Key Gaps in Malaria and Emerging Infectious Disease Control

  • View
    216

  • Download
    0

Embed Size (px)

Text of Key Gaps in Malaria and Emerging Infectious Disease Control

  • Key Gaps in Malaria and Emerging Infectious Disease Control -

    Priorities for a Regional Response

    Dr Eva Christophel, in collaboration with relevant units and the SEAROWHO Regional Office for the Western Pacific, Manila, Philippines APLMA Regional Financing for Malaria Task Force (RFMTF), Hong Kong, May 12, 2014

    *

    Outline of PresentationBurden of major communicable diseases in the Region, key gaps

    Malaria: Threats to controlling and eliminating malaria in Asia Pacific, and opportunities.

    Priorities for a Regional Response

    *

    Malaria: 20 Endemic countries in WP and SEA Regions

    2012 (WMR 2013)SEARWPRAfghanistan,PakistanTotalEstimated # malaria cases26.8 mio (21.7-32.5)1.4 mio (1.2-1.7 mio)376,7683,485,36632.1 mioEstimated # malaria deaths 42 000(25 000-60 000)3 500(2 100 5 200) 26197047,496Population at risk (high and low transmission areas) 1.6 billion711 million16,030,688102,121,2632.4 billion

    *

    Tuberculosis: Distribution of Prevalent TB Patients, by Region

    Source: Global Tuberculosis Control 2013, WHO*

    2012 EstimatesSEARWPRTB Cases (all forms)3.4 mio1.6 mioTB Deaths450,000110,000Multi-drug resistant TB90,00074,000HIV-associated TB170,00024,000

    *

    Current diagnostic algorithms are not sensitive enough to detect TB patients early; TB concentrates among high-risk and socially vulnerable populations who are difficult to reach; Multi-drug resistant TB: only a small fraction of MDR-TB patients are diagnosed, ensuring treatment is also a challenge; High percentage of external funding, esp through the Global Fund. Donor investment is shrinking in the Region, which threatens sustainability of programmes. Tuberculosis: Challenges

    *

    Tuberculosis: Financial Gap WPRIn the WPR, national TB programmes report a funding gap of over USD 200 million per year.

    *

    Source: Prepared by www.aidsdatahub.org based on UNAIDS HIV Estimates 2012 for UNAIDS.(2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.HIV: Burden and Trends in Asia PacificHIV and AIDS in Asia Pacific 1990-2012

    Chart1

    4300006800025002100005100

    68000012000041002500008700

    930000190000680027000014000

    12000002800001100034000023000

    17000004100001700044000036000

    21000005600002500048000053000

    25000007000003600049000075000

    290000085000048000510000100000

    3300000100000063000520000130000

    3600000110000079000510000170000

    3900000120000096000490000210000

    41000001300000110000470000240000

    43000001400000130000450000270000

    44000001400000150000430000300000

    45000001500000160000410000320000

    45000001500000180000390000330000

    46000001500000190000370000330000

    46000001600000200000360000320000

    46000001600000200000350000310000

    47000001600000210000350000300000

    47000001600000210000350000290000

    48000001600000210000350000280000

    49000001700000210000350000270000

    People living with HIV (Estimate)

    Women living with HIV (Estimate)

    Children living with HIV (Estimate)

    New HIV infections (Estimate)

    AIDS-related deaths (Estimate)

    Number

    350,000

    Epi estimates

    HIV 2012 EstimatesYear

    People living with HIVNew HIV infectionsAIDS-related deathsWomen living with HIVChildren living with HIVNew Infections (0-14)AIDS orphansEligible for ART; Adults (15+) - (National criteria)Eligible for ART; Children (0-14) - (National criteria)Eligible for ART; Adults (15+) - (WHO 2010 Guidelines)Eligible for ART; Children (0-14) - (WHO 2010 Guidelines)Mothers needing PMTCTReceiving

    (Estimate)(Low estimate)(High estimate)(Estimate)(Estimate)(Estimate)(Estimate)EstimateLow estimateHigh estimateEstimateLow estimateHigh estimateEstimateLow estimateHigh estimateEstimateLow estimateHigh estimateEstimateLow estimateHigh estimateEstimateLow estimateHigh estimateEstimateLow estimateHigh estimate

    UNAIDS region - Asia and the Pacific1990430000340000120000021000051006800025001400=1 confirmed cases of H5N1 virus infection and additional confirmed or probable cases associated with a specific setting, with the onset of cases occurring within 2 weeks of each other (Aditama et al. 2011, based on WHO case definition).Household; extended family; Hospital; other residential institution; OtherDate when enhanced surveillance in area surrounding case initiatedDate when enhanced surveillance in area surrounding case terminatedOutcome/findings from enhanced surveillanceNo. close contacts identified and followedNo. close contacts that had or developed ILI/SARIBackground ILI/SARI levels from routine passive surveillance system (including hospital chart data, if available)Any surveillance intelligence from MOA re animal surveillance in area

    1Li>5987MretiredShanghaiShanghaiMinhang?N??N?N????19-Feb-13fever,cough??Ythe 5th people's hospital of Shanghai26-Feb-137Died (4-Mar)Pneumonia??Y4-Mar-13severe pneumonia???29-Mar-13culture?PossibleConfirmed30-Mar-1331-Mar-13EBSY/Aanother two family member(sons) got severe pneumonia at the same time, one died. The two cases are not dignosed.1-Apr-13??/880

    2Li>5969MShanghai19/Feb/1315/Apr/13PCR15/Apr/1317/Apr/13EY/A

    3Shi>5973MShanghai24/Feb/13Y3-Mar-1315/Apr/13PCR15/Apr/1317/Apr/13E

    4Wu15-3927MPork butcherShanghaiShanghaiMinhang?N?process and sell portN?NY???27-Feb-13fever,cough??Ythe 5th people's hospital of Shanghai4-Mar-135Died (10-Mar)Pneumonia??Y10-Mar-13severe pneumonia???29-Mar-13culture?PossibleConfirmed30-Mar-1331-Mar-13EBSN1-Apr-13??/880

    5Zhou??MShanghai3/Mar/1315/Apr/13PCR15/Apr/1317/Apr/13E

    6Miao>5963MShanghai5/Mar/13Y12-Mar-1315/Apr/13PCR15/Apr/1317/Apr/13E

    7Hong15-3938McookZhejianghangzhouJiande county??YTaicang,Suzhou,Jiangsu province????????7-Mar-13???Y? In Xiaoshan,Hangzhou18-Mar-1311Died (27-Mar)Pneumonia??Y27-Mar-13severe pneumonia??1-Apr-133-Apr-13PCR?PossibleConfirmed3-Apr-133/Apr/13EBSN1-Apr-13?1250

    8Zhang>5960MJiangsuWuxiYY8/Mar/13YWuxi people's hospital11/Mar/13Y4-May-1326/Apr/13isolatePossibleC27/Apr/1327/Apr/13

    9Jia40-5951FretiredZhejianghuzhouHuzhou,Zhejiang??????13-Mar-13???Ythe 1st hospital of Zhejiang22-Mar-139CriticalPneumoniaY19/Apr/13??8-Apr-138-Apr-13PCRPossibleConfirmed9-Apr-139-Apr-13EBS?1-Apr-13?0

    10Han15-3935FunemployedAnhuiChuzhouLangya,Chuzhou???YNY10-Mar-13?????15-Mar-13fever,cough??YZhongda Hospital,Nanjing20-Mar-135Died (9-Apr)Pneumonia??Y9-Apr-13severe pneumonia???29-Mar-13culture?PossibleConfirmed30-Mar-1331-Mar-13EBSN31-Mar-13??/880

    11Meng0-142MShanghai17/Mar/13feveroutpatientN18/Mar/1311/Apr/13Virus insolationILIConfirmed15/Apr/1317/Apr/13E

    12Sang40-5948Fpanel processingJiangsuSuqianShuyang,Suqian????N??????19-Mar-13fever,dizzy,cough??Y? In Nanjing30-Mar-1311Criticalpneumonia????29-Mar-132-Apr-13PCR?PossibleConfirmed2-Apr-133-Apr-13EBSN30-Mar-13?600

    13Xu40-5945FPoultry SlaughterJiangsuNanjingJiangning,NanjingTianjingshan NeighborhoodN?YNYAll time?????19-Mar-13fever,dizzy,muscle pain??YGulou Hospital,Nanjing27-Mar-138Criticalpneumonia??Y20-Sep-13??29-Mar-132-Apr-13PCR?PossibleConfirmed2-Apr-133-Apr-13EBSN30-Mar-13?490

    14Shen>5983MJiangsuSuzhouWujiang,Suzhou????N??????20-Mar-13fever,cough,Chest stufly,asthma,Chest pain??Y? In Wujiang29-Mar-139Died (9-Apr)pneumonia??Y9-Apr-13severe pneumonia??30-Mar-132-Apr-13PCR?PossibleConfirmed2-Apr-133-Apr-13EBSN30-Mar-13?150

    15Yin>5961FretiredJiangsuNanjingQinhuai,Nanjing????N??????20-Mar-13??Y? In Nanjing2-Apr-1313CriticalPneumonia????3-Apr-135-Apr-13PCR?PossibleConfirmed5-Apr-135-Apr-13EBSN30-Mar-13?120

    16Zhang15-3932FunemployedJiangsuWuxiBinhu,Wuxi????N??????21-Mar-13fever,cough??Y? In Wuxi28-Mar-137Criticalpneumonia??Y24-Apr-13??30-Mar-132-Apr-13PCR?PossibleConfirmed2-Apr-133-Apr-13EBSY/C30-Mar-13?430

    17Lu>5979MretiredJiangsuNanjingQinhuai,Nanjing????N??????21-Mar-13??Y? In Nanjing31-Mar-1310CriticalPneumonia??Y5-May-13??2-Apr-135-Apr-13PCR?PossibleConfirmed5-Apr-135-Apr-13EBSN30-Mar-13?530

    18Cao>5967FretiredShanghaiShanghai??N??N??????22-Mar-13sore throat, fever and coughoutpatient24-Mar-13YJingshan hospital27-Mar-135CriticalPneumonia??Y13-Apr-13Pneumonai??3-Apr-134-Apr-13PCR?PossibleConfirmed4-Apr-134-Apr-13EBSN1-Apr-13?30

    19Shen40-5959MretiredShanghaiShanghaiPudong,Shanghai(registration:Anhui)????N??????25-Mar-13recurrent fever, coughself medication through pharmacy25-Mar-13Ythe Pudong branch of Renji hospital4-Apr-1310CriticalPneumonia??Y31-May-13??6-Apr-136-Apr-13PCR?PossibleConfirmed7-Apr-137-Apr-13EBSN1-Apr-13?40

    20Yang>5967MretiredZhejianghangzhouHangzhou city???????????25-Mar-13fever,coughHospitalized25-Mar-13YThe first affiliated hospital of Zhejiang University25-Mar-130CriticalPneumonia????1-Apr-133-Apr-13PCR?PossibleConfirmed3-Apr-133/Apr/13EBSN1-Apr-13?580

    21Yu40-5952FretiredShanghaiShanghai??N??N??????27-Mar-13low feveroutpatient29-Mar-13YHuashan hospital2-Apr-136Died (3-Apr)Pneumonia??Y3-Apr-13severe pneumonia??3-Apr-134-Apr-13PCR?PossibleConfirmed4-Apr-134-Apr-13EBSY/B1-Apr-13?311

    22Li40-5955Mpoultry shaughter and saleAnhuibozhouQiaocheng district, Bozhou???YNYAll time?????28-Mar-13??Y? In Bozhou,Anhui1-Apr-134Stable??exacerbation??Y19/Apr/13??6-Apr-137-Apr-13PCR?PossibleConfirmed7-Apr-137-Apr-13EBSN31-Mar-13?120

    23Yu>5985MretiredJiangsuNanjingXiaguan district, Nanjing???????????28-Mar-13??YThe 2nd affiliated hospital of Nanjing Medical University5-Apr-138Critical???Y28-Apr-13???7-Apr-13PCR?PossibleConfirmed8-Apr-138-Apr-13EBS?30-Mar-13?340

    24Chu40-5948Mtransporting chickens and ducksShanghaiShanghaiRugao,Jiangsu(home)???Rugao,JiangsuY?Y?????28-Mar-13cough,expectorationPrivite clinic1-Apr-13YTongji Hospital3-Apr-136Died (3-Apr)Pneumonia??Y3-Apr-13severe pneumonia??3-Apr-134-Apr-13PCR?PossibleConfirmed4-Apr-134-Apr-13EBSN1-Apr-13?80

    25Zhou>5974MretiredShanghaiShanghai??Y??N??????28-M