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Apr 28
Instead Of Fighting Breast Cancer, Immune Cell Promotes Its Spread
Researchers at the UC San Diego School of Medicine and the Moores UCSD Cancer Center have new evidence that a type of immune system cell thought to be part of the first line of defense against breast cancer may also help promote its spread. They have found that when these cells, known as lymphocytes, make an inflammatory protein called RANKL (RANK ligand), breast cancer is more likely to spread to the lungs.

They have also shown that blocking a cascade of cellular signals that follow RANKL's docking to its receptor (RANK) on tumor cells can halt cancer progression, or metastasis, and may be a possible target for drug therapy.

The scientists, led by first author Wei Tan, PhD, a postdoctoral fellow in the Department of Pharmacology at the UC San Diego School of Medicine and Michael Karin, PhD, professor of pharmacology in UCSD's Laboratory of Gene Regulation and Signal Transduction, say that the findings establish RANKL as a potential marker that can be used to help determine breast cancer prognosis and adds further proof to the potentially important role of inflammation in cancer development and spread. They reported their findings April 22, 2009 at the AACR 100th Annual Meeting 2009 in Denver.

According to Tan, the role of lymphocytes in breast cancer progression has been controversial for the last 20 years. Such cells are supposed to detect and eliminate cancer cells, but paradoxically, the infiltration of lymphocytes such as B cells and T cells into breast cancer is sometimes an indicator of poor prognosis, including cancer recurrence and metastasis. RANKL has been shown in previous studies to be an important inflammatory protein that can lead to bone loss by activating cells that help break down bone. Along with another protein, IKK alpha, it has been implicated both in tumor formation and metastasis.

The researchers created two types of mice that developed breast tumors. One group had lymphocytes in the tumors and expressed RANKL while the other group did not. They found that the group lacking RANKL had significantly fewer lung metastases than those mice with RANKL. They then took tumor cells from both types of mice and injected them into mice with the same genetic background to avoid rejection and monitored the ability of the mice to form tumors and metastases to the lung.

The researchers didn't find any lung tumor metastases in mice without lymphocytes. Yet, when RANKL was injected into the animals, the same potential for the cancer to spread was restored, indicating that the lymphocytes, which make RANKL, are critically important to the process.

"Without lymphocytes, there is no metastasis," said Tan. "If we treat the mice with RANK ligand, there are metastases, which indicate that RANK ligand can compensate for the function of lymphocytes."

The study establishes the role of RANKL-expressing lymphocytes as a promoting factor in breast cancer metastasis and provides a potentially good marker for breast cancer prognosis, the researchers said.

Tan noted that additional experiments showed that blocking both RANKL and IKK alpha in those breast tumor cells inhibited lung metastases. "More importantly," he said, "blocking the signaling pathway downstream of RANKL blocks primary metastasis and can potentially be developed as a treatment strategy."

Results such as these are helping to change the thinking about inflammation and cancer. "In general, we used to think that inflammation in the immune response is a part of the host defense against the tumor, but now we think that there are different kinds of inflammation," Tan said. "For example, T-helper cells can activate an anticancer response, but can also promote a separate tumor promoting response. In this study, if we target the host pro-tumor inflammation and immune response, we can also reduce tumor metastasis and are very likely to develop a therapy that is more effective."

Apr 28
Oral Care Key To Successful Organ Transplants
Study after study point to the connection between oral health and a person's general well-being. However, for thousands of Americans waiting for an organ transplant each year, maintaining good oral health, free of infection, is critical for successful organ transplantation and requires specialized dental care. In light of Organ Donor Awareness Month this April, the University of Southern California School of Dentistry is raising awareness about the importance of oral health for both organ donors and recipients.

According to the National Institutes of Health, more than 25,000 procedures are performed in the United States each year to replace organs, including the heart, kidneys, liver, intestines, and the pancreas. Transplant patients are prescribed numerous medications to prepare them physically and emotionally. "Transplant patients are being given the gift of life, but with it comes a lifetime of taking medications before and after the transplant that can create a host of other complications," said Dr. Hessam Nowzari, director of the School's Advanced Periodontics program.

Immunosuppressants such as cyclosporine, prednisone and azathioprine, are anti-rejection drugs intended to reduce the likelihood of transplant failure. Such drugs also can suppress the formation of saliva, in turn creating a dry mouth, the perfect breeding ground for infection."Our research has shown that active viral infection is frequently associated with severe clinical complications including transplant failure." said Nowzari. "Stress, immunosuppressant- or immune-dysfunction may trigger viral activation, causing damage to the organ."He added that the human cytomegalovirus (HCMV) infection is specifically associated with renal transplant failure.

Organ failure does not discriminate when it comes to age and ethnicity. Yet, children face a very different set of issues than adults who are transplant recipients. At Childrens Hospital Los Angeles, a team of doctors and dentists face the responsibility of caring for critically ill children. For the team, addressing oral health concerns is vital when working to save the life of a sick child. "We've treated children as young as six months old who have been diagnosed with congenital heart disease or have been affected by severe kidney or liver diseases and are now preparing to receive an organ transplant," said JosÈ Polido, a USC School of Dentistry faculty member who also heads the Division of Dentistry at Childrens Hospital.

Systemic problems can affect the development of the teeth. Depending on the age of the child, such problems can damage the primary teeth, permanent teeth, or portions of those permanent teeth. Polido said both baby teeth and permanent teeth can develop problems such as generalized enamel hypoplasia and hypomineralization - poor formation and mineralization of the enamel. "When we see these children in the hospital they have poorly formed teeth with a high incidence of caries and infection and now they are preparing to receive a transplant," Polido said. He added that after the transplants, they have to take anti-rejection medications that further compromise their immune systems and increase susceptibility to infections, which can include oral yeast infection (thrush), herpes and various aggressive types of bacteria. Periodontal disease, though more common in adults, can be quite severe in immunocompromised children.

When treating adults, dentists concentrate on halting the progression of gum disease. For children, the treatment plan may have to take on a more aggressive approach that can involve removing baby teeth to control the spread of the infection and prevent damage to the permanent teeth. Ultimately, prevention holds the key to a successful transplantation. Attention must be given to preventing infection in the mouth similarly to treating a sore or an ear or nail infection. Parents need daily vigilance with their children's habits and with identifying oral health providers for their children. A parent of a "medically compromised" child can stem the damage to oral health by following these steps:

- Provide your child with healthy food choices and curb the intake of sugary foods
- Refrain from offering children candy because you feel guilty and want to pamper or please your child.
- Make sure children are brushing twice a day and flossing if old enough
- Talk to health-care professionals regularly
- Always consult members of the transplant team before seeking dental treatment
- Ask for credentials when selecting a dentist
- Seek out dentists who specialize in periodontology, pediatric dentistry and compromised children with experience in hospital dentistry.

Good oral health must become part of a person's daily routine in order to ensure overall health whether you're a child or adult. For those waiting for a second chance at life--oral care is key to successful organ transplant.

Apr 28
Three Hidden Health Dangers In The Home
People are continually on the lookout for ways to safeguard their family's health at home. However, some of the most likely sources of danger may not be the first that come to mind. The National Pest Management Association (NPMA) warns that rodents, cockroaches and stinging insects pose serious, but often hidden, health risks when they infest a home.

"Many people think pests are just an annoyance and often forget that there are real health dangers associated with the presence of these pests in and around the home," says Greg Baumann, senior scientist for NPMA. "People don't think of asthma, Salmonella, or severe allergic reactions, which is why infestations should not be taken lightly."

Rodents bring other pests including fleas, mites, ticks and lice indoors and contaminate food with feces that can transmit Salmonella and Hantavirus. Cockroaches spread 33 kinds of bacteria, six parasitic worms and more than seven other types of human pathogens. More, cockroach droppings and shed skins lead to allergen accumulation that can trigger asthma attacks, especially in children. Nearly $1B is spent on professional cockroach management services in the U.S. each year, making them one of the most prevalent and hazardous pests.

Stinging insects, including wasps and hornets send more than half a million people to the emergency room every year. And according to the Center for Disease Control, West Nile virus, a disease spread by mosquitoes, resulted in more than 1,300 human cases and 43 fatalities in 2008.

NPMA offers these tips to keep pests from becoming a hidden danger at home:

- Mosquitoes breed in stagnant water. Eliminate standing water and sources of moisture in or around the home, in flowerpots, pool covers and other objects that collect water.

- Keep food and garbage in sealed containers.

- Seal cracks and holes in your home's exterior and patch ripped screens.

- If you see signs of a pest infestation, contact a licensed pest professional.

Apr 28
Vermont Authorities Ask People To Look Out For Swine Flu Signs And Symptoms
The Vermont Department of Health is alerting the state's health care providers, schools and partners and stepping up its public health surveillance efforts as part of the national response to an international outbreak of a novel strain of swine influenza in humans.

While no cases have been identified yet in Vermont, the Centers for Disease Control and Prevention (CDC) has to date reported 20 confirmed cases of swine flu in the United States, including eight cases in New York City. Hundreds of cases have been reported in Mexico.

In the U.S., illness has been relatively mild so far compared to the severe illness reported in Mexico. Vermonters are being advised to stay tuned, and take the following precautions:

* Wash your hands often and well.
* Use alcohol-based hand wipes and gel sanitizers if soap and water are not available.
* Cover your mouth and nose when coughing or sneezing.
* Cough or sneeze into a tissue and then throw it away.
* Stay home from work or school and away from others if you are sick.
* If you need medical attention, call your health care provider first.

"Vermont is ready to respond in the event of a more widespread outbreak and we are in close contact with CDC and public health officials nationwide and in the New England states," said Vermont Department of Health Commissioner Wendy Davis, MD. "We are receiving frequent updates from the CDC and will advise Vermonters if any additional steps are necessary beyond the usual precautions they should take to avoid becoming ill from the regular flu season.

" Swine flu viruses do not normally infect humans (12 cases in the previous four years). CDC has notified state health departments nationwide to look for signs and symptoms of the respiratory disease, and to consider testing patients who have flu-like illness, especially if they have traveled to Mexico or elsewhere in North America where cases have been confirmed.

Symptoms of swine flu are similar to seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea. Like seasonal flu, swine flu may cause a worsening of underlying medical conditions.

You cannot get swine flu from eating pork or pork products. No special precautions are recommended for anyone who owns a pig or is routinely exposed to the animals.

"Vermont's plan to respond to a more widespread outbreak of influenza will involve multiple state agencies and the entire Vermont health care community," Dr. Davis said. "We are counting on all Vermonters to take all the commonsense precautions to stop germs from spreading, and stay tuned to keep informed."

Apr 28
As Swine Flu Toll Rises In Mexico, The Rest Of The World Gets Ready
As the number of cases and deaths from swine flu go up in Mexico, and the US, Canada and other countries also report cases of the disease, but so far no deaths, other countries begin to take measures to contain the outbreak amid fears that this could be the start of a new global flu pandemic.

According to El Norte, a leading daily Mexican newspaper, the Mexican government's latest announcement is that 103 have died of flu, which the authorities suspect was swine flu, but this has not yet been confirmed through lab tests. According to other media reports, 20 of the deaths so far have been confirmed as swine flu.

Mexico's health minister, José Angel Córdova told Televisa network on Sunday evening that the suspected death toll had gone up from 81 on Saturday, and suspected cases of swine flu has gone up to 1,600, with about 1,000 of those people now recovered and released from hospital.

Córdova said the government has declared a state of "sanitary alert". In Mexico City and some states the authorities have closed schools and day care centres. Businesses are still open but employers have been asked to be sympathetic about absences and latecomers because people will struggle with childcare.

Hundreds of public events were cancelled in Mexico City on Sunday: two First Division football matches played to empty stadiums, church services were suspended, and many entertainment and culture events were cancelled. Restaurants in the city are being asked to shut early and limit customers to 50.

People have started using surgical masks, many of which are being handed out by government officials. Mexico City Mayor Marcelo Ebrard said they would shut down the metro if cases continue to rise: it transports about 4 million people a day, said the Washington Post.

On Sunday, the US government declared a state of public emergency after reporting 20 laboratory confirmed human cases of swine influenza A/H1N1. 8 of them in New York, 7 in California, 2 in Texas, 2 in Kansas and 1 in Ohio.

Acting head of the US Centers for Disease Control, Richard Besser, said that while the virus appeared to be the same strain as that infecting people in Mexico, the effect has been milder, reported the Financial Times. All 20 people had mild flu-like symptoms and only 1 of them had to be kept in hospital.

According to the World Health Organization (WHO), preliminary lab tests on the 20 cases found that the viruses had the same genetic pattern, and the virus is being described as a new subtype of A/H1N1 not previously seen in pigs or humans.

The New York Times reported that Secretary for Homeland Security Janet Napolitano told a news conference in Washington on Sunday that the emergency declaration was a standard measure to make sure that funds can be released and emergency measures taken without delay. She likened it to getting ready incase a hurrican strikes, but hopefully it will not.

There are also reports of confirmed cases in Canada, and suspected cases in New Zealand, Spain and Israel. No deaths have been reported outside Mexico, and most of the patients have made a full recovery.

The WHO Emergency Committee, which was formed in 2005, met on Saturday for the first time to discuss the outbreak. Under the advice of the Committee, the Director General urged all countries to " intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia".

The WHO Emergency Committee said that based on the evidence so far, the "current situation constitutes a public health emergency of international concern", although there are still many unanswered questions.

According to the Financial Times, Dr Keiji Fukuda, the WHO's assistant director-general for health security, said the committee will be reviewing the situation again on Tuesday, and will then decide whether to raise the current pandemic alert phase from 3 to 4. It has been at phase 3 for some years, but in response to a different virus, the much deadlier H5N1 Avian flu virus.

Under the WHO pandemic flu phase system, phase 3 means "an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people", but human to human transmission has not led to sustained community outbreaks. After that is phase 4, which indicates sustained human to human community level transmission, phase 5 means it has spread to sustained level in at least one other country in the WHO region and the world should prepared for global pandemic, and phase 6 is global pandemic is under way.

A BBC News report earlier this morning said that health officials are warning that the UK should expect to see cases of swine flu. Two people are still undergoing tests in Lanarkshire after they came back from Mexico with flu-like symptoms.

Health Protection Agency Chief Executive Justin McCracken told the BBC that because of the way the strain is spreading across America, it was sensible to prepare for it in the UK as well.

"We are already mobilising things in the UK in case the virus comes over here. I definitely think we have enough of the drugs," said McCracken, adding that he did not think at this stage it was necessary to declare a state of emergency.

The UK and France are rated by the WHO as the two countries that are best prepared for an outbreak, said the BBC report.

Health Secretary Alan Johnson said the UK has a stockpile of flu drugs ready. The drugs, believed to be mostly Tamiflu, deal with the virus very effectively, he said, because "we know from Mexico".

Also, as soon as the strain is confirmed, then the UK government can set in motion pre-existing arrangements to make vaccines, he added.

The Foreign and Commonwealth Office is not currently advising people against travelling to affected areas of Mexico and the US, said the BBC.

By declaring a state of emergency in the US, the government can now release a quarter of the national stockpile of 50 million courses of anti-flu medication, and also allow some unapproved tests and drugs to be given to children, said the New York Times.

In Hong Kong, where memories of the SARS outbreak are still strong, the government has implemented much stricter measures. Travellers have been told to avoid Mexico and anyone arriving with a high temperature who has been to any city with a confirmed case is being detained and sent to hospital for testing. They are only released if the test is negative.

According to the Associated Press, passengers coming off planes at Narita International Airport near Tokyo, Japan, are being scanned by thermographic devices that can detect a person's temperature from a few feet away.

Many other Asian countries are also using thermal scanners to screen out passengers with high temperatures, said a Reuters AlertNet report early this morning.

Although there is no evidence that swine flu can be caught from pig products, Russia has banned meat imports from Mexico and other Latin American countries, as well as several states in the US; while Thailand has banned all pork imports from the US and Mexico, reported the Washington Post.

Apr 25
Vitamin D Levels Linked To Asthma Severity
New research provides evidence for a link between vitamin D insufficiency and asthma severity.

Serum levels of vitamin D in more than 600 Costa Rican children were inversely linked to several indicators of allergy and asthma severity, including hospitalizations for asthma, use of inhaled steroids and total IgE levels, according to a study that will appear in the first issue for May of the American Journal of Respiratory and Critical Care Medicine.

While previous in vitro studies have suggested that vitamin D may affect how airway cells respond to treatment with inhaled steroids, this is the first in vivo study of vitamin D and disease severity in children with asthma.

Juan Celedón, M.D., Dr. P.H. and Augusto Litonjua, M.D., M.P.H. of Harvard Medical School and colleagues recruited 616 children with asthma living in the Central Valley of Costa Rica, a country known to have a high prevalence of asthma. Each child was assessed for allergic markers, including both allergen-specific and general sensitivity tests, and assessed for lung function and circulating vitamin D levels. Children whose forced expiratory volume in one second (FEV1) exceeded 65 percent of the predicted value were also tested for airway reactivity.

They found that children with lower vitamin D levels were significantly more likely to have been hospitalized for asthma in the previous year, tended to have airways with increased hyperreactivity and were likely to have used more inhaled corticosteroids, all signifying higher asthma severity. These children were also significantly more likely to have several markers of allergy, including dust-mite sensitivity.

"To our knowledge this is the first study to demonstrate an inverse association between circulating levels of vitamin D and markers of asthma severity and allergy," wrote Drs. Celedón and Litonjua "While it is difficult to establish causation in a cross-sectional study such as this, the results were robust even after controlling for markers of baseline asthma severity."

"This study suggests that there may be added health benefits to vitamin D supplementation" said Dr. Celedón. Current recommendations for optimal vitamin D levels geared toward preserving bone health, such as preventing rickets in children and osteoporosis in adults.

"This study also provides epidemiological support for a growing body of in vitroevidence that vitamin D insufficiency may worsen asthma severity, and we suspect that giving vitamin D supplements to asthma patients who are deficient may help with their asthma control" wrote Drs. Celedón and Litonjua, noting that a clinical trial should be the next step in this research. "Whether vitamin D supplementation can prevent the development of asthma in very young children is a separate question, which will be answered by clinical trials that are getting under way," he said.

A complication is that vitamin D, unlike most other nutrients, is primarily synthesized in the body rather than consumed. Because about 90 percent of circulating vitamin D is produced by the body in response to sun exposure, deficiency is often related to behavioral issues rather than an inadequate dietary intake. Increased time spent indoors, increased use of sunscreen and sun-protective clothing all lead to decreased levels of vitamin D. Dietary sources of vitamin D, primarily fortified foods and fatty fish or fish oils, and vitamin D in current multivitamin preparations are unlikely to make up the deficiency.

Apr 25
Natural Protein May Halt Colorectal Cancer's Spread
Medical College of Wisconsin Cancer Center researchers in Milwaukee have learned that a protein, CXCL12, that normally controls intestinal cell movement, has the potential to halt colorectal cancer spreading. These studies represent a potential mechanism by which CXL12 may slow cancer spreading. Controlling this process could lead to new biological therapies for colorectal cancers.

"Colorectal cancer ranks third in cancer-related deaths in the United States in 2008," says principal investigator Michael Dwinell, Ph.D., professor of microbiology and molecular genetics. "Finding therapies to prevent its spread to secondary organs would increase patient prognosis considerably." Luke Drury, a graduate student in the interdisciplinary program for biomedical research at the Medical College, was his research associate. Their abstract will be presented at the American Association for Cancer Research meeting in Denver, April 21.

Normal intestinal cells stick to underlying proteins, which provide survival signals to maintain cell health. If they become unstuck, the floating cells undergo a programmed cell death. In cancer, cells have acquired genetic changes that allow them to survive during loss of attachment. Previously, the researchers found that colorectal cancer cells lacked CXCL12 expression. In these studies, they re-introduced CXCL12 expression in colorectal cancer cells which prevented their ability to adhere to underlying proteins. Plus, the floating cells underwent programmed cell death.

Apr 25
Study Finds Blood Cells Can Be Reprogrammed To Act As Embryonic Stem Cells
In a recent study, U.S. researchers have reprogrammed cells found in circulating blood into cells that are molecularly and functionally indistinguishable from embryonic stem cells, a revolutionary achievement that provides a readily accessible source of stem cells and an alternative to harvesting embryonic stem cells. The findings were prepublished online in Blood, the official journal of the American Society of Hematology.

Embryonic stem cells have long been coveted for their potential to treat a multitude of diseases as a result of their unique properties of nearly indefinite self-renewal and pluripotency (the ability to develop into any type of cell in the body), but their use has been the subject of political controversy.

"Our findings provide the first proof that cells from human blood can morph into stem cells," said senior study author George Q. Daley, M.D., Ph.D., an investigator for the Howard Hughes Medical Institute at Children's Hospital, Boston. "Making pluripotent stem cells from blood, which is one of the easiest tissues to obtain, provides an easy strategy for generating patient-specific stem cells that are valuable research tools and may one day be used to treat a number of diseases."

To generate induced pluripotent stem cells (dubbed iPS cells), blood was collected from a 26-year-old male donor. From the blood sample, the researchers isolated CD34+ cells, a type of stem cell that produces only blood cells, and cultured them in growth factors for six days to increase their number.

During the culture, the scientists infected the CD34+ cells with viruses carrying reprogramming factors, genes normally expressed in embryonic stem cells that can reset the blood cells to an embryonic state. Colonies of cells exhibiting physical characteristics similar to embryonic stem (ES) cells appeared about two weeks after the procedure. To determine whether these cells were also functionally similar to ES cells, the scientists analyzed the CD34+ iPS cell lines to see if they had acquired stem cell "markers," the unique combination of proteins that coat the cells' surface and distinguish them from other types of cells. Indeed, the iPS cell lines expressed the same markers as ES cells and further shared the capacity to differentiate into a variety of specialized cell types.

In vitro, the iPS cells readily developed into clusters of cells called embryoid bodies from which cells of virtually any type can develop. These differentiated cells expressed genes for all three embryonic germ layers (the tissues from which all other tissue types in the body develop) and also produced myeloid and granulocyte colonies (types of white blood cells).

The group confirmed that the reprogrammed cells had acquired ES cell characteristics by injecting the newly reprogrammed cells into immunodeficient mice. The cells successfully generated well-differentiated teratomas, benign masses containing all three embryonic germ layers, including respiratory, bone, and neural tissue.

"Not only has this work identified a new programmable cell type, but the cells are easy to obtain and analyze in many research laboratories and bone marrow transplantation centers around the world," said Grover C. Bagby, M.D., Professor of Medicine and Molecular and Medical Genetics at Oregon Health and Science University, who is not affiliated with the study. "These findings will immediately enhance the pace of laboratory research in this field and will ultimately help to determine whether iPS cells have a therapeutic potential equivalent to that of embryonic stem cells."

Apr 25
How Cigarettes Calm You Down
The calming neurological effects of nicotine have been demonstrated in a group of non-smokers during anger provocation. Researchers writing in BioMed Central's open access journal Behavioral and Brain Functions suggest that nicotine may alter the activity of brain areas that are involved in the inhibition of negative emotions such as anger.

Jean Gehricke led a team of researchers from the University of California who studied the effect of nicotine patches on the subjects' tendency to retaliate in response to anger provocation. The subjects played a computer game and could see a video screen of another player who they believed to be their opponent, although, in fact, they were playing alone. After each round, the victor could give his opponent a burst of unpleasant noise - at a duration and volume set by the winner. In some of the subjects, nicotine was associated with a reduced tendency to retaliate, even after provocation by the 'opponent'.

According to Gehricke, "Participants who showed nicotine-induced changes in anger task performance also showed changes in brain metabolism. Nicotine-induced reductions in length of retaliation were associated with changes in brain metabolism in response to nicotine in brain areas responsible for orienting, planning and processing of emotional stimuli".

The authors say that their findings support the idea that people of an angry disposition are more susceptible to nicotine's effects, and are therefore more likely to become addicted to cigarettes. They conclude, "Novel behavioral treatments that affect the cortical and limbic brain areas, like anger management training, may aid smoking cessation efforts in anger provoking situations that increase withdrawal and tobacco cravings".

Apr 25
USAID Recognizes World Malaria Day
The following is a statement from U.S. Malaria Coordinator, Admiral Tim Ziemer on World Malaria Day:

Across Africa, young boys and girls wake up each morning just like children here in the Washington D.C. area. The children are no different; they do chores, eat, play sports, and go to school. That is, if they can survive the mosquito bites that transmit the deadly malaria parasites. Those parasites kill an estimated 3,000 children each day in Africa.

While malaria has been all but forgotten in the United States, it remains the leading cause of death for children under 5 in Africa, killing approximately 1 million people a year.

Malaria is often referred to as a disease of poverty as it mostly afflicts those who are least able to afford prevention and treatment services. Economic losses due to malaria in Africa are estimated to be about US$12 billion per year. Men and women are kept from work, children from school, and many families are forced to use much of their modest discretionary income to pay for expensive malaria treatments.

Each year on April 25 the world recognizes World Malaria Day to call attention to the disease and to mobilize action to combat it. I hope that soon we can celebrate the elimination of malaria as a major public health threat.

On behalf of the American people, the U.S. government has taken extraordinary steps to curb the spread of this preventable and curable disease. In 2005, $1.2 billion was committed with the goal of reducing malaria-related deaths by 50 percent in 15 of the most malaria endemic countries in Africa. In addition to a dramatic increase in funding, there was a very focused and clear commitment to contribute to expanding coverage of highly effective malaria prevention and treatment interventions to 85 percent of the most vulnerable populations -- children under 5 and pregnant women.

The President's Malaria Initiative, led by the U.S. Agency for International Development (USAID) and implemented together with the Centers for Disease Control and Prevention (CDC) is working with host countries to ramp up comprehensive control efforts.

Just during the past year, the United States reached more than 32 million people with malaria prevention or treatment measures.

Widespread distribution of mosquito nets that prevent mosquitoes from biting their intended victims, new and effective drugs to treat malaria, medicines that protect pregnant women and their unborn babies, and spraying insecticides on the inside walls of homes to kill mosquitoes that transmit the disease are all sharply reducing malaria deaths in several African countries. These efforts are bringing newfound hope that malaria is not an intractable problem, and giving children a fighting chance to improve their quality of life and build better futures.

Progress has been dramatic thanks to major contributions from our partners, including host country governments, the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), the World Bank, the Bill and Melinda Gates Foundation, and private sector companies, such as Exxon-Mobil, and NGOs like Malaria No More.

In Rwanda, Zambia, and Zanzibar we are beginning to see signs of major reductions in the proportion of people infected with malaria. At the same time in Rwanda and Zambia, there has been a striking reduction in deaths among children under the age of 5. Regional and district-level impact has also been reported from Mozambique, Tanzania, and Uganda. Malaria is beginning to be rolled back, setting the stage for big gains in the next few years.

We also are focusing on building capacity within host countries by training people to manage, deliver, and support the delivery of health services, which will be critical for sustained successes against infectious diseases.

To be successful, we must involve community, volunteer, and private sector organizations in malaria control activities at national, district and community levels. Partnerships with faith-based and community organizations are essential because of the credibility these groups have within their communities, their ability to reach the grassroots level, and their capacity to mobilize significant numbers of volunteers. In the 15 focus countries in Africa, the United States has supported more than 150 nonprofit organizations, over 40 of which are faith based.

On Malaria Day, we strengthen our commitment to rid Africa of malaria by expanding proven approaches and interventions until they reach each and every child and pregnant woman who needs them. The prize in reducing the intolerable burden of malaria in Africa will be not only be healthier mothers and children, but also a chance for the poorest of the poor to benefit from greater socioeconomic development.

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