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WHAT'S NEW THIS FRIDAY: THREE ON MALARIA

Thursday, 14th of June 2012

• THREE ON MALARIA

 

• PRICING OF BEDNETS: UNICEF TO SAVE $22 MILLION

 

Press  release

UNICEF to save $22 million through transparency in buying bed nets

NEW YORK/COPENHAGEN, 6 June 2012 – UNICEF Executive Director Anthony Lake said today that  a more transparent and competitive market will lead to savings of more than US$20 million over the next 12 months through a price reduction of 20 per cent for bed nets that protect people from malaria.

“Especially at a time of financial uncertainty, these savings are good news for governments and even better news for children,” he said during the annual session of the UNICEF Executive Board in New York.
 
“Never before have bed nets been as accessible and affordable for children and families in developing countries,” said Shanelle Hall, Director of UNICEF’s Supply Division in Copenhagen.

“This is the result of a long-term strategy to create a healthy global market for bed nets, where high quality goods can be purchased in bulk at a fair price, and demonstrates UNICEF's commitment to value for money,” she added.

The price of an insecticide-treated, long-lasting bed net has dropped to under $3.

This reduction followed projected cost savings and cost avoidances for vaccines and child survival supplies worth a total of US$735 million in the coming years, according to UNICEF Supply’s Annual Report 2011.

These included a projected $498 million in costs avoided in rotavirus vaccine procurement between 2012 and 2015 due to a price reduction. Diarrhoea is the second largest cause of under-five child deaths and the vaccine protects against the most virulent strains.

Some US$60 million in savings was secured for oral polio vaccine procurement for supply in 2011 and 2012.

As more countries reach zero transmission of polio and hope to stop buying vaccines, UNICEF and its partners have worked to stop suppliers from exiting the market too early.

Another $153 million in price decreases were obtained for pentavalent vaccines, which protect children against diphtheria, tetanus, pertussis, hepatitis B and haemophilus influenza type B, as a result of an increasingly competitive supplier base and the entry of new suppliers into the market.

Price reductions for ready-to-use therapeutic food – used to treat severe acute malnutrition in children under five – were also significant with an 8 per cent fall from 2010 to 2011.

These results were achieved in partnership with the UN Secretary-General’s Special Envoy for Malaria, the GAVI Alliance, the Bill and Melinda Gates Foundation, UNITAID, the Roll Back Malaria Partnership and the African Leaders Malaria Alliance.

The strategies implemented to achieve these savings include aggregating demand and pooling procurement to help achieve economies of scale, transparent and long-term forecasts to industry, volume guarantees, special financing terms and clear quality requirements.

In 2011, UNICEF made available on its website the prices it pays for vaccines. In 2012, the prices paid for ready-to-use food and bed nets were also published. The availability of this information improves market transparency and efficiency, and supports governments and partners in making more informed decisions.

The announcement on bed nets came shortly before the launch of a major global initiative on child survival in Washington, D.C. on 14-15 June convened by the Governments of the Ethiopia, India and the United States with 700 leaders and global experts from government, the private sector and civil society. 

 

• WOMEN AND NETS

The push toward universal coverage of long lasting insecticide-treated bed nets (ITNs/LLINs) does not negate the fact that pregnant women are still a more vulnerable group that needs protection from anemia and death themselves and miscarriage, low birth weight and greater infant and child mortality for their offspring. So far the data on net coverage for pregnant women is not encouraging. Nets are extremely important because they are the one safe malaria control intervention that women can use right from the start of pregnancy.

Recent Demographic and Health and Malaria Indicator Surveys (DHS and MIS) show a common problem.  The graph here shows general access to LLINs is low (orange bars) in many countries relative to the Roll Back Malaria target of 80% coverage by 2010. What is of equal concern is that even when households possess nets, pregnant women do not always use them (blue bars).  Rwanda with its strong national network of community health workers is the exception. What is discouraging women?

The Liberia MIS asks why people do not own nets, and since these surveys prioritize interviewing women of reproductive age, we may assume that these reasons express the views of women.  A few do not perceive mosquitoes to be a problem (especially in the dry season), some simply do not like to sleep under nets while others complain of the cost.  The latter is curious because nets are primarily provided for free these days.

Clearly we need more information on the dynamics of net use at the household level.  Field visits after a universal coverage campaign in Akwa Ibom State discovered that women themselves see alternative uses of for nets.  One picture shows LLINs covering vegetable gardens that are tended by women in this community. Maybe they believe the nets will keep insects off their vegetables, although the sun will soon render the insecticide ineffective.

Another picture shows that a woman has protected the wares in her small kiosk buy covering it with a LLIN. Customers can still see the wares but insects can’t nibble at the food items on sale (nor children easily pilfer some).

Both of these examples highlight the economic roles of women in the community. Are women making net decisions on their perceptions of what is in their best economic interest? In most communities in Nigeria, income from a woman is crucial to the welfare of her child.

The issue of nets for pregnant women will be one of the issues discussed during the upcoming summit, Malaria in Pregnancy: a Solvable Problem—Bringing the Maternal Health and Malaria Communities Together, a meeting in Istanbul, Turkey, June 26-28, 2012, organized by the Maternal Health Task Force at Harvard School of Public Health.  We will be covering the deliberations as they unfold.

• PROFESSOR ONWULIRI’S CONTRIBUTION TO MALARIA RESEARCH

 

Cross posted, with thanks, from www.malariamatters.org and best viewed, with graphics, at that address.

The recent fatal crash of Dana Air in Lagos, Nigeria claimed the life of a renown parasitologist and educator, Professor C.O. Onwuliri, most recently the Vice Chancellor of the Federal University of Technology Owerri. In his remembrance we are sharing the abstracts of two recent malaria publications of which he was a co-author. His various publications also focus on onchocerciasis, lymphatic filariasis and other parasitic diseases.

Perceptions on the use of insecticide treated nets in parts of the Imo River Basin, Nigeria: implications for preventing malaria in pregnancy. Chukwuocha UM, Dozie IN, Onwuliri CO, Ukaga CN, Nwoke BE, Nwankwo BO, Nwoke EA, Nwaokoro JC, Nwoga KS, Udujih OG, Iwuala CC, Ohaji ET, Morakinyo OM, Adindu BC. Afr J Reprod Health. 2010; 14(1): 117-28.

ABSTRACT: This study aimed at assessing perceptions on use of ITNs in parts of the Imo River Basin, Nigeria and its implications in preventing malaria in pregnancy. Data was collected using focus group discussions, key informant interviews and structured questionnaires. Results showed high awareness on the benefits of ITNs. Factors affecting use of ITNs included its high cost, perceptions of chemicals used to treat them as having dangerous effects on pregnancy, low utilization of antenatal care, husband’s lack of interest in malaria prevention and perceptions  that adolescent girls are at low risk of getting malaria. The implications of these findings include demystifying the negative perceptions on the chemicals used for net treatment and subsidizing the cost of ITNs to increase access. These findings provide important lessons for malaria programmes that aim at increasing  access to ITNs by pregnant women in developing countries.

Malaria infection in HIV/AIDS patients and its correlation with packed cell volume (PCV). Goselle ON, Onwuliri CO, Onwuliri VA. J Vector Borne Dis. 2009; 46(3): 205-11.

OBJECTIVES: The study was designed: (i) to determine the prevalence of malaria parasites; (ii) to determine the relationship between parasitaemia and age/sex; (iii) to correlate the PCV levels with parasitaemia; and (iv) to determine the influence of protection against natural transmission on the prevalence of malaria.

METHODS: Participants were recruited at the Plateau State Human Virology Research Laboratory (PLASVIREC), Robert Gallo House at the Plateau State Specialist Hospital, Jos and grouped into: (i) Malaria and HIV co-infection group (n = 64);  and (ii) HIV infected group without concurrent malaria infection (n = 136). Standard laboratory procedures were used for the HIV and Plasmodium parasites screening, malaria parasite density, and packed cell volume.

RESULTS: The results showed a significant difference (p >0.05) among the sexes and age groups. About 64 (32%) of the individuals had Plasmodium infection (30% Plasmodium falciparum, 0.5% P. malariae, and 1.5% mixed infections of P. falciparum and P. malariae). Malaria parasites were more common among the rural dwellers and in the age group of 21-30 yr. Regression analysis showed a negative  association of malaria parasitaemia and PCV among the malaria-HIV positive and malaria-HIV negative (r2 = 0.529; p < 0.001).

CONCLUSION: In the present study, PCV might be of useful indicator and if not monitored could lead to AIDS establishment especially where  high malaria parasitaemia is noted. The findings further suggest that the defined stage of HIV infection in the study, malaria coinfection may moderate the impact  of HIV infection on PCV.