Addressing the Malaria Crisis in Our Region Ric Price and Nick Anstey Menzies School of Health Research, Darwin, Au

1. Addressing the Malaria Crisis in Our Region  Ric Price and Nick Anstey Menzies School of Health Research, Darwin, Australia.

2. WORLD MALARIA SITUATION WHO 1999 Annual Report 2,020 million people (36%) live in malarious areas 273 million clinical cases annually �90% of cases in tropical Africa� Estimated annual mortality: 1.5 to 2.7 million

5. Burden of Malaria in Asia In the last 15 years $74 billion wiped out from 31 African countries 10 fold rise in mortality assoc with CQRIn the last 15 years $74 billion wiped out from 31 African countries 10 fold rise in mortality assoc with CQR

8. Antimalarial drug resistance worldwide, 2003

9. Burden of Drug Resistance In the last 15 years $74 billion wiped out from 31 African countries 10 fold rise in mortality assoc with CQRIn the last 15 years $74 billion wiped out from 31 African countries 10 fold rise in mortality assoc with CQR

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16. Huge Burden of malaria Extensive malaria control programme Significant drug resistance Falciparum and Vivax Excellent surveillance Huge Burden of malaria Extensive malaria control programme Significant drug resistance Falciparum and Vivax Excellent surveillance

29. SEAQUAMAT TRIAL Largest severe malaria trial Multicentre randomised trial of artesunate vs quinine in severe malaria Indonesia (Timika) Bangladesh India Myanmar Study completed April 2005: results to published July 2005

30. Supplementary arginine therapy Arginine: natural product Aims: stop malaria parasites sticking to blood vessels Reduce mortality Early results: Safe Improves blood vessel function in malaria

32. Collaborators NIHRD Emiliana Tjitra Hadjar Siswantoro Syahrial Harun Ibu Rini Ibu Retno Dr Sanjaja

34. �Averting a disaster� Malaria mortality set to double in 10 yrs White et al, Lancet 1999Ataran et al, Lancet 2004 Global deployment of ACT Global deployment of bednets Improved primary health services Access to prevention and treatment Political commitment Donor countries/agencies Malaria-endemic countries

35. Malaria can be rolled back An extra US$500 million/yr is needed for ACT IOM report 2004 3 days US military spending in Iraq (US$177 million/day) Similar amount for bednet deployment

36. Global Fund for AIDS, TB & malaria Funding began in 2001, shortfall since 2004 Australia�s contribution: 2001-2003: nil 2004-2005: $17.7m over 2 yrs $50m/yr required - adjusted GNI Netherlands: 2004-2005: $104m USA: $459m in 2004 $1200m/yr required � adjusted GNI

37. The Worlds Priorities? Annual Expenditure Global Reduction in Malaria $ 1 billion Basic education for all $ 6 billion * Cosmetics in the US $ 8 billion Safe water and sanitation $ 9 billion * Ice cream in Europe $ 11 billion Reproductive health for all women $ 12 billion * Perfumes in Europe and the US $ 12 billion Basic health and nutrition $ 13 billion * Pet food in Europe and the US $ 17 billion Business entertainment in Japan $ 35 billion Cigarettes in Europe $ 50 billion Alcoholic drinks in Europe $ 105 billion Narcotic drugs in the world $ 400 billion Military spending in the world $ 780 billion