Unprecedented progress against malaria—a key public health achievement over the past few years—has stalled, and an estimated 5 million more cases were reported in 2016 than the year before, according to the World Health Organization’s (WHO’s) annual report today on the status of the battle against the disease.One of the major problems is insufficient funding at domestic and international levels, which has led to major gaps in providing insecticide-treated nets, medications, and other malaria-fighting tools, according to the 196-page report.Pedro Alonso, MD, PhD, director of the WHO’s Global Malaria Program, said in a WHO press release, “We are at a crossroads in the response to malaria. We hope this report serves as a wake-up call for the global health community.”One of the main goals in the global strategy for malaria is to reduce illnesses and deaths by at least 40% by 2020, and according to the new report, the world is not on track to reach critical milestones. WHO Director-General Tedros Adhanom Ghebreyesus, PhD, who goes by Tedros, said, “Without urgent action, we risk going backwards, and missing the global malaria targets for 2020 and beyond.”Funding gapsInvestments in global malaria control and elimination for 2016 totaled an estimated $2.7 billion, well below the $6.5 billion needed annually by 2020 to meet 2030 targets of the WHO global malaria strategy, the WHO said.Governments in endemic countries provided $800 million, making up 31% of funding last year. The United States remained the largest international donor to malaria control programs, providing $1 billion—38% of all malaria funding. Other major donors included the United Kingdom, France, Germany, and Japan.Disease killed 445,000 in 2016For 2016, the WHO estimates there were 216 million malaria cases from 91 countries, up from 211 million cases in 2015. The disease killed about 445,000 people in 2016, about the same as the year before, according to the latest findings.The rates of new cases had been falling, but have leveled off since 2014, with infections increasing in some of parts of the world, such as the Americas. And fatalities followed a similar pattern. African countries still report 90% of all malaria cases and deaths, while 15 countries, all but one in sub-Saharan Africa, bear 80% of the global burden. Nigeria (27%) had the highest proportion of global cases, followed by the Democratic Republic of Congo (10%), India (6%), and Mozambique (4%).For Plasmodium vivax malaria, the WHO estimates that, for 2016, just five countries accounted for 85% of the cases: Afghanistan, Ethiopia, India, Indonesia, and Pakistan.”Clearly, if we are to get the malaria response back on track, supporting the most heavily affected countries in the African Region must be the primary focus,” Tedros said.Mixed news for control strategiesIn sub-Saharan Africa in 2016, the WHO estimated 54% people at risk for malaria slept under an insecticide-treated bednet (ITN), compared with 30% in 2010. Though the rate of ITN coverage has increased, the rate has slowed since 2014.Indoor insecticide spraying of walls, another powerful tool to prevent the disease, showed a steep drop, from an estimated 180 million people in 2010 to 100 million in 2016, with the largest reductions in the African region, the report said.One bright spot is a major increase in diagnostic testing in public health settings, where 87% of suspected case-patients were tested in 2016, compared with 36% in 2010. A strong majority (70%) of people who sought treatment received artemisinin-based combination therapies, the gold standard.Many areas, however, still have low access to public health systems, according to the WHO. For example, country surveys in the African region reveal that only about one third of children with a fever are taken to a medical provider in public health sectors.Conflict, crises compound challengesAmong other challenges in battling malaria, conflict and crises pose additional risks and complicate the response to the disease in Nigeria, South Sudan, Venezuela, and Yemen, where the WHO is currently supporting response efforts.For example, in Nigeria’s Borno state, the WHO launched a mass antimalarial drug campaign that reached an estimated 1.2 million children. And early reports suggest that malaria cases and deaths there have declines as a result.Aside from the lack of sustainable and steady funding, other challenges include shifts in climate patterns, the emergence of parasite resistance to antimalarial medications, and mosquito resistance to insecticides, the report notes.See also:Nov 29 WHO press releaseNov 29 WHO world malaria report
GET THE BEST OF THE JAPAN TIMES That’s how Saturday’s Kentucky Derby will look and sound to a long gray colt with one good eye named Storm in May.“He’s been that way since a week after his birth,” trainer Bill Kaplan said Friday morning as a thick mist blanketed the backstretch at Churchill Downs.A few yards away, the colt bent over and nibbled at the grass, his right ear cocked to track nearby sounds like a radar.“The blessing is that he doesn’t know he’s different than anyone else,” Kaplan said.The betting public does, though, which helps explain why a horse that’s won four times and finished in the money in 12 of 13 career races will go off at 30-1 odds. History isn’t on Storm in May’s side, either.Twice in the last 25 years, one-eyed thoroughbreds have cracked the Derby lineup and crossed the wire covered more in dirt than glory. Cassaleria finished 13th in 1982 and Pollard’s Vision shuffled home 17th in 2004.“I’m one of those people who don’t believe anything happens by chance,” said Kent Hersman, a chief warrant officer in the U.S. Army who bred and trained Storm in May before selling him as a 2-year-old. “So maybe there’s somebody out there that needs to see this horse do well.“From time to time, everybody takes a bad hit in life. Storm is that inspiration that says, ‘Get back up and give it your best shot.’ Because if nothing else,” Hersman added, “he’ll teach you to enjoy the trip.”And it’s been a remarkable enough journey already.There were 34,642 horses foaled in 2004, and who knows how many of those were pointed down the road that ends at the finish line of Churchill Downs. Storm in May, a grandson of Storm Cat and a great-grandson of Triple Crown winner Secretariat, was born with a pedigree worthy of a Derby horse, but that wasn’t all. A corneal ulcer in his right eye required an operation almost immediately after birth.That surgery went well enough, but several days later, a veterinarian trying to clear up a complication inadvertently punctured the eye. The only consolation was that the vision in Storm in May’s left eye was perfect. “And as long as he knows where the rail is,” Kaplan explained, “he won’t get pushed into it or jump it. The rest of the trip he can figure out for himself.”Just about anybody else would have given up on ever racing the colt then. Hersman, though, had bought the mare who carried Storm in May and used a technique called “imprint training” on the foal from birth. The training method stresses touching, stroking and constantly soothing the young horse right out of the womb to familiarize it with being handled and thus accelerate the learning curve.Hersman knew there was no recouping his investment at a yearling sale, no matter how good Storm in May’s bloodlines or temperament. So he sent the horse to an Ocala, Fla., training school run by John and Jill Stephens who, unbeknownst to Hersman, were already training a promising young colt named Barbaro. It was the first, but not the last time Storm in May followed in Barbaro’s footsteps.“As little omens go, we’ve got the same barn he had and Storm in May sleeps just two stalls over from Barbaro’s,” said Teresa Palmer, who along with husband, David, owns a half-share in the horse. “Then we found out about the training connection.”So did Kaplan, who called the Stephens’ with just one question: Was Storm in May that good?“Maybe not,” Kaplan recalled Stephens saying. “But he’ll get you there.”With that endorsement and a few workouts upon which to base his judgment, Kaplan forked over $16,000 for the 2-year-old horse, then phoned the Palmers on Derby Day a year ago to offer them a share. Kaplan told them he was keeping 25 percent and another 25 percent was held by his girlfriend and sometimes-exercise rider Felicity Waugh. He knew the Kaplans had a fondness for gray colts and touted the price. IN FIVE EASY PIECES WITH TAKE 5 LOUISVILLE, Ky. — Cover your right eye.Now imagine being loaded into a starting gate alongside the best thoroughbreds in the land. The gate flings open and just ahead and to either side, 19 other horses are jostling for position as the first turn draws near. Then add 100,000 or so railbirds in full roar, throwing off as many decibels as a jet engine on takeoff.