Challenges in the response of public health in this area includes the following:
1) a lack of medical records or documentation of predeparture therapy;
2) Limited Medicaid reimbursement for therapy and follow-up care due to the lack of documentation;
3) Difficulty in securing the appropriate treatment since Malarone is not on the FDOH.
A formulary; and 4) Initial difficulty in locating a Kirundi interpreter for the interviews. (Epi Update, 2008)
VI. BARRIERS and MISCONCEPTIONS
Barriers to funding and focus on prevention, treatment and eradication efforts are identified to be those as follows:
Malaria no longer 'king of diseases' in the tropics and hardly any threat to the industrialized countries of the North
Malariologists no longer in charge - new breed of 'managers' have taken command
Basic research dominates and the little applied research that is funded has little operational links with control programs
More complex international infrastructure; countries need to invest heavily to figure out how to seek funds
Funding biased towards 'big' projects rather than towards smaller efforts whose aim is steady, long-term growth from 'below'." (Malaria and International Health Organizations, nd)
Stated to be a strategy that is of a viable nature for future malaria control will include the following features:
Active involvement of communities, especially children, in public projects;
Strengthening of local 'managerial' capacities;
Use of graduate students to support local efforts; and Making 'local' information available to the community. (Malaria and International Health Organizations, nd)
VII. REQUIREMENTS to STRENGTHEN INTERNATIONAL COMMUNITY'S ROLE
The requirements for strengthening the role of the international community would likely include those as follows:
carry-out demonstration projects aimed at enhancing local capacity to control malaria;
develop prototype approaches for local capacity building using adaptive management workshop protocols;
integrate such projects within wider efforts to strengthen national public health functions;
extrapolate the information needed concerning malaria to other situations of the world and make that information readily and easily available on the web;
encourage national governments to adopt information policies that are supportive of local public health initiatives;
encourage and support, technically and financially, national governments in their effort to reform their educational systems to provide needed support to local public health initiatives;
invite the global applied research community, including historians, to be 'on-call' when specific skills are in short supply, locally and nationally; ensure that a representative sample of local initiatives are well evaluated. (Malaria and International Health Organizations, nd)
VIII. MALARIA a 'PUBLIC' and a 'HEALTH' ISSUE
S. Price James, stated in the report entitled: "Principles and Methods of Antimalarial Measures in Europe" in 1927 as follows: "Malaria control cannot be death with as an isolated problem separate from other social, medical and public health affairs." Indeed as noted by Rockefeller Foundation Vice President in 1937, "Malaria is a health and social problem; it must be attacked simultaneously from both these angles."
IX. VACCINES for MALARIA
On October 17, 2007 New Scientist Magazine reported that a vaccine "against malaria would save hundreds of thousands of lives each year. Now it seems we're much closer to finding one." The report states that in Mozambique, infants injected "with the experimental vaccine RTS, S/AS02 were 65 per cent less likely to be infected with Plasmodium falciparum - the mosquito-borne parasite that causes malaria - than infants injected with a control vaccine, according to the first major trial of a malaria vaccine in 210 infants. Recipients were also 35 per cent less likely than controls to develop malaria itself." (New Scientist, 2007) According to Pedro Alonson of Spain's University of Barcelona "Effectively it represents the first proof of concept that you can immunize infants against malaria." (New Scientist, 2007) the vaccine is stated to mimic:
protein found on the surface of P. falciparum during the part of its life cycle when it can be injected into human blood by feeding mosquitoes, called the circumsporozoite stage. Primed by the vaccine, the babies' immune systems produced antibodies and white blood cells to fight the parasite and stop it reaching the liver, where it would normally infect cells and multiply. Babies injected with the vaccine received three shots, the first given at between 10 and 18 weeks old." (New Scientist, 2007)
Reported by the Center for Global Development in the Global Health Policy report entitled: "Combining Interventions to Prevent Malaria While Fighting Resistance" is that the New York Times had reported findings made recently concerning the "combination of one inexpensive antibiotic pill each day and sleeping under an insecticide treated mosquito net can reduce the incidence of malaria by 7% in HIV positive children in Uganda." (Center for Global Development in the Global Health Policy) the report states that this supports combination of malaria interventions for best practice. The report sates that use of both cotrimoxazole and insecticide "can stimulate the appearance and speed the spread of resistant forms of disease agents." (Center for Global Development in the Global Health Policy, 2007) it is further related that combination interventions and ideally "combining them with other community-based MCH interventions, such as C-IMCI and Intermittent Presumptive Therapy (IPT) in pregnancy that include early recognition and care-seeking for danger signs will be more effective than single 'magic bullet' interventions. Estimated cost in high to medium transmission areas were stated at $9.00 for each household every six months as compared to netting costs of $3.00 to $15.00 per net, which are stated to "offer five years protection." (Center for Global Development in the Global Health Policy)
SUMMARY & CONCLUSION
Malaria has long been recognized as a deadly disease that cripples not only the lives of individuals but many times is crippling to government due to the heavy burden of costs associated with lack of treatment for the disease. Malaria has been identified in this report as one that is a leading cause of death throughout the world. (Center for Disease Control and Prevention, 2001) Most deaths from malaria are in Africa and most of those deaths are children under five years of age. There are more than 140 countries and regions affected by Malaria or 40% of the total population of the world.
Malaria is a parasitic disease that is more than 4,000 years old. Four components necessary for success in Malaria prevention and treatment are those of: (1) a catalytic moment; (2) demand for universal coverage; (3) pragmatic donor response; and (4) innovative problem solving. (Breiger, 2008) There are various methods used for control of the disease spread with use of insecticides and there are medicines, which have been successfully used however, it appears that Malaria has adapted to the medicines used to fight Malaria. Recent report give new hope however, that a vaccine for malaria will soon be developed.
Azarian, Taj; Kay, Robin S.; and Smith, Laura (2008)Malaria Among Recently Arrived Burundian Refugees: A Public Health Response. Epi Update. The Florida Department of Health, Bureau of Epidemiology. January 2008.
Breiger, Bill (2008) IRS in Uganda - a Call for Monitoring Resistance 21 June 2008. Indoor Residual Spraying. Malaria Matters. Online available at http://www.malariafreefuture.org/blog/
Brieger, Bill (2008) Counting Down the Cases Morbidity & Monitoring 24 June 2008. Malaria Matters. Online available at http://www.malariafreefuture.org/blog/
Combining Interventions to Prevent Malaria While Fighting Resistance (2007) Global Health Policy. 8 Mar 2007. Center for Global Development. Online available at http://blogs.cgdev.org/globalhealth/2007/03/combining_interventi.php
Comment by the Medicines for Malaria Venture (2006) for Web-Based Public Hearing of World Health Organization in View of Meeting of Intergovernmental Working Group on Public Health, Innovation and Intellectual Property, on 4-8 December.
DeAngelis, Catherine D. And Zuccotti, Gianna (2006) Theme Issue on Malaria. The Journal of the American Medical Association. Vol. 296 No. 10-13 Sept 2006. Online available at http://jama.ama-assn.org/cgi/content/full/296/10/1289
League of Nations, Report of the Intergovernmental Conference on Far-Eastern Countries on Rural Hygiene, Bandoeng, August 3rd to 13th (Geneva: League of Nations, 1937), taken from Introduction written by Gunn.
Malaria Vaccine Protects Infants Against Infection (2007) New Scientist - Health 17 Oct 2007 online available at http://www.newscientist.com/channel/health/mg19626263.200-malaria-vaccine-protects-infants-against-infection.html
Principles and Methods of Antimalarial Measures in Europe," Second General Report of the Malaria Commission (Geneva: League of Nations Health Organization, 1927) prepared by S.P. James.
Statistics and Malaria's Public Health Impact (2008) Centers for…