The MalariaWorld Journal

This is a review of Bill Jobin's book 'Improving the US Presidential Malaria Initiative'. It is mainly a review of PMI's first campaign in Angola in 2005/6. Jobin was directly involved in organising a large-scale indoor residual spraying campaign in the south of Angola and writes about the intricacies of getting such a campaign off the ground based on poor data, delays, and a myriad of other challenges. To come to a stunning conclusion: there was hardly any malaria in the region that was sprayed and essentially 2.1 million dollars of the first PMI campaign had gone to waste. Jobin adds a list of essential recommendations to improve the outcome of such campaigns in future. A must-read that can be ordered at Amazon.com.

Most donor agencies only procure drugs approved by a Stringent Regulatory Authority or the World Health Organization (WHO) Prequalification Programme in an effort to ensure high quality. This study compares the quality of artemisinin-based combination therapies (ACTs) produced by WHO-approved manufacturers with non-approved manufacturers and suggests policy changes to improve quality of donor-procured drugs. The results of this study suggest that ACTs produced by WHO-approved manufacturers perform nearly five times better than those of non-approved manufacturers, but some approved ACTs have too little active pharmaceutical ingredient. The US President’s Malaria Initiative tests every batch of every drug it procures before distribution to recipient countries. Other donors should follow suit to ensure that drugs purchased with taxpayer dollars are of the highest quality.

[The official response to this article from the World Health Organization Prequalification of Medicines Programme was published in December 2012 and is attached below]

Ivermectin (IVM) reduces the lifespan of malaria-transmitting mosquitoes after feeding on humans treated with IVM but limited data are available on the exact duration of the mosquitocidal effect of IVM. Daily mosquito feeding assays were conducted to determine this. Mosquito mortality was 70-100% when mosquitoes fed on mice, rats, or cynomolgus monkeys 1-2 days after the last IVM administration. The findings reported here, of a pronounced but short-lived mosquitocidal effect, makes the timing of IVM administration crucial to form a useful addition to anti-malarial drugs.