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Healthcare Sector in Africa

2010 | Africa Medical & Healthcare news

The healthcare sector in Africa is showing signs of remarkable improvement as the quality of hospitals and the availability of qualified doctors has dramatically improved over the last few years. By making the transformation from traditional medicine to a modern and well structured healthcare system, many African countries have been able to meet the growing demands for quality healthcare services for their people.

The Council for Health Services Accreditation for Southern Africa (COHASA) has been accrediting many hospitals under its jurisdiction that meet the applicable predetermined and published standards. However, Africa’s healthcare industry is characterized by a huge division between the private and public sectors both in terms of facilities and funding. Perhaps the biggest problem facing the public sector currently is the rising incidence of HIV/AIDS, which is and will continue to place considerable strain on the public health system in many African countries.

As a result, there exist immense opportunities for the supply of a wide range of hospital equipment, instrumentation, machinery and allied medical products. Most of the requirements of the healthcare sector in Africa are imported from Dubai. Being a price-sensitive market, African buyers are always on the lookout for high quality, competitively priced goods to meet their requirements.

South Africa - Clicks Pharmacy Sees Scope for Major Growth

16 September 2010 | By Edward West

Johannesburg — Clicks Pharmacy is the largest corporate-owned pharmacy chain in SA and a major component of Clicks Group's growth strategy.

THERE remains considerable growth potential in SA for Clicks Pharmacy - the Clicks Group-owned pharmacy chain that operates in 254 Clicks retail stores - according to Dan Zinner, head of business development at the group. Clicks Pharmacy is the largest corporate-owned pharmacy chain in SA and a major component of Clicks Group's growth strategy

Mr Zinner said yesterday, in an interview at a conference in Durban, that Clicks Pharmacy was exploring opportunities in other African countries.

Nevertheless, "the growth opportunity remains huge in SA" given that the group operated more than 370 Clicks stores across the country, and there were many of these stores where new pharmacies could be opened, Mr Zinner said.

The further establishment of pharmacies in Clicks stores in SA depended on a number of factors, including time, capacity, the shortage of pharmacists and the speed of regulatory processes. Opportunities also existed for the pharmacies to work with the government on initiatives such as the acceleration of testing for HIV, the national health insurance scheme and other changes within the medical aid industry, he said.

Willie Jordaan, head of professional services for Clicks Pharmacy, said the chain had worked hard to "improve efficiencies without affecting the quality of care", through "a tough period" after 2004 when the government first regulated the prices of medicine, and this had affected profit margins.

He said that from a pharmacy industry perspective, it was becoming important for the recent draft regulations on dispensing fees to be promulgated.

The draft regulations propose an increase in the dispensing fee of 30%- 32%. Mr Jordaan said Clicks thought the increase was "fair".

The draft regulations, although capping the amount that pharmacies may charge in dispensing fees, would improve margins for some pharmacies and help make healthcare more affordable.

Mr Jordaan said the shortage of pharmacists in the country was part of a worldwide trend and SA remained a recruiting country for pharmacists by large international groups.

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African Medical Investments opens new boutique hospital in Maputo, Mozambique

10 May 2010 | By Edward West

African Medical Investments has opened its new 30 bed private boutique hospital, trauma centre & Well Woman Clinic in Maputo, Mozambique, replicating its successful first boutique hospital, Trauma Centre & Well Woman Clinic in Dar es Salaam, Tanzania, which opened a few months back. 

The opening of this facility is in line with the group’s  strategy to rapidly accelerate the roll-out of private boutique hospitals, Trauma Centres, Well Woman and Well Man Clinics across Africa to meet soaring demand for dedicated private medical services.

The group chose Maputo as a suitable location in which to extend its offering due to its large expatriate community and the low number of health facilities currently in the city.  The facility has 30 beds including three ICU beds and two neonatal ICU incubators.  Additional facilities include a full emergency department, a major and minor operating theatre, delivery rooms, a radiology department with CT scanner, digital X-ray and 4D ultrasound machines, occupational health services, a vaccination centre and a dedicated pharmacy.

The new facility complements African Medical's current healthcare portfolio which includes the Dar es Salaam hospital, the Trauma Centre in Harare and Airport Medical and Vaccination Centres in Johannesburg and Cape Town International Airports.  

The company is also extending its current facility in Harare to include a full boutique 20 bed hospital and refurbishment work is also underway to establish a Well Woman and Well Man Clinic in Nairobi, Kenya.  It is expected that all these facilities will be fully operational by the end of June 2010.

African Medical CEO Vivek Solanki said: “By the end of June, with three hospitals and three clinics operational, we will have a solid foundation from which to make strong expansionary progress.” At the end of April African Medical completed the drawdown of funds under its equity line agreement with a fund managed by New York based Harbinger Capital Partners LLC, and the £2.995 million raised will be used to further advance the company's growth strategy.

The new funds completed the drawdown under the US$47 million equity line agreed with Harbinger in October 2009. In the latest transactions, The New York firm will subscribe to shares representing 6.05% of the enlarged capital of African Medical. This will consist of 6.5 million shares at 23 pence and 6 million shares at 25 pence and will up Harbinger’s interest in African Medical to 41.89%.

African Medical will use the proceeds to fund its expansion plans. It aims to be managing a total of ten healthcare facilities by 2012.

Tanzania - The Medical Imaging Market

30 Jan 2010 | By Frost & Sullivan

This Frost & Sullivan research service titled The Medical Imaging Market in Tanzania provides a strategic analysis of the medical imaging market in Tanzania, with the Market Engineering research methodology. This measurement-based methodology focuses on market measurement, analysis, forecasting, strategy development and monitoring. In this research, Frost & Sullivan's expert analysts thoroughly examine the following technologies: ultrasounds, computed tomography (CT) scans and X-rays.

The Tanzanian Medical Imaging Market Offers Significant Potential for New Technologies. Although the Tanzanian medical imaging market is not yet advanced, it provides primary diagnosis to a large proportion of its population. Therefore, it has a significant potential for suppliers to introduce new technologies. The growth of the private sector has paved way for innovative technologies such as three-dimensional/four-dimensional (3D/4D) ultrasounds and computed radiography (CR) X-ray systems, which continue to be mostly limited to private hospitals. The public sector is focussing more on equipping all the referral hospitals with advanced technologies. In 2000, the Tanzanian Government, in collaboration with the Dutch Government, initiated a hospital revitalisation programme, which included the provision of basic medical imaging systems to regional and district hospitals. The installation of these X-ray and ultrasound units was completed at the end of 2003, and many of these systems are now almost at the end of their lifecycle.

'The replacement or upgrading of these systems will subsequently provide solid opportunities for vendors in this market,' says the analyst of this research. 'Suppliers will have the opportunity to upgrade old and outdated equipment with new technologies such as 3D/4D ultrasound and CR x-ray systems, which have considerable scope in this market.' The digitisation of X-ray systems took place in Tanzania only during the last two years. Although the Tanzanian medical imaging market is still small, the advantages of digital processing are anticipated to drive sales in this market significantly. A slow, but steady, adoption is expected. Digital systems provide the benefits of image manipulation to enhance contrast, radiation control and patient throughput. Moreover, these systems are more cost effective than analogue radiography.

Ultrasound systems with 3D imaging are likely to drive sales in the medium-to-long term, as the benefits of real-time reconstruction and visualisation of images can be seen with greater precision, while managing to reduce the levels of invasiveness and, consequently, the cost. This 3D technology has proven to be particularly beneficial in obstetrics by providing information that is not easily obtainable in 2D imaging.

Flexible Financial Options by Manufacturers is the Key to Success in this Market. There has been an increasing influx of low-cost Chinese and Indian brands into the price-sensitive Tanzanian medical imaging market. With the government favouring public tenders, major market participants have been compelled to compete with low-priced and low-specification products. Many high-quality product providers are finding it challenging to convince the healthcare decision makers about the economic and technical benefits of their products. 'Competitors in this market are driven to review their pricing policies while, at the same time, making sufficient profit in order to achieve revenue growth,' explains the analyst. 'Thus, the trend of price cutting remains a challenge for various companies as they attempt to compete with low-cost participants.'

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African Medical Investments plans expansion of healthcare facilities

By Medical Tourism News

Africa is a continent that has a few well-off countries with good medical facilities, such as South Africa, but many more where facilities are less than adequate, often due to lack of  funding by governments. Recent years have seen more private companies moving in to fill the gaps. Any new hospital or clinic in Africa must have a first priority of serving the country it is in. Secondly it has to deal with international travelers and expatriates there for work or retirement. Thirdly it has to deal with medical tourists. Unlike many other continents, in Africa, medical tourism is more driven by need rather than want, due to lack of local facilities. It is often easier to travel to a clinic across a border, than it is to go to one in their home country. Also there is a growing middle-class who can afford to travel for treatment, and increasingly they prefer to stay within Africa rather than go to Europe or Asia.

African Medical Investments is providing healthcare in niche areas, particularly to the expanding African middle classes and expatriates. It is looking to capitalise on the growing demand for quality medical services in Africa with recently secured funding from US based hedge fund Harbinger Capital. Progress with negotiating new facilities in new target cities and increasing the number of patients has been good. African Medical’s Vivek Solanki says, “ We are being approached by foreign governments with requests for medical facilities in their cities. ”

Earlier this year it opened the first of a number of planned clinics and well women centres aimed at meeting the demand for dedicated healthcare services across Africa. The first development was a 30-bed boutique hospital and well-woman clinic in Dar-es-Salaam, Tanzania. As with other clinics, it is managed and operated by African Medical's wholly owned subsidiary, VIP Healthcare Solutions Limited (VIP).

It currently has five facilities, and the company is evaluating additional cities that meet its investment criteria. Since then it has opened a similar hospital in Cape Town. The Maputo Trauma Centre & Well Woman Clinic will open in March next year in Mozambique. Accra in Ghana and Nairobi have been identified as suitable for a Well Woman and Well Man clinic. African Medical is also in discussions with the authorities to establish boutique hospitals, trauma centres and Well Woman clinics in Kampala in Uganda and Kigali in Rwanda, which display the vital criteria including high number of expatriates and members of the African middle class. When the company bought VIP in November 2008, it already managed the Airport Medical & Travel Vaccination Centre at Johannesburg International Airport and The Trauma Centre in Harare.

The target of 10 facilities in total by 2012 and 15 by 2015 remains unchanged, with this goal looking yet more achievable now with the new funding agreement with Harbinger. More patients are expected to fall into the company’s target audience as more international investment is directed towards Africa.

 

 

Kenya - Import Enough Pain Killers, Health Ministries Told

23 September 2010 | By Daily Nation

The Kenya Cancer Association has urged the two ministries of health to intervene and ensure steady supplies of painkillers. This comes in the wake of reports that hospitals had run out of morphine, which is used by terminally ill patients, mostly suffering from cancer and Aids, to manage pain. "The Kenya Medical Supplies Agency (Kemsa) does not import morphine, ensuring availability of this critical palliative care medicine is left to the private sector.

"Although advocacy groups and non-governmental agencies involved in palliative care are making frantic efforts to bring in some morphine, this has not borne any fruits and patients around the country continue to suffer," the association's chairman, Mr Newton Siele, said. The government, he said, had a constitutional obligation to ensure patients access the painkillers. To alleviate the shortage, Mr Siele recommended that morphine be imported and distributed by Kemsa. This, he said, would avert stockouts and guarantee reliable supplies to even the most remote of locations. The drug is imported mostly by certified chemists to avoid abuse.

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Private Equity Taps Health Sector Growth

June 2010 | By Steave

Private equity funds are lining up for entry into Kenya's health sector in a move that could add a profit segment to the cost of treatment and spark a fresh rally of medical costs in the country. Health sector players say private equity's interest in private hospitals has more than tripled in the past two years and is expected to peak at not less than Sh1 billion by end of the year.

Private equity (PE) interest in Kenyan hospitals began in 2008 with TBL Mirror Fund BV's purchase of a significant stake in Meridian Medical Clinics for an undisclosed sum. That move was followed early this year by Aureos Capital's buy into the Nairobi Women's Hospital for Sh200 million.

Acumen Fund, another private equity firm, has also bought a stake in a start-up eye hospital and a pharmaceutical franchise, while Karen Hospital is in talks with an unnamed PE fund for money to expand its presence in East Africa."We are in discussions with a private equity fund for possible short and long-term capital partnerships," said Dr Ernest Mureithi, the chief operating officer at Karen Hospital. The Nairobi Hospital also confirmed that it is looking for a possible PE fund to boost its expansion plan. "A lot more PE funds are eyeing the health sector, which they now see as a profit centre rather than just a social service," said Milton Lore, the managing director of the African Venture Capital Association. Ongoing transformation of medical services into a viable investment platform for private equity is attributed to the recent expansion of Kenya's middle class between 2006 and 2007 with robust economic growth. The growth of the middle class is expected to continue this year as the economy recovers, pushing up demand for private health services that private equity is hoping to tap. The value of health services in Kenya has risen steadily from Sh33 billion in 2004 to Sh51 billion in 2008, according to the Economic Survey 2008.

 

That growth is being driven by the pharmaceuticals segment that is now valued at Sh17.92 billion, according to Business Monitor International, and is expected to register a double-digit growth this year and hit the Sh32.12 billion mark by 2014. The rising interest of PEs in the health services is in line with the general interest by investors from mature economies in Africa's most robust sectors such as small and medium scale enterprises.

Foreign PE's interest in Kenya has been rising steadily from five in early 2000 to an estimated 25 currently. A recent study by the International Finance Corporation found that Kenya needs between Sh1.8 trillion to Sh2.2 trillion in new investments by 2016 to keep pace with its development goals, half of which is expected to come from the private sector. Health experts however warned that the entry of PEs into medical services, though positive and desirable for the sector to maintain the tempo of demand, is likely to result into higher costs as hospitals factor in the necessary margins to meet the expectations of the new shareholders. Kenyan hospitals have largely operated on the social principles that are hinged on a business model targeted at meeting operating costs and modest returns. The entry of investors with a profit motive therefore sets the stage for a review of the business plans and price increases to meet the new shareholder goals.

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Ghana: Malaria Investment Pays Off

May 5 2011

A multi-million rand AngloGold Ashanti investment in a malaria control programme in Ghana has led to massive reductions in productivity losses, school absenteeism, infant mortality and treatment costs, a report released at the World Economic Forum has shown.

Malaria is a completely preventable and treatable disease that kills almost 800 000 adults and children worldwide, 90% of them in Africa - where it accounts for almost 20% of all child deaths.

According to the World Health Organisation's Roll Back Malaria (RBM) programme Malaria is costing Africa U$12-billion annually in lost productivity.

Steve Knowles, Director for Malaria Control at AngloGold Ashanti presented details on their flagship programme at one of their mines in Obuasi, Ghana were their intervention reduced the burden of malaria in the entire community, increased school attendance, reduced absenteeism at the mine, increased productivity and reduced the cost of malaria treatment.

"There was no doubt that malaria was the biggest threat to us as a company," said Knowles, who has been spearheading the programme's expansion to their mines in Ghana, Mali, Guinea and Tanzania as well as other industries and mines in these countries.

In 2005 the Obuasi Mine Hospital was seeing a staggering average of 6 800 malaria patients per month, of a workforce of 8 000.

Of these 2 500 were mine employees with an average of three days off per patient which equates to 7 500 man shifts lost per month.

"This coupled with a slow work rate during recuperation, resulted in a major loss of production," said Knowles. The cost of medication for treatment was in excess of U$55 500 per month.

The Obuasi Malaria Control Programme essentially consisted of killing the mosquitoes through indoor residual spraying, preventing the mosquitoes from biting with nets, screening and repellants, controlling breeding via environmental management and anti-malarial drugs.

The combined interventions has led to an average decline of over 5 800 cases per month (75%) since 2005. School attendance has increased by 70% and according to Knowles the infant mortality in now zero.

The average monthly cost of treatment has also declined from U$55 000 to just over U$6 000 and the lost man-days due to malaria has been reduced from almost 7 000 per month to just over 160.

The Programme has now teamed up with the Ghana government which was recently awarded U$133-million over five years by the Global Fund to Fight AIDS, Tuberculosis and Malaria. The money has been earmarked to scale up the "Obuasi Model" to 40 districts.

Knowles said they were assisted by the "very robust health system and infrastructure" in Ghana as well as the country's health insurance scheme.

"There were nurses and clinics and most of our professional training was really targeted at the laboratory personnel, training them in the diagnosis of the disease," he said.

He said the picture was very different in Guinea and Mali.

"The brain drain in West Africa is horrendous," she said.

Knowles said the insecticides they used were "100% safe" although they did not use DDT as the mosquitoes in Obuasi were resistant to it.

"There are no side-effects whatsoever and I would be quite happy to have my children live in any of the houses we spray," he said.

Knowles grinned: "I remember a time when you could not sit outside in Obuasi without having hundreds of mozzies zooming around your head. There are now no mozzies in Obuasi."

Tanzania: Young Chemist Seeks Answers in Traditional Medicine

July 6 2011

Johannesburg — When Justin Omolo was growing up in Tanzania, he preferred Western medical clinics to African traditional healers. "I was the only one in my family who didn't believe in all the traditional cures," he said. "I guess I wanted proof."

Now this young African organic chemist is looking for that proof as he conducts research for his PhD on plants used by Tanzanian traditional healers to treat HIV.

Omolo's research is supported by the Science Initiative Group (SIG), which aims to foster science in developing countries. Based at the Institute for Advanced Study in Princeton, New Jersey, SIG is governed by a board that includes scientists from developing countries, leading U.S. scientists and an entrepreneur, and is supported by the Carnegie Corporation and the Mellon and Packard foundations. SIG's chief focus is an initiative supporting PhD and MSc-level students in sub-Saharan Africa called the Regional Initiative in Science and Education (RISE).

It is through RISE that Omolo has been able to study potential drugs to combat HIV/Aids. His PhD research was inspired by reports from Tanzania's northeastern Tanga region that HIV-positive people who consulted traditional healers responded well to treatment with indigenous plants.

"People said that you drink just one cup of this medicine (made from local plants) and your condition improved," Omolo said. "Doctors at the local hospitals heard about it, too. They said that these people were living as much as 10 years longer than expected."

The Tanzanian government sent researchers to probe these reports and test the plants for toxicity. Once they proved non-toxic, the Tanga Aids Working Group (TAWG) was founded to investigate the effect of these indigenous plants on HIV. Medical doctors and scientists from the National Institute of Medical Research and the Institute of Traditional Medicine at the University of Muhimbili have joined forces with Dutch and Indian research organizations.

As part of this international effort, Omolo has travelled from the University of Dar es Salaam to South Africa, where he is conducting further research on these plants for his PhD in organic chemistry. The RISE program links graduate students such as Omolo into various networks relating to their specific fields of science.

Omolo is part of the RISE network known as SABINA, Southern African Biochemistry and Informatics for Natural Products, which aims to harness the power of southern Africa's biodiversity to increase capacity in natural products research. This kind of innovative networking in chemistry and biochemistry among universities in the Southern African Development Community (SADC) aims to contribute to development goals around food security, public health and value-added exports.

Two major South African universities, Witwatersrand and Pretoria, and South Africa's Council for Scientific and Industrial Research (CSIR) are SABINA partner institutions. Omolo is conducting his PhD research at Johannesburg's "Wits" University, with support from CSIR. These institutions act as a back-stop to his home university in Tanzania, which has far less resources and expertise.

"In order to do my research, I prepare the plants the way the traditional healers do, boiling the stems, bark, leaves and tubers," Omolo said enthusiastically. His studies have found chemical compounds in the plants that act against HIV, which targets the T4 cells that are vital to the body's immune system. The hope is that a drug made from these plants can stop HIV from binding with the T4 cells, thus allowing them to do their job of fighting infections.

Why synthesise a drug in a lab when the plants in their natural environment have been shown to do the job of fighting HIV? Omolo's supervisor, University of the Witwatersrand chemistry professor Charles de Konig, said that if the plants were to be harvested in Tanzania, it could require a ton of plant material to produce a few milligrams of the active ingredient.

On the other hand, the laboratory can replicate the required climate and soil conditions and make synthetic versions of the plants far more efficiently. Another issue is that SABINA doesn't endorse the pillaging of a natural healer's source, which is something that pharmaceutical companies had been accused of doing.

The names of these plants are not being publicly revealed because Omolo's efforts to identify and synthesise the active anti-HIV compounds could eventually lead to the patenting of an anti-HIV drug. But that's all in the future - his immediate goal is to finish writing up his research findings by the end of this year, so that he can return to teach at his university in Tanzania as Dr. Justin Omolo.

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Africa: New Hope for Malaria

July 7 2011

A drug that is regularly given to people in Africa to prevent river blindness appears also to kill the mosquitoes that spread malaria, scientists have discovered.

The breakthrough, from teams in Senegal and Colorado State University in the US, provides another useful weapon in the armoury against a disease that kills around 800,000 a year, most of them small children and pregnant women.

"There is no silver bullet for malaria control," said Brian Foy, a vector biologist at Colorado State University and senior author of the study published in the American Journal of Tropical Medicine and Hygiene, "but this could be an important tool that would also contribute to the fight against other neglected diseases. It's clearly a multi-purpose drug."

The drug is called ivermectin and has been around for more than 30 years - originally as a veterinary medicine against worms - which means it is off-patent and cheap. It is used in annual campaigns in Africa to fight the parasitic roundworm, which causes onchocerciasis, or river blindness, and also to treat children in the west with head lice.

Foy and his colleagues hit on the idea of studying the effect of ivermectin on malaria transmission. The researchers went to several Senegalese villages and collected mosquitoes from houses before and after a mass dosing of the drug for river blindness. They found there was a dramatic drop of 79% in the proportion of mosquitoes carrying the Plasmodium falciparum malaria parasite in the two weeks after ivermectin was given out. The drug in the bloodstream of people who were bitten killed the mosquitoes. By comparison, in villages that had not been treated, the number of malaria-carrying mosquitoes increased by 246%.

The effects of the drug on parasite transmission lasted for more than two weeks, said Foy. The task now is to work out how often people would need to take ivermectin to keep malaria at bay in their village. Like vaccination, everybody would need to be dosed for the benefit of all, because the mosquito has to bite for the drug to take effect and kill it.

A programme to give regular doses of ivermectin would also better control the intestinal helminths - worm-like parasites - that cause not only river blindness but also elephantiasis and other debilitating diseases.

All attempts at malaria control using drugs have encountered the problem of resistance, but the team hopes there may be less danger that a new breed of drug-resistant mosquito will start to breed, because, unlike insecticides, only those mosquitoes biting humans will be affected.

Ivermectin was developed by the pharmaceutical company Merck from the fermentation products of bacteria discovered in soil next to a Japanese golf course in 1975. It was licensed as a veterinary drug in 1981. It works by paralysing insect and nematode muscles, which slows their ability to move and feed, causing them to weaken and die. Merck has donated millions of doses since 1987 to treat river blindness, a disease affecting about 18 million people, which is spread by black flies that transmit worms that invade the skin and eyes.

Cheap Drug Now Used to Treat River Blindness in Africa Could Dramatically Reduce Malaria Transmission

July 11 2011

Deerfield — A cheap, common heartworm medication that is already being used to fight other parasites in Africa could also dramatically interrupt transmission of malaria, potentially providing an inexpensive tool to fight a disease that kills almost 800,000 people each year, according to a new study published today in the July edition of the American Journal of Tropical Medicine and Hygiene.

The study by scientists from Senegal and Colorado State University found that transmission of malaria parasites by mosquitoes fell substantially among people living in several Senegalese villages over two weeks after they took the drug ivermectin, which was administered as part of a campaign to fight the parasitic roundworm that causes onchocerciasis, or river blindness.

The drug appeared to kill malaria-carrying mosquitoes that fed on the blood of the villagers. "There is no silver bullet for malaria control," said Brian D. Foy, PhD, a vector biologist at Colorado State University and the article's senior author. "But this could be an important tool that would also contribute to the fight against other neglected diseases. It's clearly a multipurpose drug."  Foy said he became interested in studying the potential of ivermectin to control malaria after investigating different ways, including vaccines, to give human blood the ability to kill mosquitoes.

Larger, longer studies will be needed to show whether more frequent, such as monthly, doses of ivermectin during the malaria season in different parts of Africa have an important impact on the disease. But the researchers note that their study suggests it might be possible to use the drug to reduce malaria transmission during epidemics or in well-defined transmission seasons. Their work was funded with grants from The National Institutes of Health (NIH), Colorado State University, and with a Grand Challenges Explorations grant from the Bill & Melinda Gates Foundation, which rewards creative thinking to scientifically address pressing global health problems.

"This study offers good news on several fronts, not the least of which is the potential to disrupt the transmission of malaria and save needless suffering and death," said Peter J. Hotez, MD, PhD, President, American Society of Tropical Medicine and Hygiene. "We need more creative science like this that has simple yet powerful results in our battle against neglected diseases of poverty."

According to the World Health Organization, malaria kills 781,000 people each year, most of them very young children in Africa. New approaches to combating the disease are in constant demand, particularly in the area of transmission control. Current methods of reducing disease transmission rely mainly on sleeping under insecticide-treated bed nets and spraying indoors with mosquito poisons, which are very effective but  are threatened by the risk of mosquitoes developing resistance to the most commonly used insecticides. Also, these measures don't deter malaria        transmission by mosquitoes that bite during the day or outside the home.

"If using ivermectin works to reduce transmission, people will have a drug circulating in their blood that could kill mosquitoes anywhere and at any time of day," said Foy. To assess whether ivermectin might be a potential malaria control agent, researchers collected mosquitoes from villages where people were taking the drug and compared them to collections gathered at the same time from villages where people were not taking the drug. In locations where        people were taking ivermectin, two weeks after the drug was administered there was a 79 percent decline in mosquitoes
carrying Plasmodium falciparum- the world's most deadly malaria parasite. In villages where ivermectin was not in use,
malaria-bearing mosquitoes increased by 246 percent over the same period.

Since 1987, the pharmaceutical company Merck (not involved in this study) has donated million of doses of ivermectin, under the trade name Mectizan, to treat river blindness, a disease that affects about 18 million people. The disease is spread by black flies that transmit worms that invade the skin and eyes; 270,000 of those suffering the disease have      become blind as a result. "In terms of river blindness, this drug has transformed lives," said Hotez. "To add malaria to its already impressive return on investment would be an incredible development."

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Africa: Country-Led Development Improves Health

24-Jun-11

Delegates from four African health ministries taking part in this month's 38th Annual International Conference on Global Healthdescribed how leadership and country-led development are helping to improve health outcomes.

The delegates, from Mali, Ethiopia, Senegal and Sierra Leone, were traveling on behalf of the Ministerial Leadership Initiative (MLI), which was asked by the Global Health Council to hold a special session on health leadership at the conference.

MLI is a non-governmental program that supports ministries of health to advance country-led development in the areas of health financing, donor harmonization and reproductive health. A four-year program in the five countries, MLI aims to help improve country-led development by focusing first on country leaders articulating a clear and compelling vision. Nepal is the only non-African country taking part in the program.

Health ministers, doctors and others spoke to a packed room of 400 people and answered questions from the audience at the health conference, which took place in Washington last week.

"The response was great," said Sarah Lindsay, MLI program assistant. "We were really pleased with the outcome."

Delegates who spoke to AllAfrica emphasized the importance of development in the health sectors in their countries being led by the countries themselves.

"The main reason free healthcare in Sierra Leone succeeded is due it being country-led and country-driven," said Dr. Samuel A.S. Kargbo, director of reproductive health in Sierra Leone's Ministry of Health and Sanitation. "Even the origin of it all - it was not something that was brought down to us. It led to greater commitment on all sides."

Kargbo and the other delegates talked about the challenges of rehabilitating health systems to help provide free healthcare for women and children in their nations - where rates of child and maternal mortality are among the world's highest. The delegates also spoke of the difficulties associated with a lack of human resources, especially in rural areas.

Donors attending the Washington conference appeared to like what they were hearing.

"I'm happy to say that not only are we in agreement about the importance of country ownership, the U.S. government is taking very significant, very specific steps to be better partners with countries," Amie Batson, deputy assistant administrator for global health at the U.S. Agency for International Development, told the audience.

She said frequently countries have "run into a bit of a wall" with technical and donor partners who might have other ideas about the best way to deliver health services.

"We will always have some differences," she said. "But what we're striving for is that those differences have value, that we'll have a constructive dialogue about how to approach different things rather than the 'lets go separate ways' dialogue."

She said donors could play an important role of helping countries keep the focus on goals that may not be politically popular and in holding leaders accountable in a global arena in ensuring that promised services are delivered.

Lindsay said it was not yet clear whether the program would expand to other countries, although several have expressed interest in participating. Funding by the Bill & Melinda Gates Foundation is up at the end of the year.

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Healthcare & Medical Sector in Kenya

24-Jun-11

The Kenyan government is continually improving and upgrading existing health facilities and opening new ones to meet the demand of the country and its neighbours. Most of the medical equipment and supplies are imported. High-quality private practitioners require sophisticated medical equipment, but the public sector acquires less expensive equipment. Private health institutions account for 60% of total medical equipment and supplies.

Market overview

Kenya has a healthcare system that is operated by two major players, the government run and owned healthcare institutions that make up the largest number of frequented health care points in the country, and the private run healthcare institutions. The healthcare sector is governed through two ministries, the Ministry of Medical Services and the Ministry of Public Health & Sanitation. The Kenya Health Policy Framework is the overarching health policy and the National Health Sector Strategic Plan elaborates strategic imperatives for this sector.

The healthcare sector comprises the public system, with major players including the Ministry of Health and parastatal organisations and the private sector, which includes for-profit, NGO and faith based organisations facilities. Health services are provided through a network of over 4,700 health facilities countrywide, with the public sector system accounting for majority of these facilities. The public health system consists of the following levels of health facilities: national referral hospitals, provincial general hospitals, district hospitals, health centres and dispensaries. The government health service is supplemented by privately owned and operated hospitals and clinics and faith based organisations, hospitals and clinics.

According to National Health Accounts, 29.3% of health expenditure is public, with 31.0% from donors and 35.9% from households. Combination mechanisms are continuously being strengthened between the various partners including DANIDA, DfID, GDC, Italian Cooperation, SIDA, UNICEF, USG and World Bank came together under the Joint Support program to design areas of focus for their support.

Key health impact indicators suggest stagnation in the health status. This stagnation is attributable to the high disease burden due to existing and new conditions, and an inadequate response to manage the disease burden. The health impact indicators also suggest wide disparities in health across the country, closely linked to underlying socio-economic, gender and geographical disparities.

Malaria is the leading cause of outpatient morbidity in Kenya. After Malaria, the most common illness seen in outpatient clinics are diseases of the respiratory system, skin diseases, diarrhoea and intestinal parasites. Other frequent health problems include accidental injuries, urinary tract infections, eye infections, rheumatism and other infections.

Key opportunities

  • • Construction of new hospital and outpatient clinics.
  • • Supply of medical equipments to both private and public hospitals.
  • • SPrivate hospitals are expanding their services to be able to meet the demand of a growing middle-class who can afford quality care.
  • • SGlobal health partnerships, to provide resources for addressing health challenges.
  • • SContinuous training of health professionals to stay abreast of the latest developments in the sector.

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