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HEALTH & EDUCATION

Breakthrough Malaria Vaccine Offers to Reinvigorate the Fight Against the Disease

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The World Health Organization has announced a historic move: it has recommended the widespread use of the first ever malaria vaccine. The recommendation is based on the results of an ongoing pilot programme in Malawi, Ghana and Kenya. Malaria is a huge global health challenge, around 409,000 people died of malaria in 2019 alone. The WHO African region carries significant proportion of the malaria burden – 94% of all malaria cases and deaths occurred in the region. Children younger than five are the most vulnerable. Ina Skosana asked Eunice Anyango Owino to explain the development, and its significance.

It has taken 30 years. Why so long?

The most significant reason is that the malaria parasite is very complex. It has different stages; some in the mosquito and some in the human. Thus, scientists had to pursue a diversity of approaches.

For example, in the human there are two stages. These are the:

  • Pre-erythrocytic stages (sporozoite, or spore-like, stage). This is the period when the parasite’s sporozoite from a mosquito bite enters the blood stream and heads for the liver to mature and multiply after which they are then released.
  • The blood stage (Merozoite stage). This is when the parasite’s merozoites are released from the liver, and multiply in the red blood cells.

So an effective vaccine against the first stage (pre-erythroctic stage) would be one that elicits an immune response that would either prevent infection of the liver cells or lead to destruction of the infected liver cells.

An effective vaccine for the second stage (blood stage) would be the one that does one of three things: elicits immune responses that prevent infection of red blood cells; decreases the number of parasites in the blood; reduces the severity of the disease by allowing the body to develop a natural immunity with little risk of getting ill.

Another option was to develop transmission blocking vaccines. An effective transmission blocking vaccine would induce antibodies that would block maturation of malaria parasites in mosquitoes that feed on vaccinated individuals.

Another factor that contributed to the delay is that scientists working on malaria vaccines in the early stages lacked an understanding of the specific immune responses associated with protection against the parasite.

Also, malaria parasites – such as Plasmodium falciparum – display a variety of antigens on their surfaces that help them escape the immune system and also render vaccines based on specific antigens less effective.

Can you tell us more about the vaccine?

The vaccine RTS,S, trade name Mosquirx, is given in four doses to children between the ages of 5 months and 17 months; the first 3 doses are given monthly with the first at 5 months and the third at 9 months. The fourth, which is a booster dose, is given at between 15 and 18 months.

The efficacy is about 40% against malaria cases and 30% against severe malaria.

No two vaccines or diseases are comparable. The WHO has set an efficacy level of 50% and above for most vaccines and most highly efficacious vaccines offer 75 % and above level of protection. For example, the COVID-19 vaccines based on messenger (m)RNA technology by Pfizer and Moderna offer well above 90% protection level.

The RTS,S vaccine targets the parasites before they infect liver cells; it targets the circumsprorozoite protein on P.falciparum sporozoites surface and is thus considered a pre-erythrocytic vaccine.

What are the next steps?

First, the WHO and the manufacturers of the vaccine GlaxoSmithKline will be rallying countries, particularly those with high malaria burdens, to adopt the vaccine as part of their National Malaria Control Strategies.

They will also be asking these countries to set aside funds.

They will also be involved in fundraising from the global health community or work with partners, for a broader roll out of the vaccine.

There should be equitable and long term access to the vaccine. The vaccine should also be cost effective.

The hope is that the WHO announcement will re-energise the race to find even more efficient vaccines against malaria. Current reports by the Jenner Institute of Oxford University suggest that a malaria vaccine that might meet the WHO goal of 75% is under trial in Burkina Faso.

What does this mean for malaria control in Africa?

The vaccine is an additional tool to the malaria control tool kit.

The vaccine does not provide complete protection. And will be introduced as part of a tool kit geared to reducing malaria infections and reducing fatalities. Other measures include bed nets and indoor residual spraying.

Nevertheless the vaccine has a great potential to reduce death and illness in high burden areas in sub-Saharan Africa especially if used in combination with pre-existing malaria prevention methods. For example a study by the London School of Tropical Medicine reported a 70% reduction in hospitalisations and death in children given the Mosquirx vaccine plus antimalarial drugs.

Malaria control had been stagnating in some African countries, with countries like Sudan and Eritrea seeing a significant resurgence in the recent past.

The vaccine will reinvigorate the fight against malaria. And it offers the promise of bringing it back on track.


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EDITORIAL

Islamic Finance Shaping the Future: A Reflection on the International Summit on Financing Primary Healthcare Infrastructure in Nigeria

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On November 30th, 2023, the International Summit on Financing Primary Healthcare Infrastructure in Nigeria took center stage in Abuja, bringing together global leaders, financial experts, and healthcare professionals to deliberate on a critical theme: “Islamic Finance: Exploring New Sources of Financing for Primary Healthcare Transformation in Nigeria.” This landmark event, which was organized by DUKE Consult Limited in strategic collaboration with the Africa Islamic Economic Foundation, Ghana and Glocal Healthcare Systems Ltd, India, marked a significant step towards addressing the healthcare infrastructure challenges in Nigeria through innovative and sustainable financing mechanisms.

The Urgency of Healthcare Infrastructure Transformation

Nigeria, like many other developing nations, faces substantial challenges in its healthcare infrastructure. The need for adequate facilities, skilled healthcare professionals, and sustainable funding mechanisms has become increasingly urgent, especially in the wake of global health crises. The summit recognized that achieving robust primary healthcare infrastructure is pivotal to ensuring the well-being of the population and addressing health disparities.

Islamic Finance as a Catalyst for Change

The choice of Islamic finance as the central theme reflects a strategic move towards diversifying sources of funding for healthcare infrastructure. Islamic finance principles, rooted in ethical and equitable financial practices, provide an alternative framework for generating funds. By exploring these principles, Nigeria aims to tap into new avenues that align with its cultural values while fostering inclusive economic development.

Key Discussions and Agreements

The summit facilitated in-depth discussions on the potential of Islamic finance to transform Nigeria’s primary healthcare infrastructure. Attendees deliberated on the principles of Islamic finance, such as risk-sharing, profit and loss sharing, and ethical investment, as tools for shaping a more sustainable healthcare future.

One of the primary outcomes was the establishment of collaborative initiatives between the public and private sectors, leveraging Islamic finance instruments to fund healthcare projects. The summit also saw the formation of partnerships with international organizations and financial institutions, showcasing a commitment to shared responsibility in addressing Nigeria’s healthcare challenges.

Emphasizing Inclusivity and Cultural Sensitivity

An essential aspect of the summit was the emphasis on inclusivity and cultural sensitivity in healthcare financing. Recognizing that Islamic finance aligns with Nigeria’s cultural and religious values, the summit underscored the importance of tailoring financial mechanisms to the specific needs and beliefs of the population. This approach ensures that healthcare development is not only economically sustainable but also culturally resonant, promoting widespread acceptance and participation.

Looking Forward          

The International Summit on Financing Primary Healthcare Infrastructure in Nigeria has set a precedent for innovative and inclusive approaches to addressing healthcare challenges. As Nigeria strives to achieve its healthcare transformation goals, the incorporation of Islamic finance principles serves as a beacon for other nations facing similar challenges.

In conclusion, the summit marked a pivotal moment in Nigeria’s journey towards sustainable healthcare development. By exploring new sources of financing rooted in ethical principles, the country is forging a path towards a healthier, more resilient future. As the initiatives launched at the summit unfold, they have the potential not only to transform healthcare infrastructure but also to serve as a model for other nations seeking innovative financing solutions in the pursuit of universal health coverage.


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HEALTH & EDUCATION

Highlights of the One Day International Summit on Financing Primary Healthcare Infrastructure in Nigeria

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By our special correspondent

A one-day international Summit on Financing Primary Healthcare Infrastructure in Nigeria under the theme: Islamic Finance: Exploring New Sources Of Financing For Primary Healthcare Transformation in Nigeria was held in Abuja, the Capital of the Federal Republic of Nigeria on the 30th of November, 2023, at the NICON Luxury Hotel, under the distinguished Chairmanship of His Excellency, Senator Ibrahim Shekarau, former Executive Governor of Kano State.

The groundbreaking event, which was organized by DUKE Logistics & Consult (Nigeria) Limited, Abuja, in strategic collaboration with the Africa Islamic Economic Foundation, Ghana and Glocal Healthcare Services Limited, India, was held to explore innovative healthcare financing models that leverage Islamic finance instruments such as sukuk (Islamic bonds), waqf (endowments), and takaful (Islamic insurance), etc. in providing sustainable and long-term financing for primary healthcare transformation in Nigeria; and to foster collaboration between the various states of the federation to share best practices and experiences in leveraging Islamic finance for healthcare projects.

The summit featured keynote speeches and discussions on various topics related to Islamic finance, healthcare infrastructure development and digital health solutions: The role of Islamic Finance in healthcare Infrastructure Development in Nigeria, by Prof. Ahmad bello Dogarawa of the Ahmadu Bello University, Zaria; Digital Health Solutions Innovation: The Glocal Story, by Mr Shailesh Kumar, of the Glocal Healthcare Systems Limited, India; Digital Health Transformation: Opportunities & Challenges, by Hon Dr Abdel Majeed Haroun, former Minister of Agriculture, Republic of Ghana; Africa Healthcare Infrastructure Program (AHIDEP), by Hajiya Aishatu Usman Muhammad of the Gombe State University, Gombe, The foregoing presentations were supported with expert and insightful discussions by Dr Aisha Ahmed, an Islamic Finance expert and consultant, Abuja and Mr. Muhammad Lawal Shu’aibu, CEO, LCM Consult Limited Abuja.

One of the key discussions revolved around the role of Islamic Finance in healthcare infrastructure development in Nigeria. Participants delved into the potential of Islamic Finance to provide sustainable funding for the construction and maintenance of healthcare facilities. This topic explored innovative financing models that align with the principles of Islamic Finance, such as waqf (endowment) and sukuk (Islamic bonds).

Another captivating topic discussed at the summit was “Digital Health Solutions Innovation: The Glocal Story.” The term “Glocal” refers to the combination of global and local perspectives. The Summit focused on the Glocal Story, which highlighted its cutting-edge digital health solutions that bridge the gap between global advancements and local healthcare needs. Experts shared success stories, case studies, and best practices, showcasing how technology can revolutionize healthcare delivery in Nigeria by improving access, affordability, and quality of care.

Furthermore, the summit covered the topic of “Digital Health Transformation: Opportunities and Challenges.” This presentation highlighted the importance of adapting digital health solutions to the specific needs and contexts of Nigeria. It addressed how these innovations can improve healthcare accessibility, efficiency, and quality, particularly in underserved areas. Participants explored the potential benefits and challenges associated with digital health transformation in Nigeria. They examined how technological advancements, such as telemedicine, electronic health records, and artificial intelligence, can revolutionize healthcare delivery and management in the country.

The presentation of the Africa Healthcare Infrastructure Development Program, the flagship initiative of the Africa Islamic Economic Foundation, offered participants a glimpse of the functions of the Program. The presentation shows that AHIDEP is a great platform to connect with international organizations and investors who are interested in supporting healthcare initiatives in Nigeria. However, to showcase the importance and potential of a healthcare project to potential investors, potential beneficiaries would have to prepare a comprehensive proposal outlining their healthcare infrastructure development goals, strategies, and the potential impact.

The discussions also touched upon the importance of involving stakeholders and ensuring efficient management of healthcare infrastructure projects. Furthermore, the discussions elucidated in detail how Islamic finance can support the innovation and implementation of digital health solutions tailored to the Nigerian context. The conversation revolved around leveraging technologies like telemedicine, mobile health applications, and electronic health records to enhance access to healthcare services, especially in remote areas. The importance of collaborations between local and international stakeholders for effective digital health transformation was also emphasized.

Overall, this one-day event, the international summit on financing primary healthcare infrastructure in Nigeria provided a platform for experts, policymakers, and stakeholders to discuss strategies and explore new sources of financing for primary healthcare transformation in Nigeria. It showcased the potential of Islamic Finance as a viable option and emphasized the importance of digital health solutions in shaping the future of healthcare in the country.


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HEALTH & EDUCATION

Investments in Digital Can Accelerate Improvements in Health Care

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Digital technology can strengthen health systems, improve health financing and public health, and increase reach to underserved populations, according to a new World Bank report launched today. The report also finds that digital technology and data are especially helpful to prevent and manage chronic diseases, care for both young and aging populations, and prepare for future health emergencies and health risks triggered by climate change.

The report, Digital-in-Health: Unlocking the Value for Everyone, was launched today during the G20 Health Ministers Meeting in Gandhinagar, India. It presents a new way of thinking from simple digitization of health data to fully integrating digital technology in health systems: Digital-in-health. This means, for example, infusing digital technologies in health financing, service delivery, diagnostics, medical education, pandemic preparedness, climate and health efforts, nutrition, and aging.

The report also underscores that the successful use of digital technologies must be inclusive of all population groups, and ensure access to digital infrastructure, modern technologies, and skills, especially for vulnerable people.

Designed with people at the center, digital technology can make health services more personal, prevent healthcare costs from increasing, reduce differences in care, and make the job easier for those who provide health services,” said Mamta Murthi, Vice President for Human Development, World Bank. “We hope that this report will give governments confidence and practical guidance, regardless of the country’s stage of digital maturity or fiscal challenges.

Improving health is getting harder, not easier. Health systems face serious and growing challenges and policy decisions are too often not based on reliable data.  It is estimated that some countries use less than 5% of health data to improve health which means that decisions are not based on data or data is not used effectively to make improvements. Within challenging fiscal environments, people-centered and evidence-based digital investments can help governments save up to 15% of health costs. The report presents pragmatic, low-cost actions to improve digital-in-health, no matter the maturity of a country’s systems or digital infrastructure. For example, better health data governance and standards to ensure systems can readily connect and exchange information are not costly but will be game changing in reducing siloed digital solutions and fragmentation.

In India, we have shown that digital innovations such as tele-consultations have reached more than 140 million people and provided accessible, affordable and efficient healthcare for everyone,” said Mansukh L Mandaviya, Minister for Health and Family Welfare, India. “We believe a digital-in-health approach can unlock the value of digital technologies and data and has the potential to prevent disease and lower healthcare costs while helping patients monitor and manage chronic conditions.” 

To help countries embrace a digital-in-health approach, the report proposes three essential areas to guide investments:

  1. Prioritize evidence-based digital investments that tackle the biggest problems and focus on the needs of patients and providers.
  2. Connect the regulatory, governance, information, and infrastructure dots so that patients know that data is safe and health workers can use digital solutions transparently.
  3. Scale digital health for the long run based on trust with sustainable financing, and improved capacity and skills for digital solutions.

It will take global, regional, and country leadership to make digital-in-health a reality. The report recommends strong country leadership involving all relevant sectors and stakeholders, including civil society. Digital technology and data improvements will involve investments beyond the health sector and new partnerships with the private sector. A digital-in-health mindset needs to be a routine aspect of annual health system planning, budgeting, and implementation.

The World Bank is committed to helping low-and middle-income countries to make digital-in-health a reality to improve health for everyone. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems, and infrastructure.


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