J. 2009 Feb 19;8(1):30

Current use of treated mosquito nets for the prevention of malaria falls short of what is expected in sub-Saharan Africa (SSA), though research within the continent has indicated that the use of these commodities can reduce malaria morbidity by 50% and malaria mortality by 20%. Governments in sub-Sahara Africa are investing substantially in scaling-up treated mosquito net coverage for impact. However, certain significant factors still prevent the use of the treated mosquito nets, even among those who possess them. This survey examines household ownership as well as use and non-use of treated mosquito nets in Sahel Savannah and Niger Delta regions of Nigeria...

Hlongwana KW, Mabaso ML, Kunene S, Govender D, Maharaj R. Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: A country earmarked for malaria elimination. Malar J. 2009 Feb 19;8(1):29

The potential contribution of knowledge, attitudes and practices (KAP) studies to malaria research and control has not received much attention in most southern African countries. This study investigated the local communities’ understanding of malaria transmission, recognition of signs and symptoms, perceptions of cause, treatment-seeking patterns, preventive measures and practices in order to inform the country’s proposed malaria elimination programme in Swaziland...

PRESS RELEASE

Dar es Salaam, 20 February 2009

Central African Institutions with coordination from the Multilateral Initiative on Malaria secretariat have been awarded a three million Euros grant by the European and Developing Countries Clinical Trials Partnership (EDCTP) for establishing a Central Africa Network on Tuberculosis, HIV/AIDS and Malaria for the Conduct of Clinical Trials (CANTAM). The network involves following partners; in Cameroon-University of Buea, University of Yaoundé1, Centre International de Référence Chantal Biya, and the Organisation de Coordination pour la lutte Contre les Endémies en Afrique Centrale (OCEAC) ; in Congo-the University Marie Ngouabi and the Centre d’Etudes des Ressources Végétales ; in Gabon- The Medical Research Unit of the Albert Schweitzer Hospital; in Tanzania-Multilateral Initiative of Malaria (The Project Coordinator) and in Germany-The University of Tübingen.

With this grant, CANTAM will develop human resources skills such as good clinical and laboratory practice (GCP and GLP), health research ethics, required to conduct clinical trials including writing clinical trial protocols to guide such trials. The network will also strengthen laboratories in the region to enable them to perform relevant tests for HIV/AIDS and malaria clinical research; strengthen ethical review boards and regulatory authorities where they are weak or absent and establish effective community liaison at each site and identify new study cohorts in villages and towns for future clinical trials on HIV/AIDS and malaria.

As project coordinator, the MIM Secretariat Coordinator will be working hand in hand with participating research institutions in this network in Central Africa, with guidance and political goodwill from the OCEAC. Ever since the MIM Secretariat moved to Africa, the challenge has been to see MIM playing active role in coordinating both health research and the researchers themselves, especially in the Central African corridor which has not been very well  covered.

MIM Secretariat is looking forward to playing major role in networking African researchers, setting up specific and cross-cutting disease training programmes and sharing resources and information.

---

For further information contact:

Prof Francine Ntoumi

Secretariat Coordinator

Multilateral Initiative on Malaria

Hosted by the African Malaria Network Trust

PO Box 33207, Dar es salaam, Tanzania

Tel: +255 22 2700018 Fax: +255 22 2700380

Email: francince.ntoumi@amanet-trust.org

World Malaria Day – a day to make the world care

25 April is a day of unified commemoration of the global effort to provide effective control of malaria around the world.

World Malaria Day is an opportunity for malaria-free countries to learn about the devastating consequences of the disease and for new donors to join a global partnership against malaria. It is an occasion for research and academic institutions to flag their scientific advances to both experts and the general public. It is a chance for countries in affected regions to learn from each other’s experiences and back each other’s efforts. It is an opportunity for international partners, companies and foundations to showcase their results and reflect together on how to scale up what has been proven to work.

On World Malaria Day RBM Partners will tell their own chapters of the powerful malaria story; a story of triumph and struggle; a story that grabs the world’s attention to point it to the heart of the problem and engage the international community in becoming part of the solution.

World Malaria Day 2009

The second World Malaria Day – 25th April 2009 – marks a critical moment in time. The

international malaria community has merely two years to meet the 2010 Abuja targets and

achieve universal coverage with all malaria interventions as called for by the UN Secretary-

General, Ban Ki-Moon. The Global Malaria Action Plan (GMAP) has articulated clearly what

needs to be done and how Partners must collectively go forward to meet short, medium and long term goals. 2010 is an important milestone for malaria control.

The countdown has begun

In order to intensify global efforts and provide impetus and increased momentum, the RBM

Partnership proposes to kick-start a 24-month campaign on April 25th that will engage all

Partners in comprehensively tracking global progress to meet the 2010 goal of 100% coverage and move the international community inexorably closer to near-zero deaths by 2015, the gradual elimination of malaria and eventual eradication of this pernicious disease.

In the countdown to 2010 the international community needs to be able to track and

communicate progress by monitoring and counting the

•      delivery of malaria commodities to communities in endemic countries

•      increases in financial resources to meet the GMAP targets,

•      development of new and improved tools, and all new initiatives that are going to help substantially reduce deaths and suffering from malaria.

According to the Global Malaria Action Plan, endemic countries require a further

US$ 13.04 billion and comprehensive partner support over the next two years to implement their plans. Countries will need 730 million long lasting nets and 228 million treatments over the next two years. More than 172 million households will need to be sprayed with insecticide. How close are countries to these targets? Some challenges may impede progress including implementation bottlenecks, and lack of financial and human resources. What initiatives and solutions are being put into place?

After wide consultation, Partners have indicated that there is an urgent need for a comprehensive effort to count and quantify progress and impact. The Executive Director of the RBM Partnership would therefore like to propose the following theme for this year’s World Malaria Day 2009 – a theme which will continue to be relevant until the end of 2010:

˝Counting Malaria Out˝

Whether your organization or group is involved with antimalarial or commodity development, production or delivery, building malaria control capacity, committing grants and resources for malaria scale-up, monitoring malaria cases or resistance, informing, educating and mobilizing communities – "Counting Malaria Out " can be applied to each and every effort to show the international community how far it has come – and how far it needs to go to reach its global malaria response.

World Malaria Day 2009 – Counting Malaria Out

Commemorate this year with other Partners in the Roll Back Malaria Partnership. Make 2009 the start of the countdown. Make the lives of every man, woman and child count as the international community intensifies its battle against malaria.

The high cost of anti-malarial drugs – up to US$10 per course - has made treatment prohibitive for most poor people in Tanzania, the health minister said.

"Malaria is a disease of the poorest of the poor and such a cost is prohibitively high to the sick rural poor," David Mwakyusa said. "There is a need for concerted effort to bring down the costs as was the case with chloroquine."

The minister was speaking at the launch of the first high quality, dispersible anti-malarial for babies and children, in Dar es Salaam on 17 February. The drug, Coartem Dispersible, is a sweet-tasting Artemisinin combination therapy.

"In Tanzania, close to 90 percent of the population is at risk of acquiring malaria, while the number of clinical cases is about 20 million [with] approximately 60,000 deaths annually," Mwakyusa said.

A similar pattern repeated itself in most African countries south of the Sahara. The continent, he added, carried the heaviest burden of malaria - 90 percent of the world’s 500 million cases and three million deaths.

Coartem Dispersible has been formulated by Medicines for Malaria Venture in collaboration with Novartis. In Tanzania Coartem has been the first-line drug in treatment of malaria.

Officials at the launch said Coartem had often been resisted by children due to its bitter taste, especially when it was crushed and mixed with water before being administered.

"Coartem Dispersible tablets enable parents to give the sweet-tasting malaria medicine to their children more easily and, in the process, ensure they receive full and effective doses," Silvio Gabriel, executive vice-president and head of Malaria Initiative at Novartis, said.

The new drug will be sold at a no-profit price of 37 US cents per treatment for the youngest age group.

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. The parasites multiply in the human liver and then infect red blood cells.

According to the UN World Health Organization, key interventions to control malaria include prompt and effective treatment with Artemisinin-based combination therapies, use of insecticidal nets by people at risk and indoor residual spraying with insecticide to control mosquitoes.

Warmer temperatures are at least partly to blame for a surge in malaria in East Africa and the increase in drug-resistant strains of the disease, according to a University of Michigan researcher.

The malaria parasite is highly sensitive to changes in temperature, and even subtle warming can dramatically increase populations of the mosquitoes that transmit the disease, said ecologist Mercedes Pascual.

Some scientists have argued that climate is not involved in the increasing highland epidemics. Instead, they say, adaptations in the parasite that make it resistant to antimalarial drugs are the key drivers.

But Pascual said that this "either-or" view is misguided and improperly lets global warming off the hook.

"I think that’s a useless discussion," she said.

More likely, Pascual said, the two work in tandem to an effect greater than the sum of their parts, with rising temperatures leading to faster development of drug resistance.

"The literature has this controversy of ’Is it climate or is it drug resistance?’ and drug resistance is taken as evidence that we don’t need to invoke climate change," she added.

No research has shown this synergy, but Pascual said it makes theoretical sense.

By making conditions favorable for mosquitoes, "warmer temperatures increase transmission, so you’re going to increase the number of people you treat," she said.  And past research has shown a threshold at which treating more cases leads to a higher incidence of drug resistance, making the disease difficult to treat and contain.

Malaria kills 3,000 people each day in Africa, and outbreaks on the continent aren’t limited to the eastern highlands. Climate change will cause the disease to migrate away from low latitudes, scientists say.  That could rid some areas of outbreaks, but could cause others in regions whose inhabitants haven’t developed any immunity.

The specifics of how malaria’s climate-forced migration will affect outbreaks are largely unknown, but it’s already underway, said Christopher Thomas of Aberystwyth University in the U.K.

Deadline for applications: 30 April 2009

The European and Developing Countries Clinical Trials Partnership (EDCTP) aims to develop new or improved clinical tools against HIV/AIDS, malaria and tuberculosis by integrating European programmes and work in partnership with sub-Saharan African countries. This is done by funding clinical trials and supporting capacity to conduct clinical trials in sub-Saharan Africa.

EDCTP is seeking for candidates for the position of Director of South-South Cooperation and Head of Africa Office

The Director will

•      Assist and deputise for the Executive Director

•      Oversee the day-to-day running of the EDCTP Africa Office in Cape Town, South Africa

•      Coordinate the African response and inspiring African co-ownership

•      Provide African leadership and stewardship of the EDCTP programme.

The Director of South-South Cooperation and Head of Africa Office will be answerable to the Executive Director and work closely with the EDCTP High Representative. The candidate is required to have among others qualifications in medicine, public health or biological sciences at PhD level or equivalent, and at least ten years experience in institutional management.

Conditions of appointment:

A term of office initially for a one-year period with an option for renewal.

Attractive international salary based on qualification and experience.

Position will be based in Cape Town, South Africa.

Closing date for applications: 30 April 2009

For further details, please visit our website at: www.edctp.org.

Clark TG, Fry AE, Auburn S, Campino S, Diakite M, Green A, Richardson A, Teo YY, Small K, Wilson J, Jallow M, Sisay-Joof F, Pinder M, Sabeti P, Kwiatkowski DP, Rockett KA. Allelic heterogeneity of G6PD deficiency in West Africa and severe malaria susceptibility. Eur J Hum Genet. 2009 Feb 18.

Several lines of evidence link glucose-6-phosphate dehydrogenase (G6PD) deficiency to protection from severe malaria. Early reports suggested most G6PD deficiency in sub-Saharan Africa was because of the 202A/376G G6PD A- allele, and recent association studies of G6PD deficiency have employed genotyping as a convenient way to determine enzyme status. However, further work has suggested that other G6PD deficiency alleles are relatively common in some regions of West Africa...

Danquah I, Dietz E, Zanger P, Reither K, Ziniel P, Bienzle U, Mockenhaupt FP. Reduced efficacy of intermittent preventive treatment of malaria in malnourished children. Antimicrob Agents Chemother. 2009 Feb 17

Intermittent preventive treatment in infants with sulfadoxine-pyrimethamine (IPTi-SP) reduces malaria episodes by 20-59% across Africa. This protective efficacy, however, may be affected by the high frequency of malnutrition in African infants. We analyzed the impact of malnutrition as defined by anthropometry on the incidence of malaria and on the protective efficacy of IPTi in a cohort of 1200 children in hyperendemic northern Ghana…

Bejon P, Warimwe G, Mackintosh CL, Mackinnon MJ, Kinyanjui SM, Musyoki JN, Bull P, Marsh K. Immunity to febrile malaria in children: an analysis that distinguishes immunity from lack of exposure. Infect Immun. 2009 Feb 17

In studies of immunity to malaria, the absence of febrile malaria is commonly considered evidence of "protection". However, apparent "protection" may be due to lack of exposure to infective mosquito bites or due to immunity. We studied a cohort that was given curative anti-malarials before monitoring began, and documented newly acquired asymptomatic parasitemia and febrile malaria episodes during 3 months surveillance. With increasing age, there was a shift away from febrile malaria to acquiring asymptomatic parasitemia, without changing the overall incidence of infection. Antibodies to the infected red cell surface were associated with acquiring asymptomatic infection rather than febrile malaria or remaining uninfected…

Bisoffi Z, Sirima BS, Angheben A, Lodesani C, Gobbi F, Tinto H, Van den Ende J. Rapid malaria diagnostic tests vs. clinical management of malaria in rural Burkina Faso: safety and effect on clinical decisions. A randomized trial. Trop Med Int Health. 2009 Feb 14

To assess if the clinical outcome of patients treated after performing a Rapid Diagnostic Test for malaria (RDT) is at least equivalent to that of controls (treated presumptively without test) and to determine the impact of the introduction of a malaria RDT on clinical decisions…

Olszewski KL, Morrisey JM, Wilinski D, Burns JM, Vaidya AB, Rabinowitz JD, Llinás M. Host-parasite interactions revealed by Plasmodium falciparum metabolomics. Cell Host Microbe. 2009 Feb 19;5(2):191-9

Intracellular pathogens have devised mechanisms to exploit their host cells to ensure their survival and replication. The malaria parasite Plasmodium falciparum relies on an exchange of metabolites with the host for proliferation. Here we describe a mass spectrometry-based metabolomic analysis of the parasite throughout its 48 hr intraerythrocytic developmental cycle. Our results reveal a general modulation of metabolite levels by the parasite, with numerous metabolites varying in phase with the developmental cycle. Others differed from uninfected cells irrespective of the developmental stage. Among these was extracellular arginine, which was specifically converted to ornithine by the parasite...

Nyakoe NK, Taylor RP, Makumi JN, Waitumbi JN. Complement consumption in children with Plasmodium falciparum malaria. Malar J. 2009 Jan 9;8(1):7

Complement (C) can be activated during malaria, C components consumed and inflammatory mediators produced. This has potential to impair host innate defence. METHODS: In a case-control study, C activation was assessed by measuring serum haemolytic activity (CH50), functional activity of each pathway and levels of C3a, C4a and C5a in children presenting at Kisumu District Hospital, western Kenya, with severe malarial anaemia (SMA) or uncomplicated malaria (UM)...

Recent weeks have seen the publication of a number of review and opinion articles on the subject of malaria. It is no doubt the appearance of new (and in most cases encouraging) data on the impact of scaling up control efforts, particularly in Africa, which has prompted a number of malaria specialists to try to take stock of the situation and ask what have we learned – where do we go from here?

In the Lancet

Laurence Slutsker and Robert Newman (1) point out that, in 2007, 90 million children in stable malaria endemic areas were still not protected by insecticide-treated bednets. Yet, overall, coverage has increased about six-fold since 2000. So, they ask, is the glass half-empty or half-full for malaria scale-up progress?

Other interventions, as they authors remind us, lag further behind in their implementation. The use of artemisinin combinations in children with fever is less than six per cent in 14 African countries. They argue that the scaling-up malaria interventions must be accompanied by better surveillance, stronger health systems and local ownership.

The authors of a letter (2), also in the Lancet argue that: “Most of the successful African examples [of control scale-up] are from islands, fringes of endemic areas, or smaller countries with substantial external support. Whether progress can be expected to be comparable in most sub-Saharan African countries ... remains doubtful.”

Malaria Journal

This open-access publication is now recognized as one of the most important journals focusing on infectious diseases of poverty. A supplement comprising nine review articles addresses the theme ‘Towards a research agenda for global malaria elimination’. Introducing the supplement the journal’s editor Marcel Hommel (3) (http://www.malariajournal.com/content/7/S1/S1) comments that, “The decreasing pattern of incidence is encouraging and, by giving funding agencies a first impression of success, it has helped enormously in the advocacy for further increases in the global funding effort, which are considered necessary to achieve malaria control.”

The topics dealt with are:

·         Global warming and malaria: knowing the horse before hitching the cart (4)

·         Integrated vector management for malaria control (5)

·         Working without a blindfold: the critical role of diagnostics in malaria control (6)

·         Monitoring and evaluation of malaria in pregnancy – developing a rational basis for control (7)

·         Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities (8)

·         The role of anti-malarial drugs in eliminating malaria (9)

·         Plasmodium vivax: who cares? (10)

·         Malaria vaccines and their potential role in the elimination of malaria (11)

·         Malaria eradication: the economic, financial and institutional challenge (12)

Clearly it is impossible to discuss all of these detailed reviews here. Some of the conclusions reached by the authors may surprise some readers and indeed could prove controversial. Here are some direct quotes from a few of the articles:

“Obsessive emphasis on ‘global warming’ as a dominant parameter is indefensible; the principal determinants are linked to ecological and societal change, politics and economics (4)."

“Without wide implementation of accurate and discriminating diagnostic testing, and reporting of results, most fever will be inappropriately managed, millions of doses of ACT will be wasted, and malaria control programmes will be blindfolded to the impact of their efforts (6).”

“Most of those who need the drugs do not get them. Simultaneously, a high proportion of those who are given antimalarials do not in fact have malaria (8).”

“The key operational question now is whether primaquine should be added to artemisinin combination treatments for the treatment of falciparum malaria to reduce further the transmissibility of the treated infection (9).”

“The malaria research community is becoming more aware and concerned about the widespread spectrum of illness and death caused by up to a couple of hundred million cases of vivax malaria each year (10).”

“Research on malaria vaccines is currently directed primarily towards the development of vaccines that prevent clinical malaria. Malaria elimination ... requires a different vaccine strategy, since success will depend on killing all parasites in the community in order to stop transmission completely. (11).”

Awa Marie Coll-Seck, Executive Director of the Roll Back Malaria Partnership (13), has welcomed the Malaria Journal supplement saying that, “If there ever was a golden age for malaria research and innovation, it is now.”

Children and pregnancy

Other review articles on malaria that have appeared recently include an update on severe malaria in children and pregnancy (14). This article outlines new understanding of the pathogenesis of severe malaria complications. It goes on to discuss the use of new drugs such as intravenous artesunate and oral artemisinin combinations, noting that – combined with increased access to insecticide-treated bed nets – this is resulting in improved outcomes and a reduction of malaria deaths. The authors say that several research groups are now identifying the characteristics of parasite var genes associated with cerebral malaria, and that understanding of the interactions between malaria and other diseases in causing severe anaemia and cerebral malaria has increased substantially. At the cellular level, the disturbances leading to coma or other complications are becoming clearer. Discussing the challenges for continuing research, they note that: “The role of ACTs, in particular, needs to be evaluated in detail, given their widespread adoption for malaria treatment.”

Acquired immunity

A further review article (15) focuses on acquired immunity to falciparum malaria. Naturally acquired immunity to malaria protects millions of people routinely exposed to infection from severe disease and death, but there is no clear understanding of how this protection works. There is no consensus as to the rate of onset of acquired immunity or what constitutes the key determinants or the mechanism of protection. This review discusses the new insights provided by biotechnology and places these insights in the context of historical, clinical, and epidemiological observations. Controversially perhaps, the authors argue that naturally acquired immunity is virtually 100% effective against severe disease and death among heavily exposed adults and that even the immunity that occurs in exposed infants may exceed 90% effectiveness. They conclude that: “The induction of an adult-like immune status among high-risk infants in sub-Saharan Africa would greatly diminish disease and death caused by P. falciparum. The mechanism of naturally acquired immunity that occurs among adults living in areas of hyper- to holoendemicity should be understood with a view toward duplicating such protection in infants and young children in areas of endemicity.”

India too

And finally a letter from India (16), recently published in Trans R Soc Trop Med Hyg, reminds us that Asia too still faces the challenge of malaria control. A writer from the National Institute of Malaria Research (ICMR) says that in several Indian states “...there is increased risk of development and spread of multidrug-resistant strains of Plasmodium falciparum, particularly in marginalised population groups living in poverty and remote forest fringe areas”. Outbreaks of malaria in India often lead a high morbidity and death rates. A stepping up of control efforts, using tools already available, is called for here too. It is not only Africa that has a malaria problem.

References

1. Slutsker L, Newman (2009). Malaria scale-up progress: is the glass half-empty or half-full? Lancet; 373(9657):58-67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19019423

2. Müller O, Yé M, Louis VR, Sié A (2009). Malaria in sub-Saharan Africa. Lance; 373(9658)122. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19135609

3. Hommel M (2008). Towards a research agenda for global malaria elimination. Malaria Journal; 7(Suppl 1):S1. Available from: http://www.malariajournal.com/content/7/S1/S1/abstract

4. Reiter P (2008). Global warming and malaria: knowing the horse before hitching the cart. Malaria Journal; 7(Suppl 1):S3. Available from: http://www.malariajournal.com/content/7/S1/S3/abstract

5. Beier JC, Keating J, Githure JI, Macdonald MB, Impoinvil DE, Novak RJ (2008). Integrated vector management for malaria control. Malaria Journal; 7(Suppl 1):S4. Available from: http://www.malariajournal.com/content/7/S1/S4/abstract

6. Perkins MD, Bell DR (2008). Working without a blindfold: the critical role of diagnostics in malaria control. Malaria Journal; 7(Suppl 1):S5. Available from: http://www.malariajournal.com/content/7/S1/S5/abstract

7. Brabin BJ, Wasame M, Uddenfeldt-Wort U, Dellicour S, Jenny, Gies S (2008). Monitoring and evaluation of malaria in pregnancy – developing a rational basis for control. Malaria Journal;7(Suppl 1):S6. Available from: http://www.malariajournal.com/content/7/S1/S6/abstract/

8. Whitty CJM, Chandler C, Ansah E, Leslie T, Staedke SG (2008). Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities. Malaria Journal; 7(Suppl 1):S7. Available from: http://www.malariajournal.com/content/7/S1/S7/abstract

9. White NJ (2008). The role of anti-malarial drugs in eliminating malaria. Malaria Journal; 7(Suppl 1):S8. Available from: http://www.malariajournal.com/content/7/S1/S8/abstract

10. Galinski MR, Barnwell JW (2008). Plasmodium vivax: who cares? Malaria Journal; 7(Suppl 1):S9. Available from: http://www.malariajournal.com/content/7/S1/S9/abstract

11. Targett GA, Greenwood BM (2008). Malaria vaccines and their potential role in the elimination of malaria. Malaria Journal; 7(Suppl 1):S10. Available from: http://www.malariajournal.com/content/7/S1/S10/abstract

12. Mills A, Lubell Y (2008). Malaria eradication: the economic, financial and institutional challenge. Malaria Journal; 7(Suppl 1):S11. Available from: http://www.malariajournal.com/content/7/S1/S11/abstract

13. Coll-Seck AM (2008). A golden age for malaria research and innovation. Malaria Journal; 7(Suppl 1):S2. Available from: http://www.malariajournal.com/content/7/S1/S2/abstract

14. Milner DA Jr, Montgomery J, Seydel KB, Rogerson SJ (2008). Severe malaria in children and pregnancy: an update and perspective. Trends Parasitol; 24(12):590-595. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18848498

15. Doolan DL, Dobaño C, Baird JK (2009). Acquired immunity to malaria. Clin Microbiol Rev; 22(1):13-36. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19136431

16. ev V (2009). Rolling back malaria initiative in India. Trans R Soc Trop Med Hyg; 103(2):210. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19056099

Australia is host to a meeting of World health experts which aims to find ways of eradicating malaria, one of the world’s most dangerous killer diseases.

Though malaria was wiped out in Australia in the 80’s it continues to wreak havoc elsewhere in the world and kills more than one million people every year and continues to flourish in 109 countries worldwide.

Although malaria is preventable and curable, according to the World Health Organisation, a child dies of malaria every 30 seconds and in 2006 there were 247 million cases of malaria, which caused around 880,000 deaths, mostly among African children.

The WHO says half of the world’s population is at risk of malaria, particularly those living in lower-income countries and in some countries malaria is endemic - in other areas there are "malaria seasons" usually coinciding with the rainy season and devastating epidemics can occur when the mosquito-borne parasite is introduced into areas where people have had little prior contact with the infecting parasite and have little or no immunity to malaria, or when people with low immunity move into areas where malaria cases are constant.

These epidemics can be triggered by wet weather conditions and are then aggravated by floods or mass population movements driven by conflict.

The common first symptoms are fever, headache, chills and vomiting and usually appear 10 to 15 days after a person is infected - if not treated promptly with effective medicines, malaria can cause severe illness and is often fatal.

The inaugural meeting of the Asia Pacific Malaria Elimination Network in Brisbane involves delegates from 8 countries in the Asia Pacific region and the Parliamentary Secretary for International Development Assistance, Bob McMullen says the network is about the health of people, but it is central to economic development in the region and is a social, humanitarian and economic priority.

Ten countries in the Asia Pacific region are involved in the network headed by malaria expert Sir Richard Feachem who says the target date for complete eradication is 2050.

Delegates from Malaysia, South Korea, China, Solomons, Sri Lanka, Vanuatu, Indonesia and the Philippines will be at the meeting - Bhutan and North Korea, are not represented.

Sir Richard says the network will be an important tool in helping individual countries wipe-out the killer-disease by learning from each other and sharing expertise about their malaria elimination efforts.

Those most at risk from malaria are travellers from malaria-free regions, with little or no immunity, who go to areas with high disease rates, non-immune pregnant women and HIV-infected pregnant women.

A major concern on the part of experts is the rapid spread of drug resistance to commonly used antimalarial drugs and the WHO says intensive monitoring of drug potency is essential to protect against the spread of resistant malaria strains to other parts of the world.

Prevention focuses on reducing the transmission of the disease by controlling the malaria-bearing mosquito - the two main interventions for vector control are the use of mosquito nets treated with long-lasting insecticide and indoor residual spraying of insecticides but there is increasing mosquito resistance to the key insecticides DDT and pyrethroids, particularly in Africa.

Currently there are no equally effective and efficient insecticide alternatives to DDT and pyrethroids, and the WHO says the development of new pesticides is an expensive, long-term endeavour.

The WHO says insecticide resistance detection should be a routine feature of national control efforts to ensure that the most effective vector control methods are being used.

Sir Richard says if practical ways are used to stamp out the disease then about four million deaths could be prevented in the next six years.

1.    Senior Fellowship/ Bourse Senior/  Bolsas de Estudo para Quadros Superiores

2.    Ethics Review Boards/  Comités d’éthique nationaux africains ou des Conseils d’étude institutionnels/  Comissões de Ética Nacionais Africanas ou de Conselhos de Revisão Institucional

 More information: http://www.edctp.org

Senior Fellowship

Through this call, EDCTP intends to identify and support senior researchers capable of building and leading research groups at sub-Saharan African institutions that will be internationally competitive and capable of winning grants from international funding bodies. For this grant scheme EDCTP specifically targets to contribute towards building of sustainable capacity through training and networking with linkage to the EDCTP supported regional networks of excellence in sub-Saharan Africa. A maximum of one Senior Fellowship per disease per region will be supported.

Available funds:                  2.4 Million Euros

Number of projects to fund:  12

Deadline of application:        01 June 2009

Bourse Senior

L’EDCTP s’attend à ce que les institutions d’Afrique subsaharienne qui bénéficient de subventions de l’EDCTP continuent de jouer un rôle majeur en tant que sites où acquérir une expérience pratique de réalisation d’essais cliniques sur les trois principales maladies liées à la pauvreté en Afrique (VIH/SIDA, tuberculose et paludisme). Pour ce programme de bourses, l’EDCTP vise plus précisément à contribuer à l’élaboration de capacités durables grâce à la formation et à la constitution de réseaux en lien avec les réseaux d’excellence régionaux en Afrique sub-saharienne financés par l’EDCTP.

Fonds disponibles:                   2,4 millions d’euros

Nombre de projets à financer:   12

Date limite des candidatures:    1er juin 2009

Bolsas de Estudo para Quadros Superiores

A EDCTP espera que as instituições da África subsariana que recebem bolsas da EDCTP continuem a desempenhar um papel chave como locais onde se possam obter experiências práticas através de ensaios clínicos nas três maiores doenças relacionadas com a pobreza (VIH/SIDA, tuberculose e malária). Com esta bolsa, a EDCTP tem como objectivo contribuir para a construção de uma capacidade sustentável através da formação e trabalho em rede com ligação às redes de excelência regionais com apoio da EDCTP na África subsariana.

Fundos disponíveis:                    2,4 Milhões de euros

Número de projectos a financiar:  12

Data limite de candidaturas:        01 de Junho de 2009

Ethics Review Boards

EDCTP wishes to promote the establishment and strengthening of National Ethics Committees (NEC) and Institutional Review Boards (IRB) that are competent and independent. In countries where NECs do not exist, the local institutional review boards are encouraged to contribute to the formation of a NEC. Where neither NECs nor local IRBs exist, the EDCTP will encourage national recognised institutions or scientists affiliated to an established in-country institution to be contracted to initiate the formation of the NEC.

Available funds:                  €500,000

Number of projects to fund:  10

Deadline for application:      01 June 2009

Comités d’éthique nationaux africains ou des Conseils d’étude institutionnels

L’EDCTP souhaite encourager la création et le renforcement des Comités d’étique nationaux (CEN) et des Conseils d’étude institutionnels (CEI) qui sont compétents et indépendants. Dans les pays où les CEN n’existent pas, les conseils d’étude institutionnels locaux sont encouragés à contribuer à la formation d’un CEN. Là où il n’y a ni CEN ni CEI, l’EDCTP encouragera les institutions reconnues au niveau national ou les scientifiques affiliés à une institution installée dans le pays qui sera engagée pour lancer la formation du CEN.

Fonds disponibles:                   € 500,000

Nombre de projets à financer:   10

Date limite des candidatures:    1er juin 2009

Comissões de Ética Nacionais Africanas ou de Conselhos de Revisão Institucional

A EDCTP deseja promover a criação e o reforço de Comissões Éticas Nacionais (CEN) e de Conselhos de Revisão Institucional (CRI) que sejam competentes e independentes. Nos países onde as CEN não existam, encorajam-se os conselhos de revisão institucional locais a formar uma CEN. Onde não existam quer CENs, quer CRIs locais, a EDCTP irá encorajar instituições nacionais reconhecidas ou cientistas associados a uma instituição dentro do país a serem contratados para dar início à formação da CEN.

Fundos disponíveis:                     € 500 000

Número de projectos a financiar:  10

Data limite de candidature:          01 de Junho de 2009

Deadline March 11, 2009

Background

The African Network for Drugs and Diagnostics Innovation (ANDI) was launched in Abuja in 2008 (http://meeting.tropika.net/andi/) to promote & sustain African-led R&D innovation through the discovery, development and delivery of affordable new tools including those based on traditional medicines. ANDI will also support capacity building. An ANDI Task Force has now been established to implement the recommendations from the Abuja meeting, and is seeking a business development consultant to work with the Task F orce in the development of the strategic and business plan for the initiative. The Business Plan will also be a critical document for advocacy and fundraising for product R&D in Africa.

Objectives of the consultancy

The ANDI Task Force invites Letters of Interest (LOI) from qualified parties who are interested in working with the task force to develop a strategic/business plan for ANDI. The consultancy will be for a period of 3 months (May to July/August, 2009).

Who should apply

This call is open to all qualified institutions that meet the following

criteria:

1.    Demonstrated track record in the preparation of R&D strategy and business plan, with examples of previous work.

2.    Understanding of product R&D landscape in developing countries (particularly in Africa).

3.    Experience in liaising with a wide range of stakeholders and taking into account views of major stakeholders, to inform strategy and business plan development.

The content of LOI should address the criteria specified above. LOIs from institutions in developing countries especially African countries are encouraged. LOIs should be received at aliass@who.int by March 11, 2009.

Steps for selection

Following review of the LOIs by the ANDI Task Force, shortlisted applicants will be invited to develop a full proposal.

The full proposals will contain further details that will contribute to the design of a five year-business plan covering the following:

1.    Scope of work for ANDI.

2.    Suitable R&D model, organizational and governance structure (various options to be assembled and considered).

3.    Implementation plan with specific activities, deliverables and time lines.

4.    Staff, funding and advocacy plan.

5.    Costing for the consultancy.

Moorthy VS, Reed Z, Smith PG. Clinical trials to estimate the efficacy of preventive interventions against malaria in paediatric populations: a methodological review. Malar J. 2009 Feb 10;8(1):23.

Recent years have seen publication of a considerable number of clinical trials of preventive interventions against clinical malaria in children. There has been variability in the specification of end-points, case definitions, analysis methods and reporting and the relative lack of standardization complicates the ability to make comparative evaluations between trials...

Onwujekwe O, Kaur H, Dike N, Shu E, Uzochukwu B, Hanson K, Okoye V, Okonkwo P. Quality of anti-malarial drugs provided by public and private healthcare providers in south-east Nigeria. Malar J. 2009 Feb 10;8(1):22

There is little existing knowledge about actual quality of drugs provided by different providers in Nigeria and in many sub-Saharan African countries. Such information is important for improving malaria treatment that will help in the development and implementation of actions designed to improve the quality of treatment. The objective of the study was to determine the quality of drugs used for the treatment of malaria in a broad spectrum of public and private healthcare providers…

Turschner S, Efferth T. Drug resistance in Plasmodium: natural products in the fight against malaria. Mini Rev Med Chem. 2009 Feb;9(2):206-2124

…Plant-derived artemisinin is currently the only available drug that is globally effective, but alarmingly, recent studies suggest that resistance already may be developing. Nevertheless, the success story of artemisinin from the herb Qing Hao (Artemisia annua L.), used as a remedy in traditional Chinese medicine for more than two thousand years, shows once again that natural products serve as an invaluable reservoir of lead compounds for sophisticated small molecules…

Greenhouse B, Slater M, Njama-Meya D, Nzarubara B, Maiteki-Sebuguzi C, Clark TD, Staedke SG, Kamya MR, Hubbard A, Rosenthal PJ, Dorsey G. Decreasing efficacy of antimalarial combination therapy in Uganda is explained by decreasing host immunity rather than increasing drug resistance. J Infect Dis. 2009 Mar 1;199(5):758-65

Improved control efforts are reducing the burden of malaria in Africa but may result in decreased antimalarial immunity... Declining immunity in our study population appeared to be the primary factor underlying decreased efficacy of amodiaquine plus sulfadoxine‐pyrimethamine. With improved malaria‐control efforts, decreasing immunity may unmask resistance to partially efficacious drugs…

Ghani AC, Sutherland CJ, Riley EM, Drakeley CJ, Griffin JT, Gosling RD, Filipe JA. Loss of population levels of immunity to malaria as a result of exposure-reducing interventions: consequences for interpretation of disease trends. PLoS ONE. 2009;4(2):e4383

The persistence of malaria as an endemic infection and one of the major causes of childhood death in most parts of Africa has lead to a radical new call for a global effort towards eradication. With the deployment of a highly effective vaccine still some years away, there has been an increased focus on interventions which reduce exposure to infection in the individual and -by reducing onward transmission-at the population level. The development of appropriate monitoring of these interventions requires an understanding of the timescales of their effect...

McMorran BJ, Marshall VM, de Graaf C, Drysdale KE, Shabbar M, Smyth GK, Corbin JE, Alexander WS, Foote SJ. Platelets kill intraerythrocytic malarial parasites and mediate survival to infection. Science. 2009 Feb 6;323(5915):797-800

Platelets play a critical role in the pathogenesis of malarial infections by encouraging the sequestration of infected red blood cells within the cerebral vasculature. But platelets also have well-established roles in innate protection against microbial infections. We found that purified human platelets killed Plasmodium falciparum parasites cultured in red blood cells. Inhibition of platelet function by aspirin and other platelet inhibitors abrogated the lethal effect human platelets exert on P. falciparum parasites...

The deadline for Abstract submission to the Fifth MIM Pan African Malaria Conference.

To register and submit your abstract, visit: www.mimalaria.org/pamc

Deadline for Abstract Submission: 01 March 2009

Remember, it is possible to submit your abstract now and pay for registration fees later. If you don’t have a credit card, choose the second option: payment by wire transfer. This will allow you to continue with the submission of your abstract; just remember to write down details on how to send money by wire transfer.

If you are already started and have not completed your registration, log on to the registration system then click “Already Registered”. Then enter the email address used for the registration and password. On the page that opens there are several links including viewing the receipts etc.  At the bottom there is a section for editing your information. Click Personal Information, and then go to the “Abstract Submission” section to upload your abstract.

Deadline for submitting requests: 31 March 2009

Downloads: MIM Event Form and Exhibition Space Request Form

The Fifth MIM Pan-African Malaria Conference Scientific Committee invites requests for Symposia, Training Workshops, Parallel Meetings and Exhibitions as follows:

Symposia

There will be opportunities for a two and a half hours symposium. Symposia should be related to the meeting theme (see www.mimalaria.org/pamc) or address newly emerging topics or significant syntheses of relevance to malaria and MIM mission including networking and international collaboration. All symposium organisers and speakers must be registered participants.

Dates and times for parallel meetings will be structured so that they have minimal conflict with paper sessions.

The registration fee for one symposium session is USD 1600. Symposium organizers will be responsible for catering and audiovisual, organized through Kenyatta International Conference Centre.

To request a space for a symposium, fill in and submit a MIM Event Form available at the MIM Conference website.

Training Workshops And Parallel Meetings

Consortia and networks and other groups wishing to organise their own events (steering committees, training workshops, seminars, etc.) or parallel meetings outside (just before or after) MIM Conference dates are hereby invited to apply. Workshops/meetings may facilitate presentation and application of new concepts, perhaps allowing audience participation and/or round-table discussion for exploration of new or controversial issues. To request a space for a training workshop or parallel meeting fill in and submit a MIM Event Form available at the MIM Conference website. 

All workshop/parallel meeting participants wishing to attend the MIM Conference must be registered for the conference.

The registration fee for a workshop or parallel meeting is USD 1600/day. Symposium organizers will be responsible for catering and audiovisual, organized through Kenyatta International Conference Centre.

The MIM Secretariat does not provide financial support for Symposia, Workshops sessions or Parallel Meetings.

Call for Exhibitors

Over 1500 participants are expected at this year’s conference and many of them disseminate exhibitor information and materials to their staff and colleagues. Besides sharing your work with others, your participation will put you in contact with malaria researchers and control experts from malaria endemic countries in Africa, Asia, and Latin America and the Caribbean, as well as malaria scientists, administrators, and representatives from private foundations, governments and international organizations from all over the world.

Exhibits will be located in an area that will provide you with excellent access to Conference participants. Exhibition and poster areas will be open between 1000-1700hrs Monday through Friday. Participants will be encouraged to visit exhibits and posters, with all refreshment breaks in the exhibit area to encourage delegates to meet with you and discuss your products and services.

Exhibition booths measuring three (3) square metres will be set up. The booths will be equipped with a sign board, two seats, a power source and a skirted table to display your information. Exhibitors are expected to decorate their own stands.

A single exhibition booth/space costs USD 1300. To book a space for exhibition fill in and submit the Exhibition Space Request Form available at the MIM Conference website.

Deadline for submission

All symposium, workshop parallel meeting and exhibition requests should be submitted by 31 March 2009 to the Conference Organizing Committee at events@mimalaria.org. 

Applicants will be notified of the Scientific Committee’s decision as soon as possible following submission of their requests.

Contact Information

Fifth MIM Pan-African Malaria Conference
Multilateral Initiative on Malaria Secretariat
Hosted by African Malaria Network Trust,
PO Box 33207, Dar es Salaam, TANZANIA

Email: pamc@mimalaria.org
Tel: +255 22 2700018
Fax: +255 22 2700380
www.mimalaria.org/pamc

In a move likely engineered to unsettle gathered attendees at the Technology, Entertainment, Design (TED2009) Conference in Palm Springs, Microsoft figurehead Bill Gates pulled a potentially risky stunt to illustrate the deadly effects of malaria.

More pointed, during presentation surrounding malaria prevention and its devastation across developing nations, Gates took the watching audience by surprise when he suddenly opened a glass jar full of mosquitoes and unleashed the captive horde of insects.

“I brought some,” said Gates after explaining how malaria spreads through mosquito bites. “Here, I’ll let them roam around. There is no reason only poor people should be infected… not only poor people should experience this.” 

While risking a possible stampede for the exits following the slack-jawed spectacle of a technology titan losing his marbles live on stage, FOXNews reports that Gates waited for more than a minute before decreasing collective heart rates by assuring attendees the freed mosquitoes were not carrying the disease.

The TED2009 presentation on malaria prevention was given by Gates through the non-profit Bill and Melinda Gates Foundation, which the educational prankster now runs alongside his wife after stepping down as Microsoft chairman in 2008.

In an effort to better counter the deadly effects of malaria, Gates revealed that the foundation would be donating some $169 million USD to the PATH Malaria Vaccine initiative in order to contribute towards the development of a full vaccine.

With regard to his position on the forefront of charitable work, Gates said he’s, “as engaged in the new job as I ever was in software; these are amazing issues… it’s magic in the same way software was.”

“I am an optimist,” he added. “Every problem can be solved, and there are some important ones out there.” 

Calming any remaining fears in connection to the release of mosquitoes into the conference, an official spokesman for the Bill and Melinda Gates Foundation later confirmed that none of the insects had been carrying malaria.

The first comprehensive survey of global spending on neglected disease R&D, published in this week’s PLoS Medicine, finds that just over $US 2.5 billion was invested into R&D of new products in 2007, with three diseases—HIV/AIDS, TB, and malaria—receiving nearly 80% of the total.

However, the survey finds that many neglected diseases, responsible for killing millions of people in developing countries, are significantly underfunded.

Researchers from The George Institute report that while HIV/AIDS, TB and malaria collectively received the majority of R&D funding, other diseases and disease categories each received less than 5% of global funding.

Sleeping sickness, leishmaniasis and Chagas disease collectively received only 4.9% of total global funding; the diarrhoeal illnesses surveyed collectively received 4.5% of global funding; the helminth (worm) infections received 2%; and bacterial pneumonia and meningitis received only 1.3%. Five diseases - leprosy, Buruli ulcer, trachoma, rheumatic fever, and typhoid and paratyphoid fever – each received less than $10 million or 0.4% of total global investment. For many of these diseases, funding was not enough to create even one new product.

The need for R&D to develop new drugs and vaccines for preventing and treating neglected tropical infections in developing countries is widely accepted. For example, the creation of a vaccine for HIV/AIDS, more effective tools to diagnose TB, and better drug treatments for leishmaniasis and sleeping sickness would greatly improve health in the developing world. However, there has until now been an "information gap" for funders wishing to invest in this area.

In the new survey by Dr Mary Moran (The George Institute for International Health, Sydney, Australia) and colleagues, commissioned by the Bill and Melinda Gates Foundation, the researchers set out to fill this information gap. While specific R&D investment data were previously available for some neglected diseases, these cannot readily be compared since each survey used different methodologies and covered different diseases, products, donors, and countries. Moran and colleagues’ survey was designed to include all neglected diseases and all control tools of significance to developing countries, and to gather funding data as consistently and comprehensively as possible.

The survey found that public and philanthropic donors collectively invested $US 2.3 billion (about 90%) of total funding in 2007. The US government represented nearly three quarters of global public spending. The largest organizational donors were the US National Institutes of Health (42% of total funding) and the Bill & Melinda Gates Foundation (18% of total funding). About a quarter of donor funding was routed to public-private product development partnerships (PDPs), such as the International AIDS Vaccine Initiative and the Medicines for Malaria Venture.

The survey’s findings, say Moran and colleagues, suggests that "investment decisions are not only influenced by scientific or epidemiological considerations, but may also be influenced by factors such as the presence of advocacy and fundraising groups; by funder perceptions or preferences; or by the presence of policy frameworks and funding mechanisms that prioritise specific diseases."

The researchers also note that some of the world’s wealthiest countries are "missing in action" from the top 10, top 20, or even top 50 funders of R&D for neglected diseases.

"A broadening of funding efforts," they say, "so that all who are able to contribute do so, and all diseases receive the attention they deserve, would lead to a dramatic positive impact on the health of developing country patients afflicted with these diseases."

Citation: Moran M, Guzman J, Ropars A-L, McDonald A, Jameson N, et al. (2009) Neglected disease research and development: How much are we really spending? PLoS Med 6(2): e1000030. doi:10.1371/journal.pmed.1000030

Access article from here: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.1000030 

Dates: May 18 to 20, 2009

http://www-db.embl.de/jss/EmblGroupsOrg/conf_119

Abstract Deadline: February 28, 2009*

The European Network of Excellence BioMalPar is organising its fifth annual conference on the Biology and Pathology of the Malaria Parasite. This meeting will take place at EMBL in Heidelberg, Germany on May 18-20, 2009. *

BioMalPar consists of 47 partner laboratories in 21 institutions from 8 European countries and from 5 malaria endemic countries (Mali, Sudan, Uganda, Nigeria and India). It also comprises 12 European affiliated partners.

Created in April 2004, BioMalPar was established with the vision of forming a European-wide virtual institute, enhancing cohesion between its component research groups.

The scientific aims of the network are to address, in an integrated, collaborative manner, fundamental questions of the biology of the malaria parasite, its vector, and the disease, allowing optimal exploitation of the resulting knowledge to impact on public health.

BioMalPar places a particular emphasis on its training role, and has established a high profile PhD scholarship.

BioMalPar aims also to ensure a broad dissemination of research results and enhance the public awareness through the implementation of a website (http://www.biomalpar.org), and the organisation of annual conferences, training courses and meetings.

The purpose of the BioMalPar annual conference is to bring together malaria researchers from Europe and overseas (including Africa, America, Asia and Australia) in order to present and share recent groundbreaking findings on fundamental malaria research. New insights will also be featured through the use of poster sessions.

This meeting will also provide an enriched environment for researchers at all stages of their career to interact with international leaders in the field. The meeting will offer an excellent opportunity for sharing ideas and for potential development of new worldwide collaborations.

In 30 hours of oral and poster presentations over three days, participants will discuss:

-Development and Gene Regulation

-Functional Cell Biology and Metabolism

-Molecular and Cellular Biology of the Pathogenesis of Malaria

-Immune Response and Defence Mechanisms in the Host and the Vector

The organizers will select talks on abstract basis. Please specify on the registration form the session in which you would prefer to present your data (Poster or talk).

Deadline for registration and abstract submission: February 28th , 2009.

The total number of participants is limited to 240.

Registration fees: 200 €* for PhD students; 270 € for other participants

Registration fees include: Admission to plenary speaker talks and poster displays; Abstract book; Coffee breaks, Lunches, Dinners and mixers

Registration fees do *NOT* include: Lodging or Transportation

Detailed meeting programme and instructions for registration are available on the EMBL website: http://www-db.embl.de/jss/EmblGroupsOrg/conf_119

Oesterholt MJ, Alifrangis M, Sutherland CJ, Omar SA, Sawa P, Howitt C, Gouagna LC, Sauerwein RW, Bousema T. Submicroscopic gametocytes and the transmission of antifolate-resistant Plasmodium falciparum in Western Kenya. PLoS ONE. 2009;4(2):e4364

Single nucleotide polymorphisms (SNPs) in the dhfr and dhps genes are associated with sulphadoxine-pyrimethamine (SP) treatment failure and gametocyte carriage. This may result in enhanced transmission of mutant malaria parasites, as previously shown for chloroquine resistant parasites. In the present study, we determine the association between parasite mutations, submicroscopic P. falciparum gametocytemia and malaria transmission to mosquitoes…

Dong Y, Dimopoulos G. Anopheles fibrinogen-related proteins provide expanded pattern recognition capacity against bacteria and malaria parasites. J Biol Chem. 2009 Feb 4

The fibrinogen-related protein family (FREP, also known as FBN) is an evolutionarily conserved immune gene family found in mammals and invertebrates. It is the largest pattern recognition receptor gene family in Anopheles gambiae, with as many as 59 putative members, while the Drosophila melanogaster genome has only 14 known FREP members. Our sequence and phylogenetic analysis suggest that this remarkable gene expansion in the mosquito is the result of tandem duplication of the fibrinogen-domain…

Lee PJ, Bhonsle JB, Gaona HW, Huddler DP, Heady TN, Kreishman-Deitrick M, Bhattacharjee A, McCalmont WF, Gerena L, Lopez-Sanchez M, Roncal NE, Hudson TH, Johnson JD, Prigge ST, Waters NC. Targeting the Fatty Acid Biosynthesis Enzyme, beta-Ketoacyl-Acyl Carrier Protein Synthase III (PfKASIII), in the Identification of Novel Antimalarial Agents. J Med Chem. 2009 Feb 3

The importance of fatty acids to the human malaria parasite, Plasmodium falciparum, and differences due to a type I fatty acid synthesis (FAS) pathway in the parasite, make it an attractive drug target. In the present study, we developed and a utilized a pharmacophore to select compounds for testing against PfKASIII, the initiating enzyme of FAS. This effort identified several PfKASIII inhibitors that grouped into various chemical classes of sulfides, sulfonamides, and sulfonyls…

Eisele TP, Keating J, Littrell M, Larsen D, Macintyre K. Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys. Am J Trop Med Hyg. 2009 Feb;80(2):209-14

Impact of insecticide-treated bednets (ITNs) on preventing malaria may be minimized if they are not used by vulnerable populations. Among ITN-owning households from 15 standardized national surveys from 2003 to 2006, we identify factors associated with ITN use among children younger than 5 years of age and make comparisons of ITN use among children and pregnant women across countries. Within ITN-owning households, many children and pregnant women are still not using them. Between-country analysis with linear regression showed child ITN use increases as intra-household access to ITNs increases (P = 0.020, R2 = 0.404), after controlling for season and survey year...

Fillol F, Cournil A, Boulanger D, Cissé B, Sokhna C, Targett G, Trape JF, Simondon F, Greenwood B, Simondon KB. Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal. Am J Trop Med Hyg. 2009 Feb;80(2):202-8

In sub-Saharan Africa, malaria and malnutrition are major causes of morbidity and mortality in children less than five years of age. To explore the impact of malnutrition on subsequent susceptibility to malaria, a cohort of 874 rural preschool children in Senegal was followed-up during one malaria transmission season from July through December...

Lefèvre T, Gouagna LC, Dabire KR, Elguero E, Fontenille D, Costantini C, Thomas F. Evolutionary lability of odour-mediated host preference by the malaria vector Anopheles gambiae. Trop Med Int Health. 2009 Jan 28

Many species of disease-vector mosquitoes display vertebrate host specificity. Despite considerable progress in recent years in understanding the proximate and ultimate factors related to non-random host selection at the interspecific level, the basis of this selection remains only partially understood. Anopheles gambiae sensu stricto, the main malaria vector in Africa, is considered a highly anthropophilic mosquito, and host odours have been shown to play a major role in the host-seeking process of this species...

Researchers trying to create the world’s first malaria vaccine are launching a massive medical trial as early as next month involving 16,000 children that could be the largest such trial ever conducted on children in Africa.

British-drugmaker GlaxoSmithKline PLC is teaming with the PATH Malaria Vaccine Initiative, which is an anti-malaria charity funded by the Bill & Melinda Gates Foundation, and clinics and research centers in Africa to develop a malaria vaccine.

"This is probably going to be one of the largest studies in infants and in children in Africa," said Joe Cohen, a top vaccine researcher for GlaxoSmithKline.

Malaria, caused by parasites and spread by mosquitoes, kills nearly 1 million people every year, most of them children in Africa. The trial may start as early as next month, and should be well under way by January, said Cohen.

The massive vaccine trials will be conducted in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania. Dr. Christian Loucq, director of the Malaria Vaccine Initiative, said the project has been working over the past year to upgrade laboratory, computer and other equipment in those countries, train technicians, and even help develop local equivalents of the U.S. Food and Drug Administration to ensure the trials are properly monitored.

The Malaria Vaccine Initiative has so far spent $107 million on the project and has not yet calculated how much more it will spend. GlaxoSmithKline has spent $300 million so far, and estimates it will spend up to $100 million more.

Researchers working on the trial said in an interview in Johannesburg that much of the groundwork already has been laid in preliminary trials involving 4,000 children conducted since 2003. They said that even if their vaccine does not succeed, the widespread investment needed to conduct the trials means that Africa will be left with better communications, research and other infrastructure that could be used in the search for vaccines against other diseases such as AIDS.

While the researchers were optimistic, it will be several years before they know whether their vaccine candidate is safe and effective enough for wide use.

The preliminary trials showed the vaccine was likely to be at least 30 percent effective against mild malaria cases and about 50 percent effective against severe malaria. That may sound low compared to, for example, the injectable polio vaccine that is at least 90 percent effective. But researchers have found it difficult to pin down a vaccine for parasites, and further tests may show the GlaxoSmithKline candidate is more effective, Cohen said.

Dr. Michel Van Herp, an epidemiologist with the aid group Medecins Sans Frontieres, said a vaccine might have to be more effective than the GlaxoSmithKline candidate has been shown to be so far to be worth the effort of putting it in use. But he acknowledged that matching the effectiveness of the polio vaccine has proven difficult, and said a partially effective vaccine "at least will reduce the workload on the health sector."

Medecins Sans Frontieres, also known as Doctors Without Borders, is not involved in vaccine research, but is at the forefront of treating malaria among the poor in Africa and elsewhere.

The vaccine would have to be used along with preventive measures like mosquito nets and insecticides to save lives.

Dr. Eusebio Macete, who is director of the Manhica Research Centre in Mozambique and was involved in some of the early field trials, said stopping any percentage of the disease would be welcomed in areas "where people are dying every day of malaria."

"It’s a huge, huge burden, this disease," Macete said. "Whatever percentage we can get will be useful in reducing the impact of the disease."

After years of death and despair, opportunity has finally begun knocking at the door of malaria eradication.  A report released in September by the World Health Organization (WHO) showed promising signs of progress in the fight against the disease that kills one million people every year.

It found that, between 2000 and 2006, more than 25 countries managed to cut their malaria death totals in half. What’s more, the total number of infections around the world now stands at 247 million, down from the 350-500 million estimated in WHO’s 2005 report.

These drops are credited to what the report calls “a renewed assault on malaria,” which includes ever-more effective and affordable anti-malaria pills as well as a greater distribution of insecticide-laced bed nets to repel mosquitoes that carry the disease.

This is good news indeed, especially since malaria often doesn’t get the attention it deserves.

But the worst thing the world can do now is to stop and celebrate. That’s because these steps forward are just the beginning of a long road ahead. Malaria still kills some 3000 people every day in sub-Saharan Africa alone, mostly children under five.

Nearly half the world’s population lives in areas where malaria is a constant threat. Yet despite recent improvements, far too few people have access to life-saving medicine and only 2 per cent of African children sleep under a bed net.

Aside from the overwhelming human toll, the disease also wreaks havoc on economies and on social stability. The UN says that in Africa, where most cases occur, malaria costs $12 billion a year in lost GDP. Add to that the resulting poverty and increased health care costs and it becomes clear that the disease hurts far more than just those infected.

So if the battle against malaria is going to be won, we must maintain and even step up our “renewed assault.”

There’s little doubt that malaria can be completely eradicated. As the latest statistics prove, we have the knowledge and tools to defeat the disease. All that remains is to stir up enough political will.

Any global leader with enough compassion and foresight will find a wonderful opportunity to make a real difference in the world by investing in malaria treatment and prevention.

Such an investment wouldn’t even cost that much. According to the UN, just $2 billion a year is needed to halve the global impact of malaria by 2010. Even simple bed nets, which help drastically reduce the number of cases, cost less than $10 a piece to produce and ship.

Yet right now the world spends a mere $600 million on the disease.

When you consider that makeup and perfume is a $33 billion industry, or that Europeans and Americans spend just under $20 billion a year on pet food, $2 billion a year for malaria prevention is a tiny investment with a huge return.

Even in the U.S., where dire economic turmoil makes increased funding for international development very unlikely, whoever wins the upcoming election will find a straightforward and affordable way to begin restoring America’s image abroad by taking the lead on malaria eradication.

At around the same time that the WHO released its 2008 malaria report, Bill and Melinda Gates were co-hosting the UN Malaria Summit, which brought together politicians, celebrities and activists to discuss ways to tackle the disease.

What resulted from the meeting was the Global Malaria Action Plan, step-by-step instructions on how the world can improve distribution of life-saving drugs and bed nets, while also increasing funding for malaria research.

The plan estimates that more than four million lives can be saved by 2015.

This means time is of the essence. If the world can build upon its small successes, malaria can go the way of smallpox, which was eradicated in 1977. That accomplishment is heralded as one of the greatest achievements of modern medicine.

But if global attention wavers, millions of men, women and children will continue to suffer and die, not just at the hands of tiny mosquitoes, but also as a result of our indifference.

The Global Fund to Fight AIDS, Tuberculosis and Malaria is pleased to announce that its Board has approved 94 new grants worth US$2.75 billion over two years. It is the eighth time the Global Fund Board approved new proposals to support programs fighting the three diseases and it is the largest round in the history of the organization, well over twice the size of any previous round.  The decision was made in New Delhi over the weekend, where the Global Fund held its board meeting.

Round 8 now brings the Global Fund’s overall portfolio to US$ 14.4 billion in 140 countries. 

“This is the highest amount of new financing approved by the Global Fund ever. These new resources will significantly help the world in achieving global targets such as universal access to AIDS treatment and prevention, and cutting the number of deaths from tuberculosis and malaria by half by 2015,” said Rajat Gupta, Chair of the Global Fund Board.

“This exceptional expression of increased demand requires a renewed resource mobilization effort,” said Michel Kazatchkine, the Executive Director of the Global Fund. “We have a fantastic message to bring back to the rich nations of the world: Programs to fight these three diseases save lives, reduce disease burdens, and strengthen health systems. We are asking you for resources for an effective way to reduce the gap between rich and poor and build a better and safer world.”

Of the approved proposals, the majority of resources go to malaria programs accounting for 51 percent.  Proposals for AIDS and tuberculosis account for 38 percent and 11 percent, respectively, of the approved funding.

Ninety percent of the approved grants today are for low-income countries, with the majority of resources – 77 percent – for Africa and the Middle East. Asia and the Western Pacific will receive 14 percent of the newly approved funding, Latin America and the Caribbean 6 percent, and Eastern Europe and Central Asia 6 percent.

The Global Fund’s next funding round will be approved in November 2009.

In a separate development, Friends of the Global Fund South- and West Asia was launched in New Delhi.  Friends South- and West Asia will be a leading advocate for programs supported by the Global Fund in the region. The new advocacy organization will also seek to help Global Fund recipient countries to get the best possible results from the grants that they receive.  Its Board of Directors and Advisory Board include a number of leading regional business leaders, health experts and academics.

Friends South- and West Asia is the latest such organization to be established since the Global Fund’s creation in 2002 and joins a network of associations around the world including the United States, Japan, Europe, Africa and Latin America

www.mrcglobal.org/rfp

Deadline for proposal submission: 16 January 2009

The McLaughlin-Rotman Centre for Global Health (MRC) and its Ethical, Social and Cultural Program (ESC) for the Grand Challenges in Global Health (GCGH) Initiative are pleased to invite individuals, institutions, organizations and companies from the developing world to submit proposals to carry out projects that will facilitate the implementation and use of technologies in the developing world that arise from the GCGH projects.

The goal of this Request for Proposals (RFP) is to select and commission research on strategies that will facilitate the implementation and appropriate use in the developing world of technologies that arise from the GCGH projects related to diagnostics, modified insect vectors, nutritionally enhanced foods, and vaccine delivery.

Attached is the advertisement that we are currently circulating internationally. We invite you to consider this RFP for any related work you may be involved in and would also be grateful if you could kindly forward this advertisement to any of your colleagues who may be interested in applying.

Please visit www.mrcglobal.org/rfp for further information. The deadline to submit proposals is January 16th, 2009.

Giha HA, Elghazali G, A-Elgadir TM, A-Elbasit IE, Elbashir MI. Severe malaria in an unstable setting: clinical and laboratory correlates of cerebral malaria and severe malarial anemia and a paradigm for a simplified severity scoring. Eur J Clin Microbiol Infect Dis. 2008 Nov 12. [Epub ahead of print]
An interpretation of historical, clinical, and laboratory data was made to identify the correlates of and the diversity between cerebral malaria (CM) and severe malarial anemia (SMA) in a setting of low, seasonal, and unstable malaria transmission in eastern Sudan. Hemoglobin (Hb), random blood glucose (RBG), and anti-MSP antibodies were measured. Results showed that SMA and CM were significantly different with regard to age, malaria history, fever duration, convulsions, and hepatosplenomegaly…

Kursula I, Kursula P, Ganter M, Panjikar S, Matuschewski K, Schüler H. Structural Basis for Parasite-Specific Functions of the Divergent Profilin of Plasmodium falciparum. Structure. 2008 Nov;16(11):1638-48
Profilins are key regulators of actin dynamics. They sequester actin monomers, forming a pool for rapid polymer formation stimulated by proteins such as formins. Apicomplexan parasites utilize a highly specialized microfilament system for motility and host cell invasion…

Pombi M, Caputo B, Simard F, Di Deco MA, Coluzzi M, Della Torre A, Costantini C, Besansky NJ, Petrarca V. Chromosomal plasticity and evolutionary potential in the malaria vector Anopheles gambiae sensu stricto: insights from three decades of rare paracentric inversions. BMC Evol Biol. 2008 Nov 10;8(1):309. [Epub ahead of print]
In the Anopheles gambiae complex, paracentric chromosomal inversions are non-randomly distributed along the complement: 18/31 (58%) of common polymorphic inversions are on chromosome arm 2R, which represents only ~30% of the complement. Moreover, in An. gambiae sensu stricto, 6/7 common polymorphic inversions occur on 2R. Most of these inversions are considered markers of ecological adaptation that increase the fitness of the carriers of alternative karyotypes in contrasting habitats...

Behrens RH, Carroll B, Smith V, Alexander N. Declining incidence of malaria imported into the UK from West Africa. Malar J. 2008 Nov 10;7(1):235. [Epub ahead of print]
Two thirds of all falciparum malaria cases reported in the United Kingdom (UK) are acquired in West Africa (WA). To ensure recommendations and guidelines for malaria prophylaxis in travellers to West Africa correlate to the risk of infection, a study was undertaken to examine recent trends and predict future patterns of imported malaria acquired by UK residents visiting West Africa and West African visitors to the UK between 1993 and 2006...

Beare NA, Harding SP, Taylor TE, Lewallen S, Molyneux ME. Perfusion Abnormalities in Children with Cerebral Malaria and Malarial Retinopathy. J Infect Dis. 2008 Nov 10. [Epub ahead of print]
In patients with cerebral malaria (CM), retinal angiography allows the study of infected central nervous system microvasculature in vivo. We aimed to examine retinal perfusion in children with CM by use of fluorescein angiography to investigate the pathophysiology of CM...

Durand PM, Naidoo K, Coetzer TL. Evolutionary patterning: a novel approach to the identification of potential drug target sites in Plasmodium falciparum. PLoS ONE. 2008;3(11):e3685. Epub 2008 Nov 10
Malaria continues to be the most lethal protozoan disease of humans. Drug development programs exhibit a high attrition rate and parasite resistance to chemotherapeutic drugs exacerbates the problem. Strategies that limit the development of resistance and minimize host side-effects are therefore of major importance. In this study, a novel approach, termed evolutionary patterning (EP), was used to identify suitable drug target sites that would minimize the emergence of parasite resistance...

Hargreaves S. Malaria advances still not reaching patients, warns charity. Lancet Infect Dis. 2008 Nov;8(11):667
A new report from the international medical organisation Médecins Sans Frontières (MSF) says that measures to ensure new diagnostics and artemisinin-based combination therapy (ACT) actually reach patients are now crucial. Merely shipping drug treatment to resource-poor countries is not enough, say the authors, citing weak distribution and health systems and a lack of qualified staff as just some of the problems. The report was published in the wake of the high-level UN Millennium Development Goal m...

The MIM Website is now bilingual, available both in English and French.

To access the French version, click http://www.mimalaria.org/fr/

L’Initiative multilatérale sur le paludisme (MIM) fut établie en 1997 avec mission de renforcer et de soutenir la capacité des pays d’Afrique sévèrement touchés par le paludisme à effectuer les recherches nécessaires au développement et à l’amélioration des outils servant à.. Lire plus

The Multilateral Initiative on Malaria (MIM) is now accepting abstracts for the Fifth MIM Pan-African Malaria Conference to be held 2-6 November, 2009 at the Kenyatta International Conference Centre (KICC), Nairobi, Kenya.

MIM Conferences are currently the largest meetings worldwide entirely devoted to malaria research and control and provides a unique forum for the malaria community including junior scientists to meet senior researchers and discuss recent findings, representatives of the malaria stakeholders to identify priority research areas, translation of operational problems to researchable questions and available research results into policy and operational guidelines.

A limited number of scholarships are available for junior scientists/researchers from malaria endemic countries.

Visit www.mimalaria.org/pamc for more information, online registration and abstract submission.

Researchers from Nijmegen and Leiden have found potential malarial therapeutic targets that may in the development of a vaccine to treat the disease.

They have identified a large number of parasite proteins that help in bringing human malaria vaccine closer to reality.

Malaria is spread by mosquito bite, once injected the parasites migrate to the liver where they mature and then their sporozoites (infective cells) are released into the blood, causing disease and fatal complications.

During the study the researchers genetically modified the proteins essential for sporozoite development, and could weaken these parasites such that they invade liver cells and stimulate an immune response, but don”t develop further.

Previous studies have shown how to successfully vaccinate mice using a rodent malaria which had one of these liver stage genes removed, specifically p36p.

The researchers showed the first transition of such a vaccination from the rodent system to humans, by inactivating the equivalent gene (p52) in the major human malaria parasite, P. falciparum. These human parasites are unable to develop in liver cells.

The researchers believe that the findings may open up new pathways for its use as a human vaccine.

The findings are published October 31st in the open-access journal PLoS Pathogens

Incidence of malaria in Gambia has plunged thanks to an array of low-cost strategies, offering the tempting vision of eliminating this disease in parts of Africa, a study published Friday by The Lancet said.

At four key monitoring sites in the small West African state, the number of malarial cases fell by between 50 percent and 82 percent between 2003 and 2007, its authors found.

The tally of deaths from malaria, recorded at two hospitals where there had been a total of 29 fatalities out of 232 admissions in 2003, fell by nine-tenths and 100 percent in 2007. A fall of 100 percent means that no deaths attributed to malaria occurred that year.

"A large proportion of the malaria burden has been alleviated in Africa," the study concludes.

The authors also found a substantial shift in the age of Gambian children being admitted for care -- from an average of 3.9 years in 2003 to 5.6 years in 2007.

This is important because young children and infants bear the brunt of malaria mortality.

According to figures released on September 18 by the UN’s World Health Organization (WHO), around 247 million cases of malaria occurred in 2006, causing nearly a million deaths, mostly of children aged under five.

Gambia’s success is due to a combination of several factors that have especially benefited pregnant women and children, says the paper.

These include distributing insecticide-treated bed nets; programmes to spray homes; and the use of the more powerful drugs to replace treatments to which the malaria parasite has become resistant.

"(...) Increased investment in malaria interventions in Africa can have a major effect on reducing morbidity and mortality from the disease," said one of the authors, David Conway, of the London School of Hygiene and Tropical Medicine.

"We need to consider the possibility of future elimination of malaria from some areas in Africa but we also emphasize the importance of continuous surveillance, and there is no room for complacency with this disease."

A study out today shows a dramatic fall in the number of people dying from malaria infection in coastal Kenya. The research, funded by the Wellcome Trust and the Kenya Medical Research Institute (KEMRI), highlights the importance of the prevention and rapid treatment of malaria infection in preventing a potential resurgence of the disease.

Malaria is one of the world’s biggest killers, responsible for over a million deaths every year, mainly in children and pregnant women in Africa and south east Asia. It is caused by the malaria parasite, which is injected into the bloodstream from the salivary glands of infected mosquitoes.

In areas where transmission rates of malaria are high, death occurs most frequently in young children, usually as a result of severe anaemia. Surviving children rapidly develop immunity to the disease and severe malaria is rarely seen in older children. Where transmission rates are lower, the proportion of older children infected with malaria increases – in older children, malaria can lead to even more serious complications as the parasites reach the brain.

Researchers from the KEMRI-Wellcome Trust programme in Kilifi, eastern Kenya, have analysed eighteen years of detailed hospital surveillance data in a large endemic area of the Kenyan coast to look at whether incidence of malaria have been falling and what impact this will have on disease and mortality in the population. The results are published today in the journal The Lancet.

Whilst the researchers found that transmission rates for malaria have been steadily falling over the past ten years, the number of cases of severe malaria only began to fall more recently. However, the past five years have seen a remarkable fall of over 75% in the number of severe malaria deaths from malaria, down from 10.8 per 10,000 to 1.2 per 10,000.

"These are incredibly positive findings and reflect what is being seen along the east African coast," says Professor Kevin Marsh, head of the KEMRI Wellcome Trust programme and a researcher at the University of Oxford. "It gives us hope that tackling malaria across the continent is an achievable goal."

Professor Marsh and colleagues believe that a number of reasons may be behind this dramatic reduction in incidence of the disease, reflecting the success of control measures and early treatment. These include changes since the mid ’90s in the first line therapy, with new drugs replacing the previously widely-used treatment, chloroquine, which had become ineffective due to drug-resistance.

Other factors that may have contributed to the decline include the increasing use of insecticide-treated bednets and better management of mosquito breeding sites.

Researchers had predicted that falling transmission rates would have left older children unexposed to malaria and therefore with no immunity, resulting in an increase in cases of cerebral malaria. In fact, whilst they indeed found a small rise in the number of cases of cerebral malaria, this was more than offset by the marked decrease in severe malarial anaemia and other forms of malaria.

"There are many factors that may have contributed to this dramatic reduction in malaria deaths, but one thing is clear: we must not become complacent," says Professor Marsh. " As transmission rates continue to fall, younger children are growing up with less exposure to malaria. It’s essential that we maintain control measures, look for new ones and emphasise early treatment to prevent a resurgence of this deadly disease."

The findings have been welcomed by Dr Mark Walport, Director of the Wellcome Trust.

"These are important results - they show that malaria can be controlled in parts of the world where for centuries it has been a major killer of children and pregnant women," says Dr Walport. "These findings should provide encouragement to those dedicated to the control and ultimately the eradication of malaria.

No one can doubt that over the past few years, Africa has embarked on a path of unprecedented economic growth and social development. Several countries on the continent have made significant strides on delivering better education, health, and poverty reduction results. At the same time, African leaders have taken concrete steps toward improving governance, and have initiated reforms to boost trade and make the investment climate more attractive. Even though poverty has not been eradicated, the growth indicators, which show an average of 5.4% GDP per capita over the past decade, suggest an emergent continent on the path of securing a more prosperous future for its people.

This is unlikely to be sustained unless the productivity of Africa’s human capital is guaranteed.  The good news is that massive efforts by the international community and African countries themselves have resulted in thousands of lives being saved and many healthier. Still, millions of Africans die every year unnecessarily from entirely preventable causes. Malaria is one of these causes, a disease that infects more than 500 million people around the world, mostly women and children. Over 90 percent of the million worldwide annual deaths from malaria occur in Africa. This ruthless disease is estimated to cost the continent about US$12 billion a year in lost productivity. A growing Africa cannot afford this burden. There is no question that the progress already achieved will be seriously undermined if the magnitude of the disease continues at current levels.

Of all the issues Africa still faces, malaria is what one can call “a low hanging fruit”. Global partners and countries have seized the intense focus and energy around malaria by making a commitment to eliminate it from the continent. Our optimism and bold ambition are not unfounded.  We have effective medicines, bed nets and a wealth of knowledge being shared across countries and programs. We have the resources to take on regional interventions that cross borders, like the mosquitoes themselves. The international community, under the umbrella of the Roll Back Malaria Partnership, has been mobilized – governments, NGOs, global organizations, research institutions, and the private sector are working together to halve malaria deaths by 2010. Artists worldwide are putting human voices and faces behind the numbers to make malaria resonate for those unaware of its impact.  Health workers in Africa are helping people affected by malaria and parents are increasingly taking more measures to protect themselves and their children. The war to eliminate this scourge is spreading.

African countries are leading this war, but they cannot do it alone. The global community needs to help Africa massively scale up malaria control efforts. Partners have entirely subscribed to this vision and will support African countries in their efforts to provide universal coverage with effective malaria control methods to the entire Sub-Sahara African population at risk of malaria.  As one of the three largest malaria control financiers, the World Bank is contributing significantly to the progress being made.  Through its Booster Program for Malaria Control in Africa, the Bank has committed about US$470 million to malaria control efforts in Africa and plans to commit significantly more so that several countries can quickly ramp up their efforts to bring the disease under control. Responding to the urgency of the disease and with clear evidence of African countries’ commitment to doing something about it, other partners are also putting more resources on the table. The Global Fund provided more funding for malaria programs in its last round than ever before. The United Kingdom recently announced it would buy 20 million bed nets for Africa.

Increased funding is important and necessary, but it is not sufficient. The world needs to know about the progress made in the fight against malaria.  Action by African artists and musicians in this regard has been successful. The 2005 AFRICA LIVE: Roll Back Malaria Concert – a two-day stadium show in Dakar featuring seventeen of Africa’s most celebrated musicians – reached the hearts and minds of more than a billion people in broadcast coverage worldwide We need to support more of these endeavors that show malaria’s human side. A faceless disease will not be enough to spark off the commitment needed to control it.

We have before us an extraordinary window of opportunity to improve the future prospects for millions of people in Africa.  This opportunity may not come again. We have an obligation to turn the current momentum into concrete results, to help Africa defeat malaria.  Africa’s time is now and malaria’s time is up. Working together we will ensure that future generations stay alive to eat well, go to school, enjoy clean water and electricity, and fuel Africa’s transition into prosperity and sustained growth

Applications are now being accepted through December 1, 2008, for the 2010 Cunningham Memorial International Fellowship. The award is given annually to citizens or permanent residents from countries outside the United States and Canada who have both an undergraduate degree and a master’s level library degree and are working or preparing to work in a health sciences library in their countries.

The program will provide a three-week learning experience including attending MLA 2010 and a one-to-two week stay at one or more medical library host sites.  Two Cunningham awards of $3500 each are available.

The Cunningham Fellowship was established in 1967 and named in honor of Eileen Cunningham.

Go to www.mlanet.org/awards/grants/ for links to a fact sheet and application.

For more information, please contact:

Lisa C. Fried
Credentialing, Professional Recognition, and Career Coordinator at

Tel. 312.419.9094, ext 28 or
E-mail: mlapd2@mlahq.org

Deadline for applications: 15 December 2008

In collaboration with the University of Siena Medical School, Novartis Vaccines is organising a two-year Masters Programme in Vaccinology and Clinical Development which will start in May 2009.

The purpose of this Masters is to provide graduates in Medicine with training on all aspects of developing vaccines, from basic research to clinical development, health authority approval and beyond.

Students will participate in real life clinical and regulatory activities within the company and will be intensively involved in development programs.

The two year Masters will be completed with a dissertation leading to an M.Sc. degree from the University of Siena.

A 2-year grant will be provided to students who are accepted.

We are confident that participation in this Masters will prepare the students for a career in academia, public health or vaccine clinical development within the pharmaceutical industry.

In the enclosed brochure you will find more information about the Masters programme and the procedures to be followed for the application.

Apply by sending your curriculum vitae and a letter of motivation to vaccines_master.nvdit@novartis.com before December 15th, 2008.

For further information concerning applications, please consult the university website:

http://www.unisi.it/ammin/udss/affari_generali/stranieri_english.htm

For further information, contact:

Audino Podda, MD                                                                                  
Head, Clinical Development      
Novartis Vaccines Institute for Global Health (NVGH)                                   
Via Fiorentina, 1
53100 Siena
Tel. +39 0577 243496
Cell +39  335 70 26 950 

email audino.podda@novartis.com

Ouma C, Davenport GC, Were T, Otieno MF, Hittner JB, Vulule JM, Martinson J, Ong’echa JM, Ferrell RE, Perkins DJ. Haplotypes of IL-10 promoter variants are associated with susceptibility to severe malarial anemia and functional changes in IL-10 production. Hum Genet. 2008 Oct 30. [Epub ahead of print]
Plasmodium falciparum malaria is one of the leading global causes of morbidity and mortality with African children bearing the highest disease burden. Among the various severe disease sequelae common to falciparum malaria, severe malarial anemia (SMA) in pediatric populations accounts for the greatest degree of mortality…

Kyabayinze DJ, Tibenderana JK, Odong GW, Rwakimari JB, Counihan H. Operational accuracy and comparative persistent antigenicity of HRP2 rapid diagnostic tests for Plasmodium falciparum malaria in a hyperendemic region of Uganda. Malar J. 2008 Oct 29;7(1):221. [Epub ahead of print]
Parasite-based diagnosis of malaria by microscopy requires laboratory skills that are generally unavailable at peripheral health facilities. Rapid diagnostic tests (RDTs) require less expertise, but accuracy under operational conditions has not been fully evaluated in Uganda. There are also concerns about RDTs that use the antigen histidine-rich protein 2 (HRP2) to detect Plasmodium falciparum, because this antigen can persist after effective treatment, giving false positive test results in the absence of infection…

McCallum FJ, Persson KE, Mugyenyi CK, Fowkes FJ, Simpson JA, Richards JS, Williams TN, Marsh K, Beeson JG. Acquisition of growth-inhibitory antibodies against blood-stage Plasmodium falciparum. PLoS ONE. 2008;3(10):e3571. Epub 2008 Oct 29.
Antibodies that inhibit the growth of blood-stage Plasmodium falciparum may play an important role in acquired and vaccine-induced immunity in humans. However, the acquisition and activity of these antibodies is not well understood. METHODS: We tested dialysed serum and purified immunoglobulins from Kenyan children and adults for inhibition of P. falciparum blood-stage growth in vitro using different parasite lines...

van Schaijk BC, Janse CJ, van Gemert GJ, van Dijk MR, Gego A, Franetich JF, van de Vegte-Bolmer M, Yalaoui S, Silvie O, Hoffman SL, Waters AP, Mazier D, Sauerwein RW, Khan SM. Gene disruption of Plasmodium falciparum p52 results in attenuation of malaria liver stage development in cultured primary human hepatocytes. PLoS ONE. 2008;3(10):e3549. Epub 2008 Oct 28
Difficulties with inducing sterile and long lasting protective immunity against malaria with subunit vaccines has renewed interest in vaccinations with attenuated Plasmodium parasites. Immunizations with sporozoites that are attenuated by radiation (RAS) can induce strong protective immunity both in humans and rodent models of malaria. Recently, in rodent parasites it has been shown that through the deletion of a single gene, sporozoites can also become attenuated in liver stage development and, importantly, immunization with these sporozoites results in immune responses identical to RAS...

Tatem AJ, Guerra CA, Kabaria CW, Noor AM, Hay SI. Human population, urban settlement patterns and their impact on Plasmodium falciparum malaria endemicity. Malar J. 2008 Oct 27;7(1):218. [Epub ahead of print]
The efficient allocation of financial resources for malaria control and the optimal distribution of appropriate interventions require accurate information on the geographic distribution of malaria risk and of the human populations it affects. Low population densities in rural areas and high population densities in urban areas can influence malaria transmission substantially. Here, the Malaria Atlas Project (MAP) global database of Plasmodium falciparum parasite rate (PfPR) surveys, medical intelligence and contemporary population surfaces are utilized to explore these relationships and other issues involved in combining malaria risk maps with those of human population distribution in order to define populations at risk more accurately...

Download GMAP at: www.rollbackmalaria.org/gmap/

Four million malaria deaths can be diverted by 2015 cites RBM Partnership

More than 4 million lives can be saved by 2015 if resources are scaled up, reports a new malaria elimination plan today, launched by members of the international community attending the UN Summit in New York.

The Global Malaria Action Plan (GMAP) details how to accelerate action against malaria, across countries and regions, leading to elimination of the disease. Developed through the framework of the Roll Back Malaria (RBM) Partnership, it rallies 30 endemic countries and regions and 65 international institutions behind an unprecedented effort to achieve more rapid results against malaria.

Malaria affects half of the world’s population – 3.3 billion people in 109 countries – causing nearly 1 million deaths per year. According to GMAP’s projections, more than 4.2 million lives can be saved between 2008 and 2015, if the plan is put into action. In addition, millions of dollars of lost GDP can be recovered and critical healthcare resources freed up in regions to tackle other health and social challenges.

Effective malaria control will cost only a fraction of the losses that endemic countries endure today due to malaria, the GMAP posits. Africa alone is estimated to lose at least $12 billion per year in direct costs and much more in GDP losses. Achieving full control in all endemic countries, including strengthening health systems, will cost approximately $5.3 billion in 2009, $6.2 billion in 2010 and $5.1 billion annually from 2011 to 2020.

“The action plan that we are putting forward to global leaders today is a historic milestone in the fight against malaria,” said Professor Awa Marie Coll-Seck, Executive Director of the RBM Partnership. “Putting the plan into action should now become the next priority for the international community," Coll-Seck added, explaining that implementing the plan will help achieve six of the eight Millennium Development Goals.

The GMAP offers a comprehensive blueprint for reducing malaria. It provides timelines for delivering nets and drugs to all people at risk in Africa, Asia-Pacific, the Americas, the Middle East and Eurasia. It also outlines a strategy for increasing investment in research for new tools to eliminate and eventually eradicate malaria globally. Research will cost at least $750 million annually over the next ten years, according to the plan’s estimates.

"In Ethiopia, we provided universal access to protective nets in 18 months only,” said Dr Tedros Adhanom, Ethiopia’s Minister of Health and Chair of the RBM Partnership Board. “The challenge now is to make such successes work on a larger scale and in all affected regions.

This is what the Global Malaria Action Plan will help us do."

Reflecting malaria’s global scale, the plan is being launched today in all malaria endemic regions, including in the Philippines, Kenya, Mali and Brazil. It is endorsed politically at a UN Malaria Summit taking place at UN headquarters in New York.

During the New York launch event, co-hosted by the Bill & Melinda Gates Foundation, Malaria No More, the British Government as well as the UN Special Envoy for Malaria, heads of state, business leaders, and international celebrities are expected to pledge their commitment to turning the RBM plan into action.

In his opening address at the UN General Assembly earlier this week, Secretary-General Ban Ki-moon requested world leaders to honor their commitments to achieve the Millennium Development Goals, including Goal 6 which addresses malaria, AIDS and tuberculosis. Mr. Ban cited leadership and partnerships as vital ingredients in combating malaria and other pressing global challenges.

Similar calls to action were echoed by several heads of states at this week’s commencement of the 63rd Session of the General Assembly, including African Union President Jakaya Mrisho Kikwete and G8 leaders US President George W. Bush and French President Nicolas Sarkozy.

Earlier this month at a malaria awareness campaign in Paris, Nicolas Sarkozy, speaking as President of the Council of the European Union, urged his international counterparts to mobilize around efforts to eradicate malaria.

The Global Malaria Action Plan is available for download at: www.rollbackmalaria.org/gmap/

Bill Gates announced today that the Bill & Melinda Gates Foundation will provide $168.7 million to PATH for its Malaria Vaccine Initiative to develop vaccines for malaria—a disease that kills thousands of African children every day.

The PATH Malaria Vaccine Initiative (MVI) is working with GlaxoSmithKline Biologicals to develop a first-generation vaccine candidate, known as RTS,S, which could become the first-ever approved malaria vaccine. With the new grant announced today, MVI will support the development of next-generation vaccines that could provide even greater and longer-lasting protection.

"I’m very hopeful that the malaria vaccine currently in advanced testing will be proven effective, but that will just be the first step," said Gates, co-chair of the Gates Foundation. "Now it’s time to develop a new generation of vaccines that are even more effective, and could someday help eradicate malaria altogether."

Gates announced the new funding at the UN Millennium Development Goals Malaria Summit, a meeting of heads of state, CEOs, UN officials, and other leaders. At the event, the Roll Back Malaria Partnership launched the Global Malaria Action Plan, a comprehensive global strategy to fight malaria. The Gates Foundation grant and other commitments announced today will help address key priorities in the Action Plan.

Grant to Support Research on a New Generation of Malaria Vaccines

The Gates Foundation grant will support MVI’s efforts to expand its vaccine R&D pipeline with projects ranging from early-stage laboratory research to advanced clinical testing.  MVI will work with partners to discover new antigens and adjuvants that could lead to more effective vaccines, and develop new tools to select the most promising candidates for further development.

MVI will also work to foster a more competitive vaccine marketplace and help ensure that future vaccines will be affordable and accessible in developing countries.  They will conduct market assessments, demand forecasting, and modeling studies to guide policymakers and vaccine manufacturers, and partner with vaccine makers in developing countries to keep costs low.

"These new funds are recognition that we have a solid research and development strategy, and the team to deliver on it," said Dr. Christian Loucq, Director of MVI. "This commitment should signal to potential research partners that the time is ripe to work with us to help defeat this horrible disease. Already, we have added to our roster of partners and entered into collaborative agreements on vaccine components, ways to boost their potency, and methods for testing their biological activity."

"Our strategy for developing a malaria vaccine follows the PATH approach to neglected diseases, which has shown that investment in core areas of research and development, particularly vaccine technology, does yield important advances," said Dr. Christopher J. Elias, president and CEO of PATH. "The PATH Malaria Vaccine Initiative is now ready to accelerate further the development of what the world urgently needs: safe, effective, and affordable vaccines that reduce the suffering caused by malaria."

The grant addresses one of the priorities in the new Global Malaria Action Plan, released today by the Roll Back Malaria Partnership. The plan provides a unified global strategy for fighting malaria, including greater use of today’s tools, and research on vaccines and other new technologies.

"The Global Malaria Action Plan makes a compelling case for greater investment in malaria," said Gates. "If we have the chance to save millions of lives, and a clear plan to make it happen, we have an obligation to act. We’re committed to supporting a range of efforts to make the Action Plan a reality—today’s grant is just the first step."

New Malaria Control Success in Zambia and Ethiopia

Gates hailed new data from the World Malaria Report, released last week by WHO, showing encouraging progress against malaria in several African countries through 2006. He also highlighted more recent data from Zambia and Ethiopia that further demonstrate the impact of aggressive, large-scale malaria control programs.

The Zambian health ministry reported this week that since 2006, malaria control efforts have helped to reduce malaria parasite prevalence in children by 50 percent. Since 2002, the percentage of households with at least one insecticide-treated mosquito net has increased from 14 percent to 60 percent, and malaria control successes have helped to reduce overall child mortality by 29 percent.

Earlier this month, Ethiopia’s health ministry announced that it has reached nearly 70 percent of households in high-risk areas with at least one insecticide-treated mosquito net and/or indoor residual spraying, and that effective malaria treatment with artemisinin-based combination therapy is now available nationwide.

"The good news from Ethiopia and Zambia demonstrates that extraordinary progress can be made against malaria, even in the poorest and most remote communities," said Gates. "By building on and replicating these successes globally, we can save millions of lives."

Both countries are partners in the Malaria Control and Evaluation Partnership in Africa (MACEPA), a PATH initiative that is funded by the Gates Foundation

African malaria research experts have welcomed today’s announcements by Roll Back Malaria (RBM) and the Bill & Melinda Gates Foundation which pledged continued support and additional funding for malaria vaccine research.

AMANET (African Malaria Network Trust), with headquarters in Dar-es-Salaam, Tanzania and INDEPTH Research Network (the International Network for Demographic Surveillance of Populations and their Health in Developing Countries), with headquarters in Accra, Ghana, are two African research institutions currently building research capacity and searching for a malaria vaccine. Their trial sites are spread throughout Africa, and have candidate malaria vaccines being tested in Burkina Faso, Gabon, Ghana, Kenya, Mali, Sudan, Tanzania and Uganda.

Recent reports on the incidence of malaria showcase progress in providing access to short-term malaria control tools – specifically, preventive measures such as long lasting insecticidal nets (LLINs) and indoor residual spraying.

Good progress is also being made in the early diagnosis and correct appropriate treatment to cure malaria particularly in children under five years of age and pregnant women; these two constitute the most vulnerable groups in much of sub-Saharan Africa.

The enhanced malaria control as envisaged in the ambitious new Global Malaria Action Plan, when successfully implemented, will reduce malaria disease burden considerably, though in the long-term, the reduction to near zero will depend on entirely new malaria control tools. There is need therefore to focus on researching, developing and deploying the next generation of efficacious malaria control tools – and especially a successful malaria vaccine.

“Africa is where malaria strikes the hardest,” says Professor Wen Kilama, the Managing Trustee of AMANET. “Some 800 000 Africans – mainly children younger than five – die from malaria each year. This is over 90% of the global mortality from malaria, according to World Malaria Report 2008.

“Malaria also compounds Africa’s poverty and slows down its socio-economic development. It costs Africa at least USD 12 billion a year in direct losses and many times more than that in lost economic growth when examined over a long term. It is thus crucial that African scientific organisations are equipped and involved in searching for new and more effective malaria control tools,” argues Professor Kilama.

“As efforts to treat and prevent malaria are continuously being frustrated because the malaria parasite and mosquitoes are increasingly resistant to medicines and insecticides, an effective vaccine against malaria will help. Vaccines, in general, are the backbone of public health interventions, especially in poor countries, where they help contain or even eradicate leading killers. The Bill and Melinda Gates Foundation support for next generation malaria vaccines will greatly enhance current combined global efforts against malaria,” said Professor Kilama.

Speaking at the eighth INDEPTH Annual General Meeting being held in Dar es Salaam, Dr Osman Sankoh, the Executive Director of INDEPTH Network, says that malaria vaccine research in Africa has begun to provide critical leads towards an effective malaria vaccine for Africa. Commenting on just released funding commitments, Dr Sankoh said: “Sustainability of funding is so important, as effective research in Africa entails building capacity and strengthening health facilities. We are heartened by today’s announcements made by RBM and other partners, and look forward to playing our part in the global efforts to control and eventually eradicate malaria.”

Issued on behalf of AMANET & INDEPTH

By Meropa Communications, Johannesburg, South Africa, tel +27-11-772-1000

For further information or to schedule interview, please contact:

Charles Wanga, AMANET, P +255-22-2700018 M +255-78-433-7232

Samuel Mikenga, INDEPTH, P +233 21 519 395 M +27-72-529-6769

Khomotso Makuse P +27-11-7721000 Email kgomotsom@meropa.co.za or Maria Djordjevic M +27-82-334-6192 Email mariad@meropa.co.za

Sponsored by the UNICEF/UNDP/World Bank/WHO  Special Program for Research and Training in Tropical Diseases (TDR)

Organized by WHO/HQ Health Security and Environment Hosted by Faculty of Science and Techniques, University of Bamako, Mali

Dates: 3-7 December 2008

Application deadline:  15 October 2008

http://www.who.int/tdr/grants/grants/bl5_laboratory_biosafety.htm

Introduction

Vector-borne diseases occurring in more than 100 countries and affecting about half of the world’s population are emerging and resurging. Consequently, they result in high burden of disease. This worsening situation reflecting an inadequate impact of control measures is due to various factors including poor implementation of interventions, limited resources, and development of resistance to insecticides. However, it is generally recognized that effective prevention strategies can reverse this trend, and vec tor control is a key component of such strategies aiming at interrupting transmission. In addition, genome sequencing of the main vectors of malaria, dengue, and Human African Trypanosomiasis (HAT) carries the promise of radically improved vector control methods but this new approach will require careful and coordinated development, corroboration, and field evaluation.

TDR has participated for the past ten years with other organizations, in facilitating the development of genetically modified malaria and dengue vectors for interrupting pathogen transmission. This activity is actually mainly supported through the Gates Foundation Grand Challenges for Global Health projects on vector control. Therefore, TDR new strategy is focusing on the requirements to be addressed for potential field deployment of the genetic control methods. Most importantly, these include ensuring the  new methods are efficacious and particularly safe for humans and the environment.

In order to address this key aspect, TDR new strategy will help building capacity in Disease Endemic Countries (DECs) to prepare them to acquire the knowledge and experience necessary for the application of biosafety and biosecurity regulatory principles and practices. More specifically, it will strengthen their capabilities for effective and timely assessment and management of the potential risks for humans and the environment of the use of genetically-modified vectors(GMV) in view of the implementation of effective and safe genetic control tools for interrupting pathogen transmission. For this purpose, TDR has funded a project for developing best practice guidance for deployment of genetic control methods in disease endemic countries. In addition, TDR has already funded a biosafety training course for Africa and will be funding two others for Asia and Latin America. Furthermore, TDR has fund ed the  course, object of this call, to focus mainly on laboratory biosafety and biosecurity and complementing the three Regional biosafety training courses.

Objectives of the course

The course aiming at training the potential trainers in laboratory biosafety and biosecurity will run in theoretical and practical aspects for five days with the following specific objectives:

1. Highlighting the importance of implementation of biosafety and biosecurity standards to protect personnel and environment through good practices as well as safeguarding the GMVs 
2. Providing proper information to laboratory management and personnel on the principles and practices of laboratory biosafety and biosecurity guidelines.
3. Stressing the need for institutions and laboratories in Disease endemic countries to implement effective biosafety and biosecurity principles  and practices

Course content

Biosafety

1. Introduction. Principles of Laboratory Biosafety
2. Hazards and risks associated with handling of GMVs
3. Laboratory Biosafety Protocols
4. Containment Levels: Facility Design and Work Practices
5. Laboratory Animal facility
6. Biological Safety Cabinets
7. Accidents in handling GMVs/ Reporting of Accidents
8. Sterilization and Disinfection in the Laboratory
9. Risk assessment
10. Safe Handling of Laboratory Equipment and Materials
11. Personal Protective equipment PPE
12. Waste Disposal
13. Transport and Transfer of GMVs

Biosecurity

1. Introduction

2. Laboratory Biosafety VS Laboratory Biosecurity

3. Principles of Laboratory Biosecurity

4. Components of a biosecurity programme:

   - Risk assessment

   - Physical security

   - Personnel management

   - Accountability of GMVs

   - Biosecurity issues in transfer of  GMVs

   - Information security

   - Management of biosecurity activities

Course language: English

Participants eligibility

Decision makers, laboratory managers and researchers working or having the back ground knowledge on vector research and/or control from vector-borne disease endemic countries are mainly expected to participant in this course.

Selection Criteria

1. Good knowledge of vector biology and molecular entomology
2. Demonstrated experience in laboratory research on disease vectors
3. Basic knowledge and experience in laboratory biosafety and biosecurity
4. Involvement in development and implementation of laboratory based research projects
5. Ability to apply the training skill in home institution
6. Fluency in English
7. Availability for the entire duration of the course

Application procedure

All applications must be submitted using the application form (in MS Word format) to be downloaded from http://www.who.int/tdr/grants/grants/bl5_laboratory_biosafety.htm 

The completed application form, with a letter of recommendation from their institution should be sent electronically to: mohammadia@who.int 

1. All applications must be received by the deadline of 15 October 2008
2. Successful applicants will be notified by 1 November 2008
3. Course dates: 3-7 December, 2008
4. Course Venue: Faculté des Sciences et Techniques, Universite de
5. Bamako, Bamako, Mali

Course Coordinator:

Dr Ali A. Mohammadi
Scientist, Biosafety
Health security and Environment
World Health Organization
20 Avenue Appia
CH-1211  Geneva
Switzerland

Tel: +41 22-791 1804
Fax: +41 22-791 4666

E-mail: mohammadia@who.int

Mather MW, Vaidya AB. Mitochondria in malaria and related parasites: ancient, diverse and streamlined. J Bioenerg Biomembr. 2008 Sep 24. [Epub ahead of print]
Parasitic organisms have emerged from nearly every corner of the eukaryotic kingdom and hence display tremendous diversity of form and function. This diversity extends to their mitochondria and mitochondrion-derived organelles. While the principles of the chemiosmotic theory apply to all these pathogens, the differences from their hosts provide opportunities for therapeutic development. In this review we discuss examples of mitochondrial systems from a deep-branching phylum, Apicomplexa. Many important human pathogens, such as malaria parasites, belong to this phylum. Unique features of their mitochondria are validated targets for drugs that are selectively toxic to the parasites…

Chaudhuri R, Ahmed S, Ansari FA, Singh HV, Ramachandran S. MalVac: Database of malarial vaccine candidates. Malar J. 2008 Sep 23;7(1):184. [Epub ahead of print]
The sequencing of genomes of the Plasmodium species causing malaria, offers immense opportunities to aid in the development of new therapeutics and vaccine candidates through Bioinformatics tools and resources…

Vigan-Womas I, Guillotte M, Le Scanf C, Igonet S, Petres S, Juillerat A, Badaut C, Nato F, Schneider A, Lavergne A, Contamin H, Tall A, Baril L, Bentley GA, Mercereau-Puijalon O. An in vivo/in vitro model of Plasmodium falciparum rosetting and autoagglutination mediated by varO, a group A var gene encoding a frequent serotype. Infect Immun. 2008 Sep 22. [Epub ahead of print]
In the Saimiri sciureus monkey, erythrocytes infected with the varO antigenic variant of the Plasmodium falciparum Palo Alto 89F5 clone bind uninfected red blood cells ("rosetting"), form autoagglutinates and display a high multiplication rate, three phenotypic characteristics associated with severe malaria in human patients. We report here that varO parasites express a var gene presenting the characteristics of group A var genes, and show that the varO-DBL1alpha1 domain is implicated in the rosetting of both Saimiri sciureus and human erythrocytes...

Noland GS, Hendel-Paterson B, Min XM, Moormann AM, Vulule JM, Narum DL, Lanar DE, Kazura JW, John CC. Low prevalence of antibodies to pre-erythrocytic but not blood-stage Plasmodium falciparum antigens in an area of unstable as compared to stable malaria transmission. Infect Immun. 2008 Sep 22. [Epub ahead of print]
According to entomological studies conducted over the past 30 years, there was low malaria transmission in suburb of Dakar but little evidence of it in the downtown area. However; there was some evidence of local transmission based on reports of malaria among permanent residents. An entomological evaluation of malaria transmission was conducted from May 2005 to October 2006 in two areas of Dakar...

Aonuma H, Suzuki M, Iseki H, Perera N, Nelson B, Igarashi I, Yagi T, Kanuka H, Fukumoto S. Rapid identification of Plasmodium-carrying mosquitoes using loop-mediated isothermal amplification. Biochem Biophys Res Commun. 2008 Sep 19. [Epub ahead of print]
With an aim to develop a quick and simple method to survey pathogen-transmitting vectors, LAMP (loop-mediated isothermal amplification) was applied to the identification of Plasmodium-carrying mosquitoes, specifically a Plasmodium-transmitting experimental model using rodent malaria parasite (Plasmodium berghei) and anopheline mosquitoes (Anopheles stephensi). The detection sensitivity limit of the LAMP reaction amplifying the SPECT2 gene was determined to be 1x10(2) purified Plasmodium parasites, estimated to be sufficient for reliable identification of infectious mosquitoes...

Li L, Bian L, Yan G. A study of the distribution and abundance of the adult malaria vector in western Kenya highlands.  Int J Health Geogr. 2008 Sep 22;7(1):50. [Epub ahead of print]
A sharp rise in the malaria mortality rate has been observed recently in western Kenya. Malaria is transmitted by mosquito vectors. Malaria control strategies can be more successful if the distribution and abundance of mosquito vectors is predicted. However, how mosquito vectors are distributed in space remain poor understood, and this question is rarely studied using spatial methods. This study aims to provide a better understanding of the distribution and abundance of mosquito vectors

Half of the world’s population is at risk of malaria, and an estimated 247 million cases led to nearly 881 000 deaths in 2006. The advent of long-lasting insecticidal nets and artemisinin-based combination therapy, plus a revival of support for indoor residual spraying of insecticide, presents a new opportunity for large-scale malaria control. The World malaria report 2008 describes the global distribution of cases and deaths, how WHO-recommended control strategies have been adopted and implemented in endemic countries, sources of funding for malaria control, and recent evidence that prevention and treatment can alleviate the burden of disease.

Download the full report [pdf 4.9Mb] Corrigenda to the printed report

Summary & Key points English [pdf 144kb] | French [pdf 121kb] | Spanish [pdf 103kb] | Chinese [pdf 515kb] | Russian [pdf 150kb] | Arabic [pdf 100kb] | Portuguese [pdf 50kb]

New report finds more funding leading to increased coverage of malaria control interventions

The global burden of malaria remains enormous, but access to malaria control interventions, especially bednets in Africa, increased sharply between 2004 and 2006, says a new report released today.

"With dramatic increases in funding and intense momentum towards reducing the malaria burden in recent years, we have a greater need for reliable information and analysis," said WHO Director-General Dr Margaret Chan. "This report begins to answer that need. Progress in malaria control has accelerated dramatically since 2006, especially in the wake of the UN Secretary-General’s call for universal malaria control coverage by the end of 2010. We expect these expanded efforts to be reflected in future reports."

The World malaria report 2008, which draws upon data collected between 2004 and 2006, paints a complex picture. Some highlights are:

• New methods estimate that the number of malaria cases in 2006 was 247 million.
• Small children remain by far the most likely to die of the disease.
• Malaria deaths have declined in several countries, and a few African nations have managed to reduce deaths in half by following the recommended measures.
• As of 2006, more funding resulted in accelerated access to malaria interventions, including bednets and effective medicines.
• In Africa, the artemisinin-based combination therapy (ACT), which is recommended by WHO, reached only 3% of children in need.

Bednet coverage increasing

The report finds that recent increases in malaria funding were beginning to translate into coverage of key malaria interventions, especially bednets, by 2006. The percentage of children protected by insecticide-treated nets increased almost eightfold, from 3% in 2001 to 23% in the 18 African countries where surveys were held in 2006. Procurement of antimalarial medicines also increased sharply between 2001 and 2006. About 100 million people, including 22 million in Africa, were protected by indoor spraying of insecticide.

However, much more work remains to be done. In Africa, only 125 million people were protected by bednets in 2007, while 650 million are at risk.

"Malaria is a primary cause of child mortality," said Ann M. Veneman, Executive Director of the United Nations Children’s Fund (UNICEF). "If the availability of bednets and other key interventions can be increased, lives can be saved."

Positive impact

For the first time, three African countries reported dramatic reductions in malaria deaths by 50% or more. Eritrea, Rwanda and Sao Tome and Principe achieved this result between 2000 and 2006/2007 through a mix of bednet distribution, indoor spraying, improved access to treatment and advances in disease surveillance. Furthermore, significant improvements were observed in other African countries such as Madagascar, Zambia and the United Republic of Tanzania.

Six more countries reported a fall in malaria deaths by 2006: Cambodia, the Lao People’s Democratic Republic, the Philippines, Suriname, Thailand and Viet Nam.

"We know that malaria control interventions work and that we can make rapid progress towards ending malaria deaths," said Ray Chambers, the United Nations Secretary-General’s Special Envoy for Malaria. "Now is the time to expand these results to all of Africa and the rest of the world."

According to data from national malaria control programmes, Africa had a larger increase in funding than any other region between 2004 and 2006. The investments were led by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and supported by bilateral and multilateral organizations and national governments.

In other regions, sources of funding were highly variable, but national governments provided the bulk of monies. While funding for malaria was higher than ever before in 2006, it is not yet possible to judge which countries have adequate resources and there are still significant gaps.

For more information please contact:

Dick Thompson
News Team Leader
WHO, Geneva
Telephone:  +41 22 791 1492
Mobile:  +41 79 475 5534        
E-mail: thompsond@who.int

Fadela Chaib Telephone: +41 22 791 3228        
Mobile: +41 79 475 5556        
E-mail: chaibf@who.int

AT FIRST blush, the change seems like staggeringly good news. The World Health Organisation (WHO) has just issued a new report on malaria. The agency’s experts estimate that each year there are some 250m cases of malaria globally. That is a huge fall from the previous 350m-500m figure in a 2005 report.

A happy confluence of funding, political will and practical tools is indeed making a difference. Drug treatment that combines artemisinin, a powerful anti-malaria treatment, with other medicines, and the use of insecticide-embedded bed nets, are particularly effective.

Thanks to that, 20-plus countries outside Africa have seen their malaria burden decline in recent years. And even within Africa, which accounts for most of the world’s 880,000 or so malaria deaths each year, a handful of countries have made excellent progress. The number of new malaria cases in Eritrea fell by more than a half between 2001 and 2006. Rwanda and São Tomé and Príncipe made big gains too.

Sadly, the bigger reason for the seeming drop in the total number of malaria cases is the way the WHO counts them, a tricky task in countries with weak health-care systems. Previous reports relied on estimates dating back to the 1950s and 1960s in some countries outside sub-Saharan Africa. The new methodology takes the actual number of malaria cases reported by local health authorities as a starting point. Nearly half the fall comes thanks to counting cases in India by the new method.

The report comes on the eve of a United Nations malaria summit in New York on September 25th. Governments, philanthropic outfits (notably the Gates foundation), activists and celebrities will launch a new global strategy and collect hefty pledges in its support. Campaigners say that malaria’s moment has finally arrived.

If so, the assembled worthies may pay attention to a point made by Amir Attaran of the University of Ottawa. He argues that malaria and similar diseases need to be monitored like the weather, with what he calls “sentinel surveillance networks” throughout the developing world. This is essential both to measure malaria incidence more accurately and to assess the success or failure of various policies.

With enough time and effort, big reductions in malaria caseloads reported in future WHO studies could even be cause for celebration rather than embarrassment.

The World Health Organization (WHO) has cut its global estimate of yearly malaria cases by more than 100 million, according to a report released Thursday by the health agency. Almost all of that downward revision was attributable to updated surveillance numbers — mostly in Asia, and particularly in India — rather than a measurable reduction of actual malaria cases, agency staff said.

The last World Malaria Report in 2005, tallied the global incidence rate at between 350 million and 500 million new cases of malaria per year. The current report downgrades that figure to 247 million. Likewise, where the last report claimed that the disease kills "more than 1 million" people each year, the 2008 update, which is based on 2006 data (the most recent numbers available), suggests that figure is now closer to 800,000.

The impact of malaria, however, is still massive. "Whether it’s 200 million or 500 million [cases], that’s a lot of infections with a big health burden and a big economic burden," says Bernard Nahlen, deputy coordinator of the U.S. President’s Malaria Initiative — especially, he says, "for something that is treatable and to a large extent preventable. If your child’s life can be saved by treatment for 50 cents, you should treat."

But the WHO’s correction comes less than a year after the United Nations made a similar announcement, acknowledging last November that its AIDS-battling agency, UNAIDS, had overstated its estimates of the global HIV burden by about 6 million cases; that agency revised its numbers also based on newer and more accurate surveys. At the time, the U.N. came under fire from critics for inflating its estimates in order to exaggerate the urgency of the epidemic — and to spur bigger donations.

There may have been some truth to that argument. Money funneled to HIV and malaria control has soared in the last decade, to almost $9 billion and roughly $1 billion a year, respectively (those figures, too, are hazy estimates), although in the case of HIV especially, money has not always been channeled into disease-control programs based on the best scientific evidence. (That’s particularly true for politically sensitive — and, therefore, under-funded or ignored — interventions that aim to prevent high-risk sex and drug abuse.)

In large part, such massive miscalculations have less to do with politics than with the simple fact that epidemiology involves an inordinate amount of guesswork. Routine re-evaluations of existing data often result in data shifts, sometimes huge ones, which global health experts and epidemiologists have come to expect. "If you go up to a little clinic in Africa, first of all, the staff are overwhelmed with patients," says Nahlen, who used to do monitoring work for WHO. The data, if it’s properly recorded, then goes up to the officials, who may also be overwhelmed. Those records then get passed along to WHO. "It’s sometimes hard to know what these numbers actually mean," he says.

The WHO ascribes most of the current revision to a reassessment of the malaria epidemic in Asia (although the vast majority of malaria cases and deaths still occur in Africa, where the numbers for the continent remain mostly unchanged). Much of the Asian data, which was used in the 2005 WHO report to predict which regions had malaria-carrying mosquitoes — and therefore higher disease incidence — was already 40 years old, says Mac Otten, coordinator of the surveillance, monitoring and evaluation unit at the WHO’s Global Malaria Program. Over the past four decades, the situation across Asia has changed dramatically. "With urbanization, deforestation and then malaria control, [the data] is just out of date," he says. Malaria zones in Asia, especially India, where much of the revision took place, have become "patchy," as Otten puts it.

Epidemiologists are often described by the media as "disease detectives," who use statistical tools — carrying out the occasional survey, for example, or, in the case of malaria, using temperature and terrain maps to help predict where disease-carrying mosquitoes may live — to hunt down and eliminate global killers. The comparison is useful for another reason: Disease trackers, like crime solvers, often spend a lot of time sifting through a few, imperfect clues — hunches, really — to piece together a fuller picture. But that picture often ends up being indistinct as well. The WHO says, for example, that the "confidence interval" of its new estimate — the numerical range within which scientists believe the actual malaria incidence most likely lies — is 189 million cases to 327 million cases per year.

It is an enormous but unavoidable margin of error. Unlike in developed countries, such as the U.S., that have the infrastructure to compile more detailed population-wide medical records, disease surveillance in places like the Democratic Republic of the Congo, a large central African country with few doctors, few roads, limited medical infrastructure and a recent history of bloody conflict, is a much more difficult undertaking. Officials have trouble counting births and deaths in some regions, let alone getting a sense of how many people may have suffered from a particular disease.

What’s more, even where records exist, there is usually no way to confirm their validity. Doctors in the developing world often lack lab facilities to authenticate cases of suspected malaria. Perhaps more often, they never even get to see patients who have the disease — many patients either cannot afford the time or money to see a doctor or they simply self-diagnose and take cheap over-the-counter medications to battle malaria-like symptoms. The WHO estimates that nationally reported (but often unvalidated) malaria cases account for just 40% of the global estimate; the other 60% comes from "detective work" by epidemiologists.

The fuzzy math aside, the good news is that malaria control efforts are working. The 2008 World Malaria Report singles out Eritrea, Rwanda, Sao Tome and Principe, and the Tanzanian region of Zanzibar for their remarkable improvements in cutting malaria illness and death. Since 2000, all of them have managed a greater than 50% drop in both rates, and all of them have done it through a combination of familiar methods: using long-lasting insecticidal bed nets to prevent mosquito bites; treating the disease with the newer, more effective artemisinin-based combination drug therapy; and spraying homes with insecticide. In these countries, there is little doubt that interventions are working, but the impact doesn’t translate to a measurable reduction in global figures because the populations involved are relatively small. Larger countries like Nigeria have been slower to implement prevention and treatment programs.

But similar programs are underway across much of Africa, and so malaria workers are newly optimistic. "When the coverage of the malaria interventions — the nets, the medicines and the spraying — was high, cases came right down and deaths came down as well," says Otten. With luck, for the next World Malaria Report, global figures will be more accurate still — and they’ll be falling because real people are really healthier.

TRANSVAC is a 10 million Euro EC-funded project to accelerate the pharmaceutical and clinical development of promising vaccine candidates for public health use, and aims to bridge the gap between academic research and early phase clinical development, through carefully managing the advancement of promising vaccine candidates from preclinical animal experiments to proof-of-principle studies in humans.

TRANSVAC is managed by the European Malaria Vaccine Initiative and the TB Vaccine Initiative, under the guidance of the TRANSVAC Coordinator. In order to support the TRANSVAC Programme Manager in the day-to-day running of TRANSVAC, a Project Manager and Trainee Project Manager are required. These posts present an exciting and unique opportunity for two individuals to be part of an unprecedented advancement of the European vaccine development infrastructure, and provide excellent opportunities for personal and professional development in a multinational environment.

Responsibilities:

1. Facilitate delivery of projects to agreed time lines, quality and budget
2. Drive progression of the project within the defined parameters
3. Ensure the project team adherence to group policies, standards and procedures, legal requirements and good practices
4. Provide guidance and leadership to the cross-functional members of the Project teams
5. Drive continuous improvement across the project
6. Identify and drive the communication and inter-personal relationships within the project
7. Clearly identify and solve problems, as well as implementing plans to eliminate any forthcoming issues and problems
8. Ensure the preparation and presentation of reports, project budgets and financial evaluations to tight deadlines
9. Provide the Senior Management with key project information throughout the project
10. Understand and promote the project goals and objectives
11. Manage complex relationships with project participants and ensure participant satisfaction
12. To escalate items appropriately through the governance structure and ensure contractual obligations are met
13. Provide input to strategic management
14. Organisation of meetings and workshops

Essential Skills/Competencies for both positions:

•          A high standard of written and spoken English
•          Organised, with drive and motivation
•          Hold, or be about to complete, one of the following: MBA, PhD, or other relevant biology-related degree (e.g. microbiology, vaccine development etc.)
•          Strong co-ordination skills and ability to work in a team
•          Good communication and presentation skills
•          Demonstrated ability to deliver results against deadlines, to a high level of quality
•          The ability to travel occasionally to international meetings, conferences, workshops etc.
•          Competent with Microsoft Office
•          Management experience (for Project Manager position only)

Desired Skills/Competencies:

•          People management experience
•          Experience in managing projects
•          Knowledge of poverty related diseases and/or the vaccine development process
•          Experience in preparing and maintaining websites

On offer to the successful candidates are superior benefits packages and career development opportunities in a dynamic and stimulating environment. Both positions will include a comprehensive project management training package. The posts will be based in Berlin or in a member country of the TRANSVAC consortium. Informal enquiries regarding the posts may be made to Dr. Roland Ventura (ven@ssi.dk).

If you feel that you possess the relevant skills and working background please send a Curriculum Vitae and cover letter explaining:

1. Your preferred choice of post (Project Manager or Trainee Project Manager (or both))
2. Your suitability for the post(s)
3. Your salary range expectations

Applications providing all of the requested information should be received no later than 17:00 (CET) on Friday the 17th of October 2008, and sent by email to:

Dr. Odile Leroy
Executive Director
oly@ssi.dk

Oshaughnessy PT. Parachuting Cats and Crushed Eggs: The Controversy Over the Use of DDT to Control Malaria. Am J Public Health. 2008 Sep 17. [Epub ahead of print]
The use of DDT to control malaria has been a contentious practice for decades. This controversy centers on concerns over the ecological harm caused by DDT relative to the gains in public health from its use to prevent malaria. Given the World Health Organization’s recent policy decisions concerning the use of DDT to control malaria, it is worth reviewing the historical context of DDT use. Ecological concerns focused on evidence that DDT ingestion by predatory birds resulted in eggs with shells so thin they were crushed by adult birds. In addition, DDT spraying to control malaria allegedly resulted in cats being poisoned in some areas, which led to increased rodent populations and, in turn, the parachuting of cats into the highlands of the island of Borneo to kill the rodents, a story that influenced the decision to ban DDT spraying. I focus on this story with the intention of grounding the current debate on lessons from the pas …

Lundie RJ, de Koning-Ward TF, Davey GM, Nie CQ, Hansen DS, Lau LS, Mintern JD, Belz GT, Schofield L, Carbone FR, Villadangos JA, Crabb BS, Heath WR. Blood-stage Plasmodium infection induces CD8+ T lymphocytes to parasite-expressed antigens, largely regulated by CD8{alpha}+ dendritic cells. Proc Natl Acad Sci U S A. 2008 Sep 17. [Epub ahead of print]
Although CD8(+) T cells do not contribute to protection against the blood stage of Plasmodium infection, there is mounting evidence that they are principal mediators of murine experimental cerebral malaria (ECM). At present, there is no direct evidence that the CD8(+) T cells mediating ECM are parasite-specific or, for that matter, whether parasite-specific CD8(+) T cells are generated in response to blood-stage infection. To resolve this and to define the cellular requirements for such priming, we generated transgenic P. berghei parasites expressing model T cell epitopes. This approach was necessary as MHC class I-restricted antigens to blood-stage infection have not been defined. Here, we show that blood-stage infection leads to parasite-specific CD8(+) and CD4(+) T cell responses…

Mayor S. WHO report shows progress in efforts to reduce malaria incidence. BMJ. 2008 Sep 17;337:a1678. doi: 10.1136/bmj.a1678
…The World Malaria Report 2008 found an estimated 247 million cases of malaria and 881 000 deaths from the disease, mostly among children in Africa, meaning that it remains one of the world’s leading causes of death. However, several countries had achieved a sharp fall in the number of people affected by malaria after increasing control measures.

Eritrea, Rwanda, São Tomé and Príncipe, and Zanzibar (in Tanzania) each reported reductions of 50% or more in the number of malaria cases and deaths between 2000 and 2006 or 2007...

Pages F, Texier G, Pradines B, Gadiaga L, Machault V, Jarjaval F, Penhoat K, Berger F, Trape JF, Rogier C, Sokhna C. Malaria transmission in Dakar: a two-year survey. Malar J. 2008 Sep 16;7(1):178. [Epub ahead of print]
According to entomological studies conducted over the past 30 years, there was low malaria transmission in suburb of Dakar but little evidence of it in the downtown area. However; there was some evidence of local transmission based on reports of malaria among permanent residents. An entomological evaluation of malaria transmission was conducted from May 2005 to October 2006 in two areas of Dakar...

Hetzel MW, Obrist B, Lengeler C, Msechu JJ, Nathan R, Dillip A, Makemba AM, Mshana C, Schulze A, Mshinda H. Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania. BMC Public Health. 2008 Sep 16;8(1):317. [Epub ahead of print]
Malaria is still a leading child killer in sub-Saharan Africa. Yet, access to prompt and effective malaria treatment, a mainstay of any malaria control strategy, is sub-optimal in many settings. Little is known about obstacles to treatment and community-effectiveness of case-management strategies. This research quantified treatment seeking behaviour and access to treatment in a highly endemic rural Tanzanian community. The aim was to provide a better understanding of obstacles to treatment access in order to develop practical and cost-effective interventions...

Zikusooka CM, McIntyre D, Barnes KI. Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests?  Malar J. 2008 Sep 15;7(1):176. [Epub ahead of print]
Within the context of increasing antimalarial costs and or decreasing malaria transmission, the importance of limiting antimalarial treatment to only those confirmed as having malaria parasites becomes paramount. This motivates for this assessment of the cost-effectiveness of routine use of rapid diagnostic tests (RDTs) as an integral part of deploying artemisinin-based combination therapies (ACTs)…

The African Malaria Network Trust (AMANET) is pleased to announce the expansion of its web based training. AMANET has launched today an Advanced Course on Health Research Ethics, which becomes the fourth web-based course provided by AMANET and funded by the European-Developing Countries Clinical Trials Partnership (EDCTP).  Other ongoing AMANET web-based courses are Basic Health Research Ethics (English version), Basic Health Research Ethics (French version) and Basic Good Clinical Practice.  All courses are freely available at http://webcourses.amanet-trust.org/.

The Basic Health Research Ethics Course provides a basic understanding of ethical issues and equips trainees (members of ethics committees, health researchers, scientists and other key personnel in health research) with the necessary tools and knowledge required to safeguard the safety and welfare of human research participants.

The Advanced Health Research Ethics (HRE) Course  aims to flag topical ethical issues that are relevant to health research in developing country settings particularly in Africa, and explores various schools of thought regarding contemporary ethical challenges and dilemmas.

Commenting on the launch, Prof Wen Kilama, AMANET Managing Trustee, said “Since the founding in 1995 of the African Malaria Vaccine Testing Network (AMVTN) the predecessor of AMANET, we have been very much concerned not only on attaining high scientific standards  in health research undertaken in Africa, we have further aspired at attaining high ethical standards. But given the ever increasing challenges to health researchers particularly in Africa, AMANET has found it appropriate to launch this Advanced Course on Health Research Ethics, which will address newer challenges and contemporary issues likely to face African health researchers.”

“I very much hope that this course will benefit not only health researchers, but also managers of health research institutions, researchers in other fields, policy and decision makers, sponsors of health research undertaken in developing countries, regulatory authorities, and professional bodies” added Prof Kilama,

The Advanced HRE course has seven modules namely; Ethical Principles in Health Research and Review Processes; Responsibilities in Health Research; Ethical Issues in Research Design and Recruitment of Research Participants; Models and Practicalities of Community Engagement; Ethical Issues in International Collaborative Health Research; Animal Research Ethics; and Ethical Issues in Traditional Medical Practice and ‘Research.

 “It is hoped that successful completion of the course will bring participants up to date with topical ethical issues surrounding current research practices, and enable them to effectively address pertinent ethical and practical challenges of research from the design stage, through the implementation stage, to post-research stage. Indeed the ultimate goal is to enhance the protection of the welfare of research participants in the wake of increasing volume of health research in the developing world” said Dr Aceme Nyika, AMANET Ethics Coordinator, one of the Facilitators for the online course.

Dr Roma Chilengi, AMANET Clinical Trials Coordinator and Facilitator for this course said “The faculty for the course constitutes one of the best in Africa as far as health research ethics is concerned. It’s been rewarding developing this and the preceding HRE course. As faculty, we have probably learned ethics all over and are very excited to take HRE training to a higher level and wider audience, for free”

AMANET continues to strengthen human resource capacity required for ethical and high standard research in Africa. AMANET has organized short-term training workshops which have benefited over 1000 African health researchers and scientists: Good Clinical Practices (GCP), Good Laboratory Practices (GLP), Health Research Ethics, molecular biology and immunology, and data management.

# # #

For further information contact:

Dr Charles L. Wanga
Communications Officer
African Malaria Network Trust [AMANET]
PO Box 33207
Dar es Salaam, Tanzania.
Email : clwanga@amanet-trust.org 
www.amanet-trust.org 
Tel: +255 22 2700018
Fax: +255 22 2700380

The war against malaria in tropical countries was fought and lost in the 20th Century on the basis of faulty intelligence, a ’dodgy dossier’ which argued that the same methods used to tackle the disease in temperate countries would also work in the tropics.

Eradication failed in almost every tropical and sub-tropical country, because tactics that had been proven to work in countries such as the USA, Greece and Italy were also deployed in tropical countries, despite the existence of evidence that they would they not work, particularly in sub-Saharan Africa.

Dr. Colin Sutherland, a Senior Lecturer at the London School of Hygiene & Tropical Medicine, who is contributing to a session entitled ’How science addresses developing world issues’ at the BA Festival of Science in Liverpool today, explains: ’Previous efforts to eradicate malaria, if considered on a nation-by-nation basis, only succeeded in countries where the Plasmodium parasite was weak and its mosquito vector was vulnerable, particularly where populations were wealthy enough to afford the best tools available.

’The failure to eradicate malaria in tropical countries, where the parasite is now at its strongest, and the mosquitoes are doing very well, thank you very much is, in part, due to the miscalculation that a one-size-fits-all approach would be effective in every setting – a miscalculation that could have been avoided if we had heeded the evidence from Africa over half a century ago’, he adds.

Dr. Sutherland cautions against the obsession among the western media with the ’scientific breakthrough’, a concept which consequently dominates popular notions of science. Although breakthroughs do occur, and are undoubtedly newsworthy when they do, it is the careful synthesis of incremental advances in knowledge, and the dissemination of that knowledge to key decision-makers, health ministries and governments that will help us win the war against malaria. Today’s session will look at ways of best achieving this, with a particular focus on open access publishing. It will also emphasise the importance of training and support for high calibre African scientists.

’In the war against malaria, knowledge is the most powerful weapon we have’, concludes Dr. Sutherland.

All current anti-malaria drugs target the parasite that causes the disease, but those are becoming less effective due to increasing drug resistance. Now, Howard Hughes Medical Institute researchers report that they may be able to fight malaria by targeting human liver cells instead of parasites.

HHMI international research scholar Maria M. Mota and her colleagues have identified a receptor on human liver cells that appears to help the malaria parasite sneak inside to fully develop. The SR-BI receptor is normally an entry point for HDL cholesterol and other lipids from the bloodstream into liver cells, which break them down. But new experiments show that the malaria parasite may also be using this doorway. When scientists disabled the SR-BI receptor, they saw a dramatic reduction in the number of infections from two species of malaria in mouse and human cells. The experiments are presented in the September 2008 issue of Cell Host & Microbe.

“This study establishes the first clear molecular link between malaria infection and cholesterol uptake pathways, thus describing a new intervention strategy in the fight against malaria,” says Mota, a faculty member at the Instituto de Medicina Molecular at the University of Lisbon in Portugal.

Malaria parasites enter the human bloodstream via mosquito bites and travel to the liver, where they burrow into liver cells, multiply, and return to the bloodstream to wreak havoc on the body.

Previous research had linked the lipoprotein clearance rate by the liver to increased malaria infection, so Mota thought the parasite might enter liver cells by hijacking the liver’s own cellular machinery. The group focused its attention on the part of liver cells that filter fatty molecules like cholesterol and other lipids out of the bloodstream.

Mota’s team used RNA interference (RNAi) to examine the receptors that filter lipoproteins. The RNAi technique permitted the researchers to create cell lines with specific genes inactivated. They then tested each cell line to see how it responded to the malaria parasite. “We looked through 53 lipoprotein receptors and found one that really stood out from the rest,” Mota says. That receptor was SR-BI (class B, type I scavenger receptors). Removing SR-BI cut down infections in these cells more than any other receptor they tested.

To confirm their suspicions about SR-BI’s key role in malaria, the team conducted a series of experiments that examined mouse cells, human cells, and living mice. First, they induced mouse cells to produce much more of the protein than usual. When they exposed those cells to the parasite that causes malaria in mice, they found the cells were infected more readily than cells with a normal amount of the receptor. The team then tested the receptor’s role in a line of human cells with a human-specific malaria parasite, and got similar results.

Cells in living animals often respond differently than cultured cells, so Mota’s team explored SR-BI’s role in live mice. First they suppressed the gene for SR-BI in these mice, and later injected them with a malaria-causing parasite. Forty hours after exposure, the researchers examined whether the parasite infected the animals’ liver cells. They found that the mice with reduced SR-BI had liver infection levels 50-70 percent lower than the normal mice.

Read full story at: http://www.hhmi.org/news/20080910mota.html

It has been a bad few months for mosquitoes. First, billionaire Bill Gates resigned his Chairmanship of Microsoft to concentrate on funding the fight against malaria.

Next, scientists in Australia invented a new drug that prevents the malaria parasite binding with human red blood cells, thereby preventing its spread. However, the mosquitoes are regrouping in the world’s malaria capital.

Statistical data obtained from Apac District Health Department shows there were 88,286 reported cases of malaria in Apac district between January and June 2008. That is approximately 467 people diagnosed with malaria everyday. But it is business as usual for Apac, where the malaria incidence rate is arguably the highest in the world.

The claim is backed by studies conducted in Apac by the National Malaria Control Programme of Uganda’s Ministry of Health, with funding from USAID, the American government’s international development agency. They determined the local Entomological Inoculation Rate (EIR), that is, "how many times somebody can get bitten at night by one specific species, the female anopheles mosquito, the one that transmits malaria parasites," elaborates Dr. Matthew Emer , the Apac District Health Officer. "Anybody living in Apac is bitten by an infected mosquito, i.e. one able to transmit the malaria parasite, about six times in a night. That translates to about 1,560 times per person per year."

In comparison, Kampala residents receive an average of seven infected bites per year.

The most recent study to track EIR in Apac was carried out by the Malaria Control Programme between January and March 2008, as it assessed the feasibility of using the chemical DDT (dichlorodiphenyltrichloroethane) as a deterrent to mosquitoes. Earlier studies conducted by the Epidemiological Surveillance Division of the Ministry of Health in 2001-02 had mapped EIR in seven Ugandan districts. They found Apac to not only have the highest incidence in the country (at 1,586 infected bites per year), but also amongst the highest reported in Africa. These studies, along with existing data on global EIRs, show Apac to have the highest malaria levels on record.

Big threat

The malaria burden is hardly surprising. Over one-quarter of Apac district’s land area is covered by swamps and it is bordered by freshwater bodies like Lake Kwania and the Victoria Nile. Brick-making enterprises, which create pools of stagnant water, are scattered around it. These are ideal habitats and breeding grounds for anopheles mosquitoes, and help make malaria the district’s single biggest threat to public health. EIRs are also astonishingly high in Lango sub-region (where Apac is situated) as a whole, with 314,796 reported cases of malaria in the first six months of 2008.

Records at Apac Hospital’s outpatient department reveal malaria to be the highest cause of sickness in the district, with nearly 40% of those admitted, ultimately proven to have malaria. Nearly all detected malaria cases are of the strain plasmodium falciparum, which can prove fatal. Infants, young children and pregnant mothers are at greatest risk, with Apac Hospital estimating that up to 80% of patient deaths in its paediatric ward are related to malaria. In June alone it admitted 206 inpatients (and 610 outpatients) under the age of five who tested positive for malaria, of whom seven eventually died. Of 32 pregnant mothers diagnosed for malaria and automatically admitted during the same period, there was one fatality. The ratio of male to female inpatients contracting malaria, or dying from it, was roughly equal.

However, many malaria cases may be completely unreported. Dr. Alfred Acana, Director of Apac Hospital, observes that "patients come literally having diagnosed themselves, saying ’I have malaria’. Ideally all of them should have a blood slide to check if their complaints are related to malaria," but only "40-50% actually have blood slides done."

He refers to the tendency of local people classifying any ailment as ’malaria’. "Many go and treat themselves symptomatically with anti-malarials [but] it may not be malaria they’re treating. If they’re lucky it is malaria, then they get better."

Read full story at: http://allafrica.com/stories/200809110933.html

Sometimes even fetuses need to take matters into their own hands. Researchers have discovered a genetic mutation that protects a child from the devastating effects of a mother’s malaria infection.

“The fetus is individually trying to figure out how to ensure its own survival,” says Patrick Duffy, a malariologist at Seattle Biomedical Research Institute, who led the study along with colleague Atis Muehlenbachs.

Placental malaria occurs when parasite-infected blood cells latch onto the placenta, bringing the wrath of the maternal immune system with them.

While mothers may experience few symptoms, thanks to years of malaria exposure, for the children, the disease can result in low birthweight and even stillbirth. Women that live in places rife with malaria, such as sub-Saharan Africa, are usually most at risk.

Millions at risk

More than 30 million women are at risk of the disease, which causes about one-third of stillbirths in malaria-endemic areas.

Among 565 women in the Tanzanian district of Muheza, Duffy’s team noticed that a mutation in a fetal gene called sFlt1 seemed to spare the foetus from malaria, yet only during a mother’s first pregnancy.

For first-time mums, all of 75 children with two copies of the mutation were delivered alive. Yet among first children with another version of sFlt1, common in places without malaria, 10% did not carry to term. These children were also more than twice as likely to be born underweight as children with the protective version of the gene.

This version of sFlt1 seems to cut down on maternal inflammation and protect first-borns, says Duffy.

Alternate role?

After bearing one or two more children, mothers develop antibody resistance to placental malaria, allowing children without the non-protective mutation to survive. “This is the first resistance gene identified for any infectious disease that functions in [the womb],” he says.

Stephen Rogerson, an immunologist at the University of Melbourne, Australia, says the study makes a good case for sFlt1’s role in placental malaria, but he wonder whether the version of the gene that seems to predispose first-borns to placental malaria – called SS – might have some other positive role.

“The fact that SS is still around in the Tanzanian population, although at lower levels than in non-malaria-exposed Europeans," he says, "is also in keeping with the idea that the SS type may be protecting against something else.”

Indeed, 68% of Americans and 88% of Britons have the SS version of sFlt1 that could put their unborn children at risk. In malaria-endemic Tanzania, about a third of people have this mutation.

Journal reference: Proceedings of the National Academy of Sciences (DOI: 10.1073/pnas.0803657105)

Scientists suggest that the best way to treat malaria is to avoid using same drug for everyone, and opt for multiple first-line therapies.

With the help of a computer model, a research team from Princeton University and Resources for the Future has found that many governments worldwide are recommending the wrong kind of malaria treatment.

Despite the availability of many drugs many countries have been recommend using what is known as a single first-line therapy- that is, using one drug repeatedly with many patients.

Lead researcher Maciej Boni said that countries could cut the death rate and forestall the development of drug resistance if a variety of different drugs were distributed to patients.

This approach, known as multiple first-line therapies or MFT, can be use

by making sure different drugs cost about the same, so that patients would not be forced into buying the cheapest available drug.

“What we found is that using multiple first-line therapies is the best way to avoid treatment failures and to delay the development of resistance for as long as possible,” said Boni, who recently has joined the staff of the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam.

Boni, a mathematician and an evolutionary biologist, along with co-authors, Ramanan Laxminarayan and David Smith, designed a computer model with inputs based on more than 100 years of malaria field research.

They simulated dozens of treatment paths for a malaria outbreak among patients contrasting many variations of the status quo strategy of using a single first-line therapy with one employing MFT.

They found that there were major benefits to employing an MFT strategy, namely, fewer cases of malaria, fewer unsuccessful drug treatments, and a very significant delay in the onset of drug resistance in the parasites.

However, the researchers suggested that multiple effective therapies may not always be available. In some African countries where drug-resistance is already widespread, the only effective therapies are a class of drugs known as artemisinin-based combination therapies (ACTs).

“MFT does not necessarily solve all our problems,” said Boni. “Antimalarial drug development needs to continue with the hope of producing novel and highly effective antimalarials that can be deployed alongside ACTs.”

The study appears in Proceedings of the National Academy of Sciences.

Culleton RL, Mita T, Ndounga M, Unger H, Cravo PC, Paganotti GM, Takahashi N, Kaneko A, Eto H, Tinto H, Karema C, D’Alessandro U, do Rosario V, Kobayakawa T, Ntoumi F, Carter R, Tanabe K. Failure to detect Plasmodium vivax in West and Central Africa by PCR species typing. Malar J. 2008 Sep 11;7(1):174. [Epub ahead of print].
Plasmodium vivax is estimated to affect 75 million people annually. It is reportedly absent, however, from west and central Africa due to the high prevalence of the Duffy negative phenotype in the indigenous populations. Despite this, non-African travellers consistently return to their own countries with P. vivax malaria after visiting this region. An attempt was made, therefore, to detect the presence of P. vivax parasites in blood samples collected from the indigenous populations of west and central Africa…

Agomo PU, Meremikwu MM, Watila IM, Omalu IJ, Odey FA, Oguche S, Ezeiru VI, Aina OO. Efficacy, safety and tolerability of artesunate-mefloquine in the treatment of uncomplicated Plasmodium falciparum malaria in four geographic zones of Nigeria. Malar J. 2008 Sep 9;7(1):172. [Epub ahead of print].
The combination of artesunate and mefloquine has been reported to be effective against multi-drug resistant Plasmodium falciparum malaria, which has been reported in Nigeria. The objective of this multi-centre study was to evaluate the efficacy, safety and tolerability of the co-packaged formulation of artesunate and mefloquine in the treatment of uncomplicated malaria in two weight groups: those between 15 - 29kg and [greater than or equal to]30kg, respectively…

Schwarz NG, Adegnika AA, Breitling LP, Gabor J, Agnandji ST, Newman RD, Lell B, Issifou S, Yazdanbakhsh M, Luty AJ, Kremsner PG, Grobusch MP. Placental Malaria Increases Malaria Risk in the First 30 Months of Life. Clin Infect Dis. 2008 Sep 9. [Epub ahead of print]
Plasmodium falciparum infection during pregnancy is associated with stillbirth, fetal growth restriction, and low birth weight. An additional consequence may be increased risk of malaria in early life, although the epidemiological evidence of this consequence is limited...

Schmidt NW, Podyminogin RL, Butler NS, Badovinac VP, Tucker BJ, Bahjat KS, Lauer P, Reyes-Sandoval A, Hutchings CL, Moore AC, Gilbert SC, Hill AV, Bartholomay LC, Harty JT. Memory CD8 T cell responses exceeding a large but definable threshold provide long-term immunity to malaria. Proc Natl Acad Sci U S A. 2008 Sep 9. [Epub ahead of print]
Infection of mice with sporozoites of Plasmodium berghei or Plasmodium yoelii has been used extensively to evaluate liver-stage protection by candidate preerythrocytic malaria vaccines. Unfortunately, repeated success of such vaccines in mice has not translated readily to effective malaria vaccines in humans. Thus, mice may be used better as models to dissect basic parameters required for immunity to Plasmodium-infection than as preclinical vaccine models. In turn, this basic information may aid in the rational design of malaria vaccines...

Boni MF, Smith DL, Laxminarayan R. Benefits of using multiple first-line therapies against malaria. Malar J. 2008 Sep 2;7(1):169. [Epub ahead of print]
Despite the availability of many drugs and therapies to treat malaria, many countries’ national policies recommend using a single first-line therapy for most clinical malaria cases. To assess whether this is the best strategy for the population as a whole, we designed an evolutionary-epidemiological modeling framework for malaria and compared the benefits of different treatment strategies in the context of resistance evolution. Our results show that the population-wide use of multiple first-line therapies (MFT) against malaria yields a better clinical outcome than using a single therapy or a cycling strategy where therapies are rotated, either on a fixed cycling schedule or when resistance levels or treatment failure become too high....

Muehlenbachs A, Fried M, Lachowitzer J, Mutabingwa TK, Duffy PE. Natural selection of FLT1 alleles and their association with malaria resistance in utero.  Proc Natl Acad Sci U S A. 2008 Sep 8. [Epub ahead of print]
Placental malaria (PM) caused by Plasmodium falciparum contributes significantly to infant mortality in sub-Saharan Africa and is associated with pregnancy loss. We hypothesized that fetal genes that modify PM would be associated with fetal fitness. During PM, placental trophoblasts produce soluble fms-like tyrosine kinase 1 (sFlt1), also known as soluble VEGF receptor 1, an angiogenesis inhibitor associated with preeclampsia…

Rodrigues CD, Hannus M, Prudêncio M, Martin C, Gonçalves LA, Portugal S, Epiphanio S, Akinc A, Hadwiger P, Jahn-Hofmann K, Röhl I, van Gemert GJ, Franetich JF, Luty AJ, Sauerwein R, Mazier D, Koteliansky V, Vornlocher HP, Echeverri CJ, Mota MM. Host Scavenger Receptor SR-BI Plays a Dual Role in the Establishment of Malaria Parasite Liver Infection.  Malaria Journal 2008, 7:142
An obligatory step of malaria parasite infection is Plasmodium sporozoite invasion of host hepatocytes, and host lipoprotein clearance pathways have been linked to Plasmodium liver infection. By using RNA interference to screen lipoprotein-related host factors, we show here that the class B, type I scavenger receptor (SR-BI) is the strongest regulator of Plasmodium infection among these factors. Inhibition of SR-BI function reduced P. berghei infection in Huh7 cells, and overexpression of SR-BI led to increased infection. In vivo silencing of liver SR-BI expression in mice and inhibition of SR-BI activity in human primary hepatocytes reduced infection by P. berghei and by P. falciparum, respectively…

There’s no magic bullet for wiping out malaria, but a new study offers strong support for a method that effectively delays the evolution of drug resistance in malaria parasites, a University of Florida researcher says.

David Smith, associate director of disease ecology at UF’s Emerging Pathogens Institute, said the study will guide scientists and policy makers in extending the longevity of current artemisinin-based malaria drugs combined with partner drugs. Smith is a co-author of a report on the study, scheduled to publish online this week in the Proceedings of the National Academy of Sciences and in print on Sept. 16.

Smith collaborated with lead author Maciej Boni of Resources for the Future and Princeton University, and Ramanan Laxminarayan, also with RFF, to create mathematical models assessing the strategic effectiveness and clinical outcomes of using one, two and three first-line drug therapies to treat malaria within a population over a 20-year period. Their results show that using two or three drugs simultaneously reduced the total clinical cases and number of failed treatments , and slowed the rate at which drug-resistant genes spread within the parasites that cause malaria: Plasmodium falciparum, P. vivax, P. malariae and P. ovale.

"The models indicate that we can slow the evolution of resistance to current artemisinin-based therapies if nations use them in combination with two or more partner drugs," Smith said. "Currently, most nations don’t do this. They use one therapy at a time, wait for it to fail, and then switch to a different therapy."

Artemisinin-combined therapies, or ACTs, are currently not widely implemented due to operational challenges and expense, Smith said. But he said the study offers compelling evidence for global leaders to collaborate and overcome these issues.

"This is not to say that implementing multiple first-line therapies solves all of our malaria problems," Boni said. "Anti-malarial drug development needs to continue so that we have novel and highly effective anti-malarials that can be plugged into the recommended strategy of deploying multiple therapies."

In the past century, chloroquine and sulfadoxine-pyrimethamine were widely used to combat malaria, but the parasites eventually evolved resistance leading to the drugs’ failure. Artemesinin drugs, derived from the herb Artemisia annua, are relatively new and the malaria parasite does not yet appear to have a resistance to it. They work by triggering chemical reactions which damage the Plasmodium parasite.

"We don’t have anything in the pipeline after ACTs, and it’s basically just a matter of time until drug resistance evolves and artemisinin also fails," Smith said. "So the question becomes how do we keep ACTs in our arsenal for as long as effectively possible?"

The researchers’ models also show that cycling through single drugs accelerated the rate at which malaria parasites evolved drug resistance. Smith said this occurred because cycling a single drug degraded the parasite’s average fitness, which made it easier for drug-resistant genes to spread throughout the parasite population.

The cycling models predicted a declining therapeutic value of a single drug within 3.54 years, versus a longer effective therapeutic value of 9.95 years when three drugs were used in equal proportions within a population. The research was funded in part by grants from the Bill and Melinda Gates Foundation, and the National Institutes of Health.

"Using multiple first-line drugs reduces the selection pressure for resistance to a single drug," Smith said. "This is one way to make the ACTs last longer and benefit more people."

Co-author Laxminarayan, a senior research fellow at RFF, said ACTs are the best treatment option for malaria, now as well as in the foreseeable future.

"Novel treatment strategies improve our ability to delay the emergence of drug resistance without the need to deny treatment," Laxminarayan said.

Wil Milhous, associate dean for research at the University of South Florida’s College of Public Health, said the research is "clearly a superb breakthrough in mathematical modeling applied to malaria drug deployment." Milhous has worked to develop new drugs for malaria for more than 25 years and is unaffiliated with the study.

"We have done the math in drug development, but only in terms of the cost of goods for drug combinations to include advanced preclinical and clinical testing. These are extremely time-consuming and costly but critical to regulatory approval," Milhous said. "Now we have a highly quantitative reality check that poor implementation strategies doom drugs to failure."

In work that could lead to new ways of detecting and treating malaria, MIT researchers have used two advanced microscopy techniques to show in unprecedented detail how the malaria parasite attacks red blood cells.

The researchers’ images show red blood cell membranes becoming less flexible, which causes the cells to clump as they try to navigate tiny blood vessels. They also show the destruction of hemoglobin, the critical molecule that red blood cells use to carry oxygen.

The images are made possible by microscopy techniques that reveal tiny vibrations in red blood cell membranes.

"By studying the way the cell membrane vibrations progressively change as the malaria parasite matures inside the cell, we can study the changes in its mechanical, elastic and dynamic properties," said Michael Feld, director of MIT’s George Harrison Spectroscopy Laboratory and a professor of physics.

Feld and Subra Suresh, dean of MIT’s School of Engineering, are senior authors of a paper on the work to be published in the Proceedings of the National Academy of Sciences the week of Sept. 1.

The study establishes the first experimental connection between cell membrane vibration and the pathological state of a living cell.

"You can establish a measurement of membrane-fluctuation changes as a function of the gradual progression from a healthy state to a severely pathological state," said Suresh, who has appointments in materials science and engineering, biological engineering, mechanical engineering and the Harvard-MIT Division of Health Sciences and Technology.

It has been known for more than a century that red blood cell membranes continuously undulate. These vibrations are difficult to study because the measurements involved are so tiny (nanometer, or billionth of a meter, scale), and occur in just microseconds.

Suresh and colleagues have previously shown that the cell membranes of red blood cells invaded by the malaria parasite lose their elasticity, as proteins transported from the parasite attach to the membranes and make them significantly stiffer.

In the new paper, the researchers describe using a technique called diffraction phase microscopy to image living cells over the first 48 hours of malaria parasite maturation inside the cell. They showed that infection reduces elasticity and decreases the vibration frequency of the cell membrane.

The team also used a technique called tomographic phase microscopy, which was developed in Feld’s laboratory and is based on the same concept as a CT scan: To create a 3D image, the researchers combine about 100 two-dimensional images taken from different angles. Those images are produced with a technique known as interferometry, in which a light wave passing through a cell is compared with a reference wave that doesn’t pass through it.

The technique allowed them to study changes in the refractive index of a cell, which is a measure of how much the speed of light is reduced as it passes through the material.

Images generated by tomographic phase microscopy revealed the degradation of hemoglobin as the malaria parasite interacted with the cell.

In the future, the microscopy technology could be used to develop a diagnostic tool that would detect malaria or other human diseases by measuring cell membrane properties. It could also be used to test the efficacy of potential drugs.

The current project got underway about two years ago, after Suresh gave a talk at the Spectroscopy Laboratory on his work studying the mechanical stiffness of malaria-infected red blood cells. Feld and his colleagues were already working on microscopy techniques to visualize red blood cells, so the groups decided to collaborate.

"This project brought physics, engineering, materials science, and cell biology all to bear on a problem of infectious disease," said Suresh.

Lead authors of the paper are YongKeun Park, a graduate student in the Harvard-MIT Division of Health Sciences and Technology, and Monica Diez-Silva, a microbiologist trained at Institut Pasteur and currently a postdoctoral fellow in the Department of Materials Science and Engineering (DMSE). Other authors are Gabriel Popescu, now at the University of Illinois at Urbana-Champaign; George Lykotrafitis, a DMSE postdoctoral fellow; and Wonshik Choi, a postdoctoral associate in the Spectroscopy Lab.

 The South African government is poised to change its regulations for medications, allowing appeals against approvals on unscientific grounds and giving the health minister final say on new treatments.

Opponents say the amendment will strike a blow to evidence-based scientific evaluation of medicines, giving political views precedence over safety and necessity.

The Parliamentary Portfolio Committee on Health approved the Medicines and Related Substances Amendment Bill this week (25 August), which will create a new regulatory authority to replace the 43-year-old Medicines Control Council that currently oversees new medicines entering the market.

The legislation will allow the health minister to make a final decision on all new medicines and potentially pass treatments that have not undergone full scientific testing.

The minister can decline to register products which have passed clinical trials, says Ruth Rabinowitz, an opposition health committee member, calling the legislation ’’counterfeit".

The amendment will also introduce an appeals process, whereby any person can oppose the approval of a medicine.

Announcing the bill, James Ngculu, chairperson of the portfolio committee, argued that though some medications might work for individuals, they might be bad for communities, and people had the right to object to medicines on unscientific grounds.

Thami Mseleku, director-general of South Africa’s health department, claimed the measure would empower members of public to challenge medical decisions on political and economic grounds.

But Mike Waters, health spokesman for opposition party the Democratic Alliance, says the legislation has "opened a can of worms," and created a "bureaucratic nightmare".

Vicki Ehrich, chief operating officer of the Pharmaceutical Industry Association told SciDev.Net that they "strongly advocated" to the portfolio committee that the registration of medicines should be based only on safety, quality and effectiveness and are now "greatly concerned" that this has been replaced by an appeals process.

"This is contrary to our stance that registration should be separate from such considerations," she told SciDev.Net.

"A further concern is that the appeals process itself could be abused and used to delay entry of products to market, for example by competitors."

Abieda Williams, of the Pharmaceutical Industry Association and who testified against the proposals, says the amendment is modelled on a Brazilian system, which led to "significant delays" in medicine approval. As a result, she says, citizens in urgent need of medications that lack approval are suing the Brazilian government.

The bill is expected to be passed into law by the full parliament when it reconvenes in September.

Nongovernmental organisations the Treatment Action Campaign and the AIDS Law Project, acting on behalf of South African HIV patients, say they will take legal action if it is passed. They argue that antiretroviral medications — which the government has opposed in the past — could be blocked

MAKERERE University Medical School is preparing to carry out trials on a malaria vaccine. The African Malaria Network Trust (AMANET) has announced that the GMZ2 vaccine trials will be carried out in Iganga and Mayuge districts.

“Before the end of this year, we shall give the medical school a grant of over 300,000 Euros for capacity building to help them prepare for the trials,” said Prof. Wen Kilama, the managing trustee of AMANET.

The money will be used to train personnel in addition to recruiting and sensitising participants for the trial. Makerere University Medical School is one of the 21 institutions across Africa, which are benefiting from AMANET’s projects.

AMANET is also carrying out trials on three other malaria vaccines. These are: MSP3 LSP in Burkina Faso and Tanzania, AMA1 in Mali and GMZ2 in Gabon.

About 400 people in Uganda die from malaria everyday. The country’s efforts to fight the disease have largely depended on the distribution of insecticide-treated mosquito nets and residual spraying.

However, in May, internal residual spraying in northern Uganda was stopped following a High Court injunction. This was after environmental activists petitioned over the use of the DDT chemical.

While opening the sixth Basic Research Ethics Workshop for African ethics committees at Munyonyo Commonwealth Resort on Monday, health state minister Emmanuel Otaala said: “Our research must be geared towards finding suitable drugs and vaccines for diseases like malaria, tuberculosis and AIDS, which are the main causes of high mortality and morbidity rates on the continent.”

Otaala urged researchers to follow proper ethical practices while carrying out medical trials on human beings.

“There is evidence that some trials have violated the rights of those on whom they are carried out. The poverty in most parts of Africa has made Africans vulnerable to coercion and exploitation by people carrying out medical trials. I urge researchers to protect the participants,” Otaala said.

Kilama also called for the establishment and strengthening of ethics review committees to ensure that medical research participants are well protected.

The Bill & Melinda Gates Foundation announced on 3 September 2008 that it is now accepting grant proposals for Round 2 of Grand Challenges Explorations, a five-year US$100 million initiative to encourage bold and unconventional research on new global health solutions. Proposals for six topics will be accepted online at www.gcgh.org/explorations through November 2, 2008.

Round 2 follow on the heels of the initiative’s first funding round, which closed in May of this year, and generated nearly 4,000 applications from scientists in more than 100 countries. Two new topics are being introduced in Round 2 along with the initial four topics from Round 1.

One of the primary objectives of Grand Challenges Explorations is to involve scientists around the world who do not typically work in global health. This includes those with innovative ideas in Africa, Asia, and other parts of the developing world; people working in the private sector; and young investigators.

The initiative uses an agile, accelerated grantmaking process. Applications are two pages, and preliminary data about the proposed research are not required. In addition, the online application process has been streamlined for Round 2.

The topic areas for which proposals will be accepted in Round 2 are:

1. Create new vaccines for diarrhea, HIV, malaria, pneumonia, and TB.
2. Create new tools to accelerate the eradication of malaria.
3. Create new ways to protect against infectious diseases, including alternatives to traditional vaccination.
4. Create new drugs and delivery systems to limit the emergence of resistance in the disease-causing agent.
5. Create new ways to prevent or cure HIV infection that fall outside current research on vaccines and other biomedical and behavior-change strategies.
6. Explore the basis for latency in TB, with the goal of discovering new ways to identify and eliminate latent infection.

The foundation and an independent group of reviewers will select the most innovative proposals, and grants will be awarded within approximately three months from the proposal submission deadline. Initial grants will be $100,000 each. Projects showing success will have the opportunity to receive additional funding of $1 million or more. Round 1 grants are expected to be announced in October.

Full descriptions of the topic areas and application instructions are available at www.gcgh.org/explorations.

When:
Friday, September 26, 2008 8:00 am - 4:00 pm

Where:
Jurys Hotel Washington
1500 New Hampshire Avenue
Washington, DC 20036
USA

Register at: https://www.regonline.com/builder/site/Default.aspx?eventid=652554

We invite you to a Consultative Forum on the Affordable Medicines Facility-malaria (AMFm) at Jurys Hotel in Washington, DC, on Friday September 26th, 2008.

AMFm is the operational version of the "global subsidy" for malaria drugs first proposed in 2004 by an Institute of Medicine Committee. The purpose of AMFm is twofold: 1) provide widespread financial access to artemisinin-combination therapies (ACTs) and 2) delay the emergence of resistance to artemisinins. AMFm has been approved by the Board of the Roll Back Malaria Partnership and in November, the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria will continue its deliberatations about hosting AMFm.

The purpose of this forum is to discuss the rationale for AMFm, and to explore biomedical, economic and operational challenges related to AMFm.

We would be most appreciative if you could register as soon as possible if you plan to attend. Please forward this invitation to others who you think would be interested in this event. Space is limited but we would like to accommodate as wide a range of perspectives as possible. Attendance at this all-day meeting, including lunch, is free of charge, but you must register in advance.

A webcast of this event is provided by kaisernetwork.org, a free service of the Kaiser Family Foundation and will be available after 9 a.m., September 29th, 2008 at http://www.kaisernetwork.org/healthcast/rff/26sep08.   Along with the webcast, a transcript will also be available.

Sincerely,

Barry R. Bloom
Dean, Harvard School of Public Health
Chair, AMFm Consultative Forum

Ramanan Laxminarayan
Senior Fellow, Resources for the Future

Dates: 23-27 February 2009
Venue: Dar es salaam, Tanzania
Deadline for applications: 31 October 2007

http://www.amanet-trust.org/ext/news/AHRECall2009.html

Background/Rationale

The high disease burden of African countries, the emergence of new diseases, and efforts to address the10/90 gap, have led to an unprecedented increase in health research activities in Africa. In light of the generally poor health delivery systems, the lower levels of education, and poverty of communities and governments, it has become imperative that HRE in Africa be strengthened in order to minimise the risk of unethical research being conducted on the poor populations.

Historically, research participants and research institutions have been exposed to abuse and are inadequately prepared to handle complexities that characterize justice and beneficence desirable for research involving human participants and communities.  This is ever so important in the less developed world where regulatory systems are either very weak or non existent in majority of cases.

Over the next three years, and through a grant from The Bill and Melinda Gates Foundation, AMANET will organize a series of 5 workshops on Advanced Health Research Ethics (HRE) primarily for health investigators and secondarily for Ethics Committee members and policy makers. Since the workshops will be at an advanced level, basic HRE training will be a pre-requisite. The first Advanced HRE workshop was held in Dar es Salaam from 23 to 27 June 2008.

Precedence:

AMANET continues to champion the need for training in biomedical research ethics to various stakeholders of research in Africa. With regard to health research ethics for ethics review committees, the following workshops have been organized by AMANET:

• Workshops on Ethics in Health Research in Africa,  in Kenya (Kisumu, 2001), Ethiopia (Addis Ababa,   2001), South Africa (2002, Pretoria), Gabon, (Libreville, 2002), Sudan (Khartoum, 2003), Cameroon (Yaoundé, 2003), Ethiopia (2007), Ghana (2008) Senegal (in French, 2008), Uganda (2008) and Tanzania (Dar es Salaam, 2005, 2006 and 2007)
• The first Advanced Health Research Ethics Workshop for investigators was held in Tanzania, in June 2008.
• Workshop on Standard Operating Procedures for Ethics Review of Health Research in Africa, 17-21 February 2003, Entebbe, Uganda;
• Workshop on Advanced Ethics in Biomedical Research that Involves Human Subjects, 1-3 December 2004, Zanzibar, Tanzania; and
• Workshop on Protection of Human Research Participants: Writing of Standard Operating Procedures for Ethics Review Committees in Eastern Africa: 29-31 August 2005, Dar es salaam, Tanzania.

Reports on the above activities are available in the various issues of the AMANET Newsletter available online at: www.amanet-trust.org.  

Workshop Pedagogical Methods

The workshop will apply participatory approaches including overviews, case studies, discussion groups, panelists, and participants presentations and other interactive and adult teaching/learning methods. To broaden discussions special panels for some of the topics will be convened. Lecture type presentations will be followed by question and answer sessions. Experienced facilitators have been carefully selected from within Africa.  

Workshop Participants (Selection)

Senior investigators and research project Principal Investigators (PIs) are encouraged to apply. Junior investigators who have successfully completed basic Health Research Ethics (HRE) course available on the AMANET website are also eligible. Participation in the AMANET online HRE Discussion Forum will be considered in the selection process. The online Discussion Forum can be accessed via the AMANET website; some of the case studies discussed online will be used during the workshop. The target candidates are health researchers, but few places may be available for applicants outside these criteria. Interested candidates who meet the selection criteria should submit their applications by 31 October 2008.

Workshop Objectives

This workshop aims firstly to flag topical ethical issues that are relevant to health research in developing country settings, and secondly to explore various schools of thought with the aim of coming up with well thought out positions and/or recommendations. Examples and case studies pertinent to Africa will be used. The following are the highlights of the topics to be covered:

• Applying Ethical principles in Health Research and Ethical review process
• Responsibilities in Health Research
• Ethical issues in research design and recruitment of research participants.
• Research with vulnerable persons and groups
• Legal and social issues in Health Research Ethics
• Ethical Issues in international collaborative health research 
• Models and practicalities of community consultation
• Ethical issues surrounding the 10/90 gap
• Ethical issues in traditional medical practice and “research”
• Professional Ethics
• Animal Research Ethics

Workshop Outcomes

By the end of the five day workshop, it is further hoped that:

• Participants will be brought up to date with topical ethical issues around current research   practices;
• Participants will be able to address ethical issues at the design stage of health research and be able to enhance the protection of the welfare of research participants when implementing health research protocols.  

Language:

The workshop will be conducted in English; there will be no translations to other languages.

Workshop Reports:

Three participants will be nominated to be rapporteurs for the workshop. Proceedings will be recorded for publication in the AMANET newsletter and will be available for participants. 

AMANET Scholarship

Selected participants will be awarded scholarships by AMANET, which will cover costs for economy class airfares (where needed), visas, tuition and accommodation and meals.

Timelines:

• This call sent out on or before 05 September 2008
• Applications should reach AMANET secretariat no later than 31 October 2008
• Please note that only short-listed candidates will be contacted, a list of selected candidates will be made available on the AMANET web site. Selected participants will be informed by 30 January 2009

Applications (with brief CVs and one-half page justification) should be submitted by email to: 

The Managing Trustee,
African Malaria Network Trust,
Tanzania Commission for Science and Technology Building,
PO Box 33207,
Dar es Salaam, Tanzania.
E-mail: info@amanet-trust.org
Fax: +255 22 2700380
www.amanet-trust.org

Acknowledgements

The workshop is supported by a grant to AMANET from the Bill and Melinda Gates Foundation on strengthening institutional health research ethics capacity in Africa.

Blanco YC, Farias AS, Goelnitz U, Lopes SC, Arrais-Silva WW, Carvalho BO, Amino R, Wunderlich G, Santos LM, Giorgio S, Costa FT. Hyperbaric oxygen prevents early death caused by experimental cerebral malaria. PLoS ONE. 2008 Sep 4;3(9):e3126.
Cerebral malaria (CM) is a syndrome characterized by neurological signs, seizures and coma. Despite the fact that CM presents similarities with cerebral stroke, few studies have focused on new supportive therapies for the disease. Hyperbaric oxygen (HBO) therapy has been successfully used in patients with numerous brain disorders such as stroke, migraine and atherosclerosis…

McCollum AM, Basco LK, Tahar R, Udhayakumar V, Escalante AA. Hitchhiking and selective sweeps of Plasmodium falciparum sulfadoxine and pyrimethamine resistant alleles in a population from central Africa. J Pharmacol Exp Ther. Antimicrob Agents Chemother. 2008 Sep 2. [Epub ahead of print]
Sulfadoxine pyrimethamine (SP) resistance in Plasmodium falciparum is encoded by a number of mutations in the genes dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps). Here, we have characterized point mutations in dhfr and dhps and microsatellite loci around dhfr on chromosome 4 and dhps on chromosome 8 as well as neutral markers on chromosomes 2 and 3 in 332 samples from Yaoundé, Cameroon...

Hancock PA, Thomas MB, Godfray HC. An age-structured model to evaluate the potential of novel malaria-control interventions: a case study of fungal biopesticide sprays. Proc Biol Sci. 2008 Sep 2. [Epub ahead of print]
It has recently been proposed that mosquito vectors of human diseases, particularly malaria, may be controlled by spraying with fungal biopesticides that increase the rate of adult mortality. Though fungal pathogens do not cause instantaneous mortality, they can kill mosquitoes before they are old enough to transmit disease. A model is developed (i) to explore the potential for fungal entomopathogens to reduce significantly infectious mosquito populations, (ii) to assess the relative value of the many different fungal strains that might be used, and (iii) to help guide the tactical design of vector-control programmes...

Sowunmi A, Balogun ST, Gbotosho GO, Happi CT. Plasmodium falciparum gametocyte sex ratios in children with acute, symptomatic, uncomplicated infections treated with amodiaquine. Malar J. 2008 Sep 2;7(1):169. [Epub ahead of print]
Amodiaquine is frequently used as a partner drug in combination therapy or in some setting as monotherapy, but little is known about its effects on gametocyte production and sex ratio and its potential influence on transmission in Africa. The effects of amodiaquine on sexual stage parasites and gametocyte sex ratio, and the factors associated with a male-biased sex ratio were evaluated in 612 children with uncomplicated Plasmodium falciparum malaria who were treated with amodiaquine during the period 2000 - 2006 in an endemic area...

Greenwood BM. Control to elimination: implications for malaria research.  Trends Parasitol. 2008 Aug 27. [Epub ahead of print]
Recent reports indicate that a high level of malaria control can be achieved with existing control tools once their use has been scaled up. This has led to renewed interest in the possibility of malaria elimination, an approach that is now supported by several influential organisations. An increasing focus on elimination requires a review of priorities within the malaria research agenda. The development of drugs and vaccines with a strong transmission-blocking potential becomes increasingly important. Novel approaches to surveillance will be necessary to ensure that once elimination has been achieved, it is not threatened by a rapid reintroduction of malaria from neighbouring areas …

Daniel Dodoo, Anastasia Aikins, Kwadwo Asamoah Kusi, Helena Lamptey, Ed Remarque, Paul Milligan, Samuel Bosomprah, Roma Chilengi, Yaa Difie Osei, Bartholomew Dicky Akanmori and Michael Theisen. Cohort study of the association of antibody levels to AMA1, MSP119, MSP3 and GLURP with protection from clinical malaria in Ghanaian children.  Malaria Journal 2008, 7:142
Antigen-specific antibody-mediated immune responses play an important role in natural protection against clinical malaria, but conflicting estimates of this association have emerged from immuno-epidemiological studies in different geographical settings. This study was aimed at assessing in a standardized manner the relationship between the antibody responses to four malaria vaccine candidate antigens and protection from clinical malaria, in a cohort of Ghanaian children…

The package, known as the President’s Emergency Plan for AIDS Relief (PEPFAR), was originally signed in 2003 and helped to buy large amounts of antiretroviral drugs to support medical care for more than 1.4 million people.

Increasingly, experts say, this kind of disease-focused model is defining the global health agenda.

Bush’s reauthorisation of the plan this year aims to provide essential treatment to three million people by 2015. The United States isn’t alone in focusing on AIDS. The Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria currently funds treatment for an estimated 1.4 million people, and the U.N. General Assembly and the Group of Eight industrialised nations support universal access to AIDS treatment.

The priority of fighting AIDS and other diseases is also one of the U.N.’s Millennium Development Goals.

However, despite the massive amounts of money driving current efforts, the global health agenda is still in its infancy. Finding the best way to fight poverty and diseases abroad is still a matter of debate.

Ruth White, an associate professor of sociology and anthropology at Seattle University who runs an aid organisation, says that a narrow focus on disease has drawbacks.

"It’s dangerous because it sucks up resources that could be spread around to have more general health impact instead of focusing efforts on people with one disease and ignoring people with others," she said.

"Basic nutrition can help provide immunity support that can prevent or ameliorate malaria, AIDS and tuberculosis. When people have poor nutrition and are generally unhealthy they are more susceptible to these illnesses," White said.

White is hardly the only voice in Seattle speaking on global health. The city is host to undoubtedly the largest private powerbroker in prioritising global health issues in the country, the Bill and Melinda Gates Foundation. The behemoth, which employs more than 620 people, has about 65 billion dollars in assets and has supplied 16.5 billion dollars in grants since its inception in 2000.

Bill Gates has stated that HIV/AIDS is the top priority of his foundation, which has provided large grants towards fighting the disease in Sub-Sahara Africa.

However, according to the Los Angeles Times, the strict disease focus carried out by the Gates foundation has created some problematic results.

The Times found that the high level of grants provided by the Gates Foundation to fight high-profile disease, notably HIV/AIDS, has led to recipients increasing their demands for specially trained clinicians, resulting in a diverting of staff from basic medical care. Such shortages have led to increased neglect of common medical conditions.

According to the article, such focus has shortchanged basic needs like nutrition and transportation. In many instances, patients actually vomit up their free AIDS medication due to malnutrition, and others lack money to travel to clinics providing such life-saving services.

An IPS request for an interview with the Gates Foundation was denied.

Part of the dilemma may be a lack of understanding of local community needs, according to Loyce Mbewa-Ong’udi, president of the Rabuor Village Project (RBV), a Seattle-based aid organisation that works on a super-local level in the rural Kenyan village of its name.

"You can’t go in with a pre-designed programme, and that needs to improve big time," she said. "Communities know what they want and what they need. They understand their priorities."

Mbewa-Ong’udi believes that a pitfall for some organisations comes from being out of touch with a majority of African communities, which are rural. As many aid organisations operate in large urban centres, they fail to see challenges faced in the countryside, and tend to undervalue local knowledge.

The RBV’s approach has been to work in partnership with community members focusing on disseminating health and development knowledge by forming a village committee, and by training 50 men and women in basic health-care knowledge.

"We identify what is going on and address what they’d like to improve," Mbewa-Ong’udi said.

RBV has also worked on solving more than just the AIDS crisis. The organisation is concentrating on developing local industries, including brick making, sunflower oil production and dairy goats, in addition to a micro-lending programme. RBV has also drilled a well and is looking to develop a large-scale water distribution system for households and agriculture.

White agrees with the approach and thinks it needs to be more prevalent.

"There is not enough humility in the willingness to be equal partners in our efforts on the ground," she said. "We may have technical knowledge, but they (locals) have the cultural and practical knowledge we need to be most effective and efficient."

However, the emphasis on diseases like AIDS remains a difficult challenge to overcome.