The U.S. government Thursday released a six-year strategy to address malaria globally, Reuters reports (Fox, 4/22). The plan was issued through the President’s Malaria Initiative (PMI) in conjunction with World Malaria Day, April 25, and is a “core component of President [Barack] Obama’s Global Health Initiative,” according to a USAID press release (4/22).

The strategy expands the five-year 2005 U.S. malaria initiative that focused on combating malaria in 15 African countries. The new plan includes the Democratic Republic of Congo and Nigeria and up to seven more countries, Reuters reports. According the new strategy, “The selection of the seven additional countries will be based on population, malaria burden, health infrastructure, and availability of other donor funding,” Reuters writes (4/22).

The strategy (.pdf) notes that expanded plans also include adopting a “woman-centered approach … at both the community and health facility levels, since women are the primary caretakers of young children in most families and are in the best position to help promote healthy behaviors related to malaria” (4/25).

Overall, the goal “is to reach 450 million people, or about 70 percent of the highest-risk populations in sub-Saharan Africa. The plan is to use insecticide-treated nets, indoor insecticide spraying, preventive treatment of pregnant women, and treatment of infected people with artemisinin-based drug cocktails,” according to Reuters. Malaria control methods will be integrated “with each country’s preferred approach to fighting malaria,” the Reuters writes (4/22).

The strategy also seeks to accelerate malaria control through health system strengthening, according to the press release. “The strategy also outlines contributions to curtail the spread of antimalarial multi-drug resistance in Southeast Asia and South America and to increase emphasis on strategic integration of malaria prevention and treatment activities with programs for maternal and child health, HIV/AIDS, neglected tropical diseases, and tuberculosis,” the press release notes.

Rear Adm. Tim Ziemer, U.S. global malaria coordinator, said sustainable malaria control is a “critical goal” for the U.S. In the press release he noted, “The United States is focusing on building capacity within host countries by training people to manage, deliver, and support the delivery of health services, which will be critical for sustained successes against infectious diseases” (4/22).

PMI also released its Fourth Annual Report. More information is available on Kaiser’s Policy Tracker (4/22).

Study Finds Single-Dose Malaria Drug As Effective As Standard Treatment

South Korean drugmaker Shin Poong Pharmaceuticals’ drug Pyramax “proved as effective as Novartis’ leading treatment Coartem in a clinical trial, researchers said on Friday, although an outside expert said the findings had limitations,” Reuters reports (Hirschler, 4/22).

Researchers tested the new treatment, which is a combination of pyronaridine and artesunate, “at seven sites in Africa and three in Southeast Asia alongside the standard drugs, artemether and lumefantrine,” Agence France-Presse writes. “A total of 1,272 malaria patients were enrolled, with 849 randomly assigned to pyronaridine-artesunate, which was taken once a day over three days, and 423 to artemether-lumefantrine, taken twice daily, also for three days.”

The study results, published Friday in the journal Lancet, found that both drugs “were equally effective in clearing out malarial parasites in the blood at a 28-day mark, and had an equal number of reported side effects,” AFP reports. The researchers recommend that pyronaridine-artesunate be incorporated into malaria treatment programs since it “costs less than one dollar to treat an adult and less than 50 cents for a child,” the news service writes (4/22).

An accompanying Lancet comment by Francois Henri Nosten of the Mahidol-Oxford University Tropical Medicine Research Programme “said a limitation of the study was that it consisted of many older African children and adults who had probably acquired some malaria immunity,” according to Reuters. “He also raised concerns about patients on Pyramax having raised liver enzymes, a possible signal of liver toxicity” (4/22). Writing in the Lancet, Nosten said, “My criticism is that it might satisfy developed-world regulatory requirements but it provides limited information of value to the clinician in the field” (4/24).