World Malaria Report 2011

World Health Organization 2011.Geneva, 13 December 2011. Malaria mortality rates have fallen by more than 25% globally since 2000, and by 33% in the WHO African Region, according to the World Malaria Report 2011, issued today by the World Health Organization. This progress is the result of a significant scaling-up of malaria prevention and control measures in the last decade, including the widespread use of bed nets, better diagnostics and a wider availability of effective medicines to treat malaria.

However, WHO warns that a projected shortfall in funding threatens the fragile gains and that the double challenge of emerging drug and insecticide resistance needs to be proactively addressed.

"We are making significant progress in battling a major public health problem. Coverage of at-risk populations with malaria prevention and control measures increased again in 2010, and resulted in a further decline in estimated malaria cases and deaths," says Dr Margaret Chan, WHO Director-General. "But there are worrisome signs that suggest progress might slow."

During the past decade, malaria incidence and mortality rates have been cut in all regions of the world, according to the World Malaria Report 2011. In 2010, there were an estimated 216 million cases of malaria in 106 endemic countries and territories in the world. An estimated 81% percent of these cases and 91% of deaths occurred in the WHO African Region. Globally, 86% of the victims were children under 5 years of age.

There were an estimated 655 000 malaria deaths in 2010, which is 36 000 lower than the year before.* While this 5% year-on-year decline represents significant progress, the mortality figures are still disconcertingly high for a disease that is entirely preventable and treatable.

"With malaria deaths in Africa having fallen significantly since 2000, the return on our investment to end malaria deaths has been greater than any I have experienced in the business world.But one child still dies every minute from malaria - and that is one child and one minute too many,” says Raymond G. Chambers, the UN Secretary General's Special Envoy for Malaria.

“The toll taken by the current economic crisis must not result in our gains being reversed, or progress slowed. With Secretary-General Ban Ki-moon’s charge for near zero deaths by end of 2015, turning back now is not an option,” Mr Chambers adds.

Steady progress in malaria control

Long-lasting insecticidal nets have been one of the least expensive and most effective weapons in the fight against malaria. According to the new report, the number of bed nets delivered to malaria-endemic countries in sub-Saharan Africa increased from 88.5 million in 2009 to 145 million in 2010. An estimated 50% of households in sub-Saharan Africa now have at least one bed net, and 96% of persons with access to a net use it. There has also been further progress in rolling out diagnostic testing, which is crucially important to separate malaria from other febrile illnesses. The number of rapid diagnostic tests delivered by manufacturers climbed from 45 million in 2008 to 88 million in 2010, and the testing rate in the public sector in the WHO African Region rose from 20% in 2005 to 45% in 2010.

Worldwide, the volume of antimalarial medication delivered to the public sector has also increased. In 2010, 181 million courses of artemisinin-based combination therapies (ACTs) were procured, up from 158 million in 2009, and just 11 million in 2005. ACTs are recommended as the first-line treatment for malaria caused by the most deadly malaria parasite, Plasmodium falciparum.

Projected shortfall in funding

Despite significant progress in 2010, the projected shortfall in malaria funding threatens the hard-earned gains of the last decade. International funds for malaria control reached US$ 1.7 billion in 2010 and US$ 2 billion in 2011, but remained significantly below the US$ 5-6 billion that would be needed annually to achieve global malaria targets. According to projections in the report, despite increased support from the United Kingdom, malaria funding will slightly decrease in 2012 and 2013, and will likely drop further to an annual US$ 1.5 billion by 2015.

Triggered primarily by the reduction in available funding within the Global Fund to Fight AIDS, Tuberculosis and Malaria, this decrease will considerably alter the malaria control landscape and threaten the sustainability of the multipronged approach to fight the disease, which relies heavily on investments in bed nets, indoor residual spraying, diagnostic testing, treatment, research and innovation.

"We need a fully-resourced Global Fund, new donors, and endemic countries to join forces and address the vast challenges that lie ahead. Millions of bed nets will need replacement in the coming years, and the goal of universal access to diagnostic testing and effective treatment must be realized," says Dr Robert Newman, Director of WHO's Global Malaria Programme. "We need to act with urgency and resolve to ensure that noone dies from malaria for lack of a 5 dollar bed net, 1 dollar antimalarial drug and a 50 cent diagnostic test."

World Malaria Report 2011

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Countries of the Americas Advance toward Elimination of Mother-to-Child Transmission of HIV and Syphilis

Washington, D.C., Dec. 1, 2011 (PAHO/WHO) — A handful of countries in the Americas appear to have virtually eliminated mother-to-child transmission of HIV and congenital syphilis, according to a new report from the Pan American Health Organization/World Health Organization (PAHO/WHO). But the goal of hemisphere-wide elimination requires stepped-up action in countries and population groups where progress is lagging, the report says.

“The Americas is the first region in the world to set its sights on eliminating mother-to-child transmission of HIV and syphilis through simultaneous efforts in a joint framework,” said PAHO Director Dr. Mirta Roses. “This new report shows how much progress has been made but also suggests there is a lot of work that still needs to be done.”

An estimated 5,000 children become infected with HIV in the Americas each year, most through mother-to-child transmission, and between 164,000 and 344,000 babies are born with congenital syphilis. If untreated, the conditions can produce miscarriages, fetal death, premature birth, stillbirth, newborn death, low birth weight, and congenital infection with different degrees of severity. These imply major human, social and economic costs.

The countries of the Americas have collectively committed to the goal of eliminating mother-to-child transmission of HIV and syphilis as public health problems by 2015, by improving the quality of care for pregnant women and babies, including wider and timelier treatment for HIV and syphilis. The report released today assesses progress in the Region’s countries in implementing such efforts to advance toward elimination.

According to the report, Canada, Cuba, Antigua and Barbuda, the United States, and the British territory of Anguilla have all reported reduced rates of mother-to-child (“vertical”) transmission of HIV to less than 2 percent and have reduced pediatric HIV cases to no more than 0.3 per 1,000 live births, while also reducing congenital syphilis cases to no more than 0.5 per 1,000 births. These levels are considered low enough to no longer constitute public health problems, although experts say sustained efforts are needed to keep these rates low. PAHO, UNAIDS, and UNICEF have begun developing a certification process to validate countries’ progress toward elimination.

At the regional level, the report estimates the rate of mother-to-child transmission in Latin America and the Caribbean at 15 percent, significantly higher than the 2 percent rate needed to achieve elimination but lower than the 35 percent transmission rate that would occur without public health interventions. To further reduce rates, countries need to increase HIV testing in pregnant women, provide wider coverage with antiretroviral drugs for mothers and infants, and increase early diagnosis of exposed infants. Countries with the highest rates of mother-to-child transmission should rapidly scale up action in these areas, through joint efforts between health authorities, international agen­cies, academia, civil society, and other partners, says the report.

Other challenges and achievements highlighted in the report include:

• Rates of HIV screening for pregnant women are increasing in most countries and range from 21 percent in Guatemala to 97-98 percent in Canada and the United States. In Latin America, HIV screening rates are much lower for women from remote rural and indigenous areas than for urban women.
• On average, 61 percent of women receiving prenatal care in the Americas were screened for syphilis in 2010. To increase screening, the report urges wider use of rapid tests in primary health care settings.
• Coverage with antiretroviral medication increased in Latin America and the Caribbean from about 50 percent of HIV-positive pregnant women in 2005 to 61 percent in 2010.
• The percentage of pregnant women diagnosed with syphilis who receive appropriate treatment ranges from under 15 percent in El Salvador to 100 percent in Chile, Cuba, Guyana, Honduras, Trinidad and Tobago, and Venezuela (among 18 reporting countries).
• Most countries report access to prenatal care at 80 percent or better (that is, pregnant women have at least one visit with a skilled antenatal care attendant). However, early access is not necessarily the norm, and shortages of supplies and medications (HIV and syphilis tests, antiretrovirals and penicillin) often compromise the quality of care.
• Skilled attendance at birth ranges from 26 percent to 100 percent, with half of countries reporting 99 percent coverage or better. Countries with the lowest rates include Haiti (26 percent), French Guiana (49 percent), Guatemala (51 percent), Honduras (67 percent), Bolivia (65 percent), and Ecuador (71 percent).
• Indigenous women have consistently lower rates of access to prenatal care and delivery by skilled birth attendants, as indicated by data from Bolivia, Ecuador, Guatemala, Nicaragua, and Peru.
• In most countries for which data are available, less than half of youths aged 15 to 24 know how to prevent sexual transmission of HIV and also reject major misconceptions about HIV transmission.
• The percentage of unmet need for family planning/contraception ranges from a low of 6.6 percent in North America to over 20 percent in Haiti, Guatemala, Belize, Bolivia and the Caribbean overall.

The PAHO/WHO report recommends stepped-up efforts to overcome challenges in the delivery of prenatal and childbirth care and to eliminate geographic, social, economic and cultural barriers to early access to quality care.

It also recommends strengthening of surveillance and information systems related to HIV and syphilis among women and babies to eliminate data gaps, noting that many countries and territories in the hemisphere have not reported on key indicators of progress toward elimination.

Links

• 2010 Situation Analysis: Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in the Americas
• Mother-to-Child Transmission of HIV and Syphilis Elimination Initiative: www.paho.org/eliminationinitiative
• PAHO World AIDS Day page
• PAHO HIV-STI website: www.paho.org/HIV
• “Unparalleled global progress in HIV response but sustained investment vital” (WHO news release)
• WHO fact sheet on HIV
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Third Ibero-American Contest for Good Health Promotion Practices in School Settings

Pan American Health Organization/World Health Organization (PAHO/WHO) is pleased to announce that registration to the Third Ibero-American for Good Health Promotion Practices in School Settings will remain open through January 31, 2012.

The  contest objectives are:• To identify and encourage good practices in school environments in countries of Latin America and the Caribbean.
• To promote horizontal cooperation between countries through the exchange of experiences and lessons learned in school-based health promotion.
• To strengthen work by the health-promoting school networks at the national level.

Who can participate?All schools or educational institutions (public or private; preschool, primary or secondary levels; rural or urban) from the countries in the Americas or Spain are eligible to participate.  Schools must have developed experiences in school-based health promotion or have implemented the Health Promoting School Strategy in one of the established categories of the contest.

National and international Health Promoting School Networks are also invited to participate in this contest under a special category for this group.

Registration period
• The period for registering and submitting experiences will remain open until 6:00pm (Bogotá/Washington time, GMT−5) Tuesday, January 31st 2012.

Prizes• A commemorative plaque for each winner
• Each winning experience at the international level will be documented and shared throughout the Pan American Health Organization/World Health Organization communication channels
• More prizes and special awards will be given at the national level

How can I obtain the registration form?
Contest rules
 School registration form
 Registration form for School Networks

How can I submit the registration form?
Once the form has been completed, please only use one of these two options below to send the registration form. Within 48 hours, you will receive an email notification to confirm that the form has been received.

Where can I request assistance if necessary?
For further information, please send an email to: concursoiberoamericano2011@gmail.com  j

Caribbean conference on forging a sustainable response to the regional HIV epidemic

WHO News. Monday November 21, 2011 marked the last day of the 2011 Caribbean HIV conference. Under the theme “Strengthening evidence to achieve sustainable action”, this important conference brought together more than 2700 stakeholders on November 18-21, in Nassau, The Bahamas, to focus on forging a sustainable response to the HIV epidemic in the region.

 

This event was the third Caribbean HIV conference in the past decade and was designed to build on successes of the previous events. This year’s conference highlighted two critical and related issues affecting the HIV response in the region: sustainability and the importance of evidence in guiding strategies to attain this goal.

Presentations and discussions broached issues such as the evidence of progress made in the Caribbean, the challenges in the region to sustain the response, and critical evidence-based interventions to attain HIV-free generations. (Please download the newsletter  highlighting discussions on sustainability.)

 The conference reviewed the high rates of HIV infection among certain key populations like men who have sex with men and sex workers, as well as gender relations that increase vulnerability and risk, and limited strategic information. Countries  and delegates were urged to increase domestic allocations for HIV services and programs, strengthen regional solidarity in resource allocation so that countries that are worse off will not be left behind, address inefficiencies, strengthen public health leadership and public-private partnerships, focus on evidence-based interventions, and renew emphasis on surveillance of new infections.

Through the Caribbean HIV Office (PHCO), PAHO has been actively involved in the organization of this important event. PAHO staff Dr. Noreen Jack was a member of the organizing committee and the PHCO team, and HIV advisors from the regional and country offices contributed to the agenda through presentations in plenary sessions related to sustainability of the response, poster presentations, and the coordination of four special sessions on Men’s Health and HIV,  Strengthening Sexual and Reproductive Health and HIV Linkages in the Caribbean, HIV Drug Resistance Prevention and Monitoring, and a special session on Small Island States’ Challenges to Strengthen the HIV Response, with keynote speaker the Honorable Prime Minister of St. Maarten, Sara Wescot-Williams.
 

USAID Grants PAHO $5 Million to Improve Health in Latin America and the Caribbean

Washington, D.C., 21 November 2011 (PAHO/WHO) The United States Agency for International Development (USAID) signed an agreement today with the Pan American Health Organization/World Health Organization (PAHO/WHO) that provides $5 million to improve health in Latin America and the Caribbean, with a focus on maternal and neonatal health and tuberculosis (TB). Under the agreement, USAID will provide an estimated $5,041,913 over the next three years to support PAHO/WHO technical cooperation in the following areas: Improving health services for TB and maternal and neonatal health, through the use of evidence-based neonatal interventions, improved planning and policies, stepped-up responses to multi-drug-resistant (MDR) and extremely multi-drug-resistant (XDR) TB, and stronger routine systems for implementing DOTS (directly observed treatment short-course) for TB. Building competencies in the health workforce, with a focus on midwifery, prevention and control of MDR and XDR-TB, and health sector leadership. Strengthening health information systems, including systems that incorporate gender and ethnic perspectives as well as systems for surveillance of congenital syphilis diagnosis and treatment, and for epidemiological surveillance of MDR-TB. Improving the capacity of national health authorities to carry out essential public health functions, including by monitoring and evaluating their functions and performance. The agreement also provides support for efforts to eliminate onchocerciasis (river blindness) and for prevention and control of malaria in Haiti. Today’s agreement builds on a 20-year partnership between USAID and PAHO/WHO that has produced significant progress in areas including essential public health functions, health systems and services, health information systems, and surveillance and healthcare practices in maternal health, among other areas. In the area of newborn health, for example, USAID support was critical to the development of the Interagency Neonatal Strategic Consensus and PAHO’s Regional Strategy and Action Plan within the Continuum of Maternal, Newborn and Child Care. Based on these frameworks, national neonatal action plans have been developed and are being implemented in countries including Bolivia, El Salvador, Guatemala, Honduras, Panama and the Dominican Republic. “We are extremely grateful to the United States for this important funding, but also for the very close relationship we have with USAID, which has made this such an exceptional collaboration,” said PAHO Director Dr. Mirta Roses. “Both technically and in terms of funding, it is truly a pillar of PAHO’s strategic plan.”

First Regional Forum on Human Resources for Health and Indigenous People: The Challenge of Interculturality

PAHO.On 21-23 November 2011, Panama City will host the First Regional Forum on Human Resources for Health and Indigenous Peoples: The Challenge of Interculturality. The forum is a joint initiative of the Pan American Health Organization/World Health Organization, Health Canada, the Fondo Indígena and the Inter-American Development Bank, in collaboration with the Ministry of Health of Panama.

You can follow the event live via webcast on November 21 and 22 (8:30 am to 5:30 pm, Washington DC time) at:http://www.livestream.com/paho

Interpretation into English is available at: https://sas.elluminate.com/m.jnlp?password=M.B8CD32A3FA5D970A769D8C9BEAF7ED&sid=1110

More information (in Spanish) is available at:http://www.paho.org/pueblosindigenas