Tit bits on Malaria

• Early diagnosis and prompt treatment are two basic elements of malaria control.
• According to the WHO, about 3.3 billion people - half of the world's population - are at risk of malaria.
• One in every five (20%) childhood deaths is due to the effects of malaria 
• Inappropriate use of anti-malarial drugs in the past century contributed to widespread resistance in the malaria parasite due to drugs such as chloroquine
• Over the past decade, a new group of anti-malarials known as artemisinin-based combination therapies has brought new hope in the fight against malaria.
• Long-lasting insecticidal nets can be used to provide protection to risk groups, especially young children and pregnant women in high transmission areas.
• Indoor residual spraying is the most effective means of rapidly reducing mosquito density.
• Pregnant women are at high risk not only of dying from the complications of severe malaria, but also spontaneous abortion, premature delivery or stillbirth

Tit bits on INESS
INESS is the project on effectiveness and safety of antimalarial drugs in Africa starting now in Tanzania and Ghana and soon in Burkina Faso and Mozambique.

Goal of INESS
To provide national, regional and international health decision makers with independent and objective evidence on safety and effectiveness of new antimalarial drugs as a basis for malaria treatment policy in Africa.

Objectives
To develop and maintain Phase IV Safety and Effectiveness Studies Platform in Africa

To assess the effectiveness of new malaria treatments and its determinants in real life setting in Africa.

Approach
The candidate drug will be introduced in routine public health facilities at district-wide scale.
Information on safety, efficacy, coverage, provider compliance, patient adherence and costs, among others, will be collected.   

Expected Outcomes

• Reduced time between licensure of drug and wide scale use in malaria endemic countries through provision of all essential information for rational decision.
• The ability to generate large scale district-level effectiveness and safety data between countries and between districts within countries in Africa.
• Better informed policy at national, regional and international level.
• Strengthening surveillance sites and district health information systems by linking household and health facility information.
• Strengthening national drug safety monitoring system.

Rationale
The need for a Phase IV effectiveness data on how a drug works when delivered outside trial conditions is needed by health decision makers in Africa before the widespread use of such new treatments can be justified.