Thursday March 5, 9:56 pm Eastern Time
By Maggie Fox, Health and Science Correspondent

USAID to focus on malaria, TB, new bugs

WASHINGTON, March 5 (Reuters) - The U.S. Agency for International Development (USAID) said on Thursday it would spend most of a $50 million budget windfall on malaria, tuberculosis and fighting drug-resistant "superbugs".

Better surveillance networks aimed at nipping epidemics ranging from measles to Ebola in the bud would be set up with the money, Nils Daulaire, senior health adviser at the agency, told reporters.

"We expect that the strategy will reduce infectious disease deaths around the world, excluding HIV/AIDS, by 10 percent over the next 10 years," Daulaire said.

Congress approved the $50 million for the agency last year. USAID officials gathered experts from around the world to ask how best to spend the money.

"We made a conscious decision that we were not going to run out and just throw money at a program," Daulaire said, adding that about $30 million of the $50 million had been targeted.

"We are certainly going to be focusing on malaria in Africa," Daulaire said. "Malaria is the main killer of children in Africa. We are also going to initiate some work in Latin America as well as Asia, where malaria is making a comeback."

Daulaire said the approach would be to keep things simple.

"We have found that there are certain clinical symptoms that local health workers can be trained to recognize," he said. Drug treatment was usually cheap and easy, he said.

The agency would also distribute insecticide-impregnated nets which kept mosquitoes at bay even if the nets had holes.

"Almost all bed nets have tiny little holes ripped in them," Daulaire said. "Because mosquitoes are so strongly attracted by the odor of blood they will find their way through the smallest hole or tear in a mosquito net."

As for tuberculosis, the agency hoped to start wide-scale programs in three to five countries but Daulaire said he could not give details as negotiations were still being held.

One possible approach was directly observed treatment (DOTS), in which trained health workers watch to make sure infected people take their drugs.

Surveillance could be improved by giving communities incentives. If local health workers reported an outbreak of polio, for example, vaccination teams could head there to show there was an immediate benefit from reporting.

"It certainly could have helped the Ebola outbreak in Zaire in 1995," Daulaire said. "Ebola had been slowly burning through Kikwit for, I think, five months before the world came to know about it."

With a better system, officials would have known of the outbreak months before and hundreds of lives would have been saved.

Education would be key to stopping the spread of drug-resistant bacteria, Daulaire said.

"Right now in most countries in the developing world you can walk up to any of millions of storefront pharmacies and point to an antibiotic and walk away with three of them," he said.

"That's responsible for a great deal of antimicrobial resistance because taking a little of the wrong antibiotic is the best way to encourage resistance in a bug."

Daulaire said Americans should be happy to have their tax dollars spent in this way.

"We think it is a very valuable down-payment both on the health of people around world and on the health of Americans themselves," he said. "This really is America's first line of defense."

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