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News Article | October 25, 2016

The little guppy Poecilia reticulata has developed a big reputation. For decades, the fish has been championed as a mosquito fighter and dumped into ponds and ditches to eat up the insect’s larvae. But among scientists, it has a different reputation—as an invasive species with a remarkable ability to reproduce and spread. Now, as health officials in regions facing mosquito-borne viruses like Zika consider expanding use of these predatory fish, ecologists are urging them to think twice. In a paper published online today in , a group of ecologists argues that the guppies—and other nonnative fish used for mosquito control—haven’t actually proven very effective mosquito fighters, but are known to pose ecological risks. “It all sounds like it’s magical—you put the guppies in, they eat the mosquitoes, everything is fine,” says Rana El-Sabaawi, an ecologist at the University of Victoria in Canada and lead author on the new paper. “Our concern is that you have a potentially invasive species that is being introduced haphazardly.” Larva-gobbling guppies may have been cutting-edge technology for U.K. colonialists aiming to rid the empire of mosquitoes at the turn of the century. But to El-Sabaawi, the strategy seems so old-fashioned that she was surprised to find out large-scale projects are underway. While “randomly Googling guppies,” she came across news reports from Pakistan that health officials had released thousands of the fish into the ponds and sewers of Karachi in 2013 to fight the transmission of dengue fever. And in a widely circulated news video documenting Zika control efforts in Brazil, El-Sabaawi was troubled by footage of a municipal government worker apparently “wandering around with a bunch of guppies and basically just introducing them in ditches.” That’s unnerving for El-Sabaawi and her co-authors because they know guppies are efficient invaders. They’re hearty and fertile, surviving in relatively polluted water, reproducing often, and giving birth to fast-growing, live young. A combination of accidental aquarium releases and mosquito control projects have spread the species from its native range in the Caribbean and the northern coast of South America to at least 69 countries, according to a 2011 survey. And several studies suggest that introduced guppies threaten biodiversity. Researchers in Hawaii found that guppies released in the 1920s drove down native fish populations, perhaps by competing with them for food and living space, and had likely changed the cycle of nutrients in water: Guppy-rich areas showed increased levels of dissolved nitrogen—from ammonium in fish urine and gill excretions—which, in turn, stimulated algae growth. (Another fish commonly used in mosquito control—Gambusia affinis—has also been associated with declines in native fish species.) The authors also question whether guppies are reliable mosquito slayers. Studies that back their effectiveness tend to have flaws, they say. Lab tests often starved the fish before exposing them to a diet of exclusively mosquito larvae. And studies in the wild have been small and poorly designed. That critique may be correct, but dismissing guppies as a control strategy is counterproductive, says John Hustedt, senior technical officer of the nonprofit Malaria Consortium in Phnom Penh, which has been releasing the fish into water storage jars in rural households to combat dengue fever and other mosquito-transmitted diseases. Hustedt hopes that a study his group has just completed will provide new evidence for the guppies’ value. Preliminary results showed that reductions in the number of adult mosquitoes were two times greater in households with guppies than in those without. “If someone comes out and says, ‘Actually it doesn’t work and it’s going to cause you a problem,’ that can decrease the chance that the government would be more open to trying [guppy release] on a large scale,” he says. As for ecological risks, guppies in isolated containers may be less likely to spread than those dumped into urban sewers and ditches. But Hustedt also questions the distinction between native and nonnative for a species that is already so ubiquitous. The guppies used in his project were found in a farm in a province outside Phnom Penh; their original source is unknown. “It seems to me that they’ve been here for quite a long time, and they’re already in the environment,” he says. Although the benefits and risks of guppy releases may be highly context-dependent, some researchers are simply taking a hard line. “The use of fish to control mosquito disease vectors should be abandoned by authorities,” says Valter Azevedo-Santos, an ichthyologist at São Paulo State University in Botucatu, Brazil, who co-authored a letter objecting to the strategy published in Science earlier this year. He believes resources would be better spent on other control measures: insecticides, sanitary measures such as eliminating standing water in homes, and even the experimental release of genetically engineered mosquitoes to spread a lethal gene. As health workers cast around for ways to combat Zika, he hopes this paper will give them pause. “This mismanagement must be abandoned, or new fish invasions will occur in the near future,” he says. “This is a special moment.”

News Article | October 28, 2015

The world's first vaccine against malaria should be rolled out in limited 'pilot' demonstrations in Africa, an advisory group to the World Health Organization (WHO) in Geneva said on 23 October. The demonstrations — involving up to 1 million children — are needed because the vaccine is ineffective against malaria unless children receive four doses spread out over 18 months, and even then offers only modest protection. “If we can’t get four doses of this vaccine into children, we’re not going to be using it,” Jon Abramson, a paediatric infectious disease specialist at Wake Forest School of Medicine in Winston-Salem, North Carolina, and chair of the WHO Strategic Advisory Group of Experts (SAGE) on Immunization, said in a press briefing. The decision to recommend the vaccine pilots — which the WHO’s director-general is expected to formally endorse in November — follows 28 years of development by the London-based drug firm GlaxoSmithKline (GSK) and other backers including the Bill & Melinda Gates Foundation in Seattle, Washington; together they have spent US$565 million on the drug. The imperfections of the vaccine, called RTS,S, are well known: trials in more than 15,000 children, who were followed for up to four years in seven countries in sub-Saharan Africa, found that a series of four shots reduced the number of malaria cases by only 36% in young children, and by 26% in infants1. Still, even its modest effect could be significant because malaria kills nearly half a million people annually, most of whom are children in sub-Saharan Africa, and all other candidate vaccines are in much earlier stages of development. “I think the reason they’ve gone forward with the pilot is that there’s nothing else available right now,” says Adrian Hill, a vaccinologist at the University of Oxford, UK. The advisory group recommended a series of 3–5 pilot demonstrations in areas with medium to high incidence of malaria, involving up to 1 million children in total. These will reveal whether parents bring their children back for all four doses of the vaccine: without the final dose, RTS,S provides no more protection against malaria than do controls, Abramson said. The pilots will also investigate safety issues associated with the vaccine, such as the potential to develop meningitis. They are needed to ensure that precious funding is not wasted, he said. “If this vaccine is not effective and we use it widely, we have spent a ton of money where it could be better placed.” The demonstrations could start in 2016 and are expected to last 3–5 years. As data roll in, SAGE will review its position: a final decision on whether to recommend deploying the vaccine more widely could come during this period. Seth Berkley, head of Gavi, the Vaccine Alliance, in Geneva, Switzerland, says that his organization will soon decide whether to help pay for the pilot demonstrations. Gavi has in the past supported similar pilots to determine the feasibility of delivering other vaccines in resource-poor settings. “It certainly is possible that the board will say yes to this, but there’s no guarantee,” says Berkley. Even if the WHO does eventually recommend the vaccine for widespread use, it is not clear what the uptake would be. Although African malaria-control officials welcome RTS,S, they say that they would need more funding to deploy the vaccine. Budgets for malaria prevention and treatment using measures such as insecticide-treated bed nets and artemisinin-combination therapies are already stretched thin. Speaking to Nature before the WHO announcement was made, Philip Rosenthal, a malaria researcher at the University of California, San Francisco, said that the vaccine was exciting, but added, “I am worried that the WHO’s approval will be misinterpreted, and lead decision-makers to shunt resources away from other malaria-control measures.” GSK says that it will charge $1–10 per shot, covering the company's manufacturing costs and a return of 5%, to be re-invested in new vaccines for malaria or other diseases common in the developing world. But on top of the price of the shots, funding will also be needed to deliver them to children and for programmes to disseminate information. “One challenge is to be sure that mothers understand that their children can still get malaria even with the vaccine, so that means their children must continue to sleep under bed nets,” says James Tibenderana, development director at the Malaria Consortium in Uganda. It is also important for parents to know that when their children have a fever, they must still go for a malaria test, he says. A study published on 21 October revealed2 that the vaccine’s poor performance in clinical trials is in part because it mimics a strain of the malaria parasite Plasmodium falciparum that is not commonly found in Africa. The vaccine is composed partly of a fragment of circumsporozoite (CS) protein, which is found on the surface of the parasite. Those who are immunized with RTS,S — sold as Mosquirix — build up some immunity to malaria. But different parasites have slightly different CS proteins — and the study showed that fewer than 10% of parasites infecting some 5,000 children in the trials matched the CS protein sequence in the RTS,S vaccine. If the vaccine could be re-engineered to include bits of several surface proteins, it would be more effective, says Dyann Wirth, an infectious-disease researcher at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts, who led that study. That re-development could take years, however, although some researchers have been discussing the possibility, according to David Kaslow, who oversees the vaccine’s development at the non-profit health organization PATH. “It’s not trivial to tweak the vaccine to match the prevalent strains in an area,” he told Nature, “but it’s not impossible.” Hill says that SAGE’s decision to pilot the vaccine sends the right message to other researchers. “Stopping this dead would have been a very bad signal,” he says. “What the field needs is other players to come forward and accelerate their more modern vaccine candidates toward licensure.”

News Article | December 28, 2016

When dengue fever hit Yangon, Myanmar earlier this year, the government was better prepared than ever. The department of health has worked since 2014 with the Malaria Consortium, an NGO, to develop a detailed outbreak response plan. Community health workers in four townships at high risk had been trained to recognise and treat the disease. They worked with local officials to target mosquito breeding sites in villages and homes, while stepping up chemical control of mosquitoes. But efforts to develop similar dengue response strategies are being slowed down by the outbreak of a more headline grabbing mosquito-borne virus – Zika. Dengue researchers and public health specialists are telling Break Dengue that Zika has soaked up a lot of attention. Our own Google Trends analysis shows the interest in Zika has been out of proportion to its real impact The World Health Organisation declared a public health emergency in February 2016 in the wake of a significant rise in cases of the birth defect microcephaly caused by Zika. The White House sought $1.9bn (£1.5bn) in emergency funding to “prevent, detect and respond” to the threat posed by the virus. But while the media and general public focus attention on Zika, similar diseases continue to spread in the background, causing severe harm to both individuals and the public health system. Dengue fever is just one such disease. It causes fever, headache, vomiting, joint pain and skin rashes, and has been linked to pregnancy risks. Spread by the same mosquito responsible for the Zika outbreak, it is the fastest-growing mosquito-borne viral infection in the world today, resulting in around half a million hospitalisations and an estimated 22,000 deaths each year. The socio-economic toll of diseases transmitted by mosquitoes is severe; the total annual cost of dengue alone has been put at $8bn (£6.5bn). What’s more, outbreaks adversely affect other health service users. Health system capacity can adapt to meet predictable demand for illnesses like malaria or diabetes, but these virulent outbreaks are sporadic, unpredictable and highly disruptive, putting enormous pressure on clinics, health workers and laboratories. Getting diseases like dengue under control would have a vast positive impact across the whole of the public health system. Despite the risks, most cases of dengue and Zika still remain undiagnosed. Better diagnostics and disease surveillance data are required if we are to understand and measure the true scale of the challenge. Dengue Track, for example, is an innovative crowdsourced tool which integrates new and existing data to not only track the disease worldwide but also predict and prevent future dengue outbreaks. Through an online chat system, users can report cases of dengue and this information is combined with statistics from larger national databases to create a real-time map of outbreaks and provide advice to travellers, organisations and local communities. The same tool could be just as effective in mapping other mosquito-borne diseases and turning big data into actionable information. Once this first step in the outbreak response plan is in place, health authorities can build a system capable of springing into action once the alarm is raised. Lessons learned from three US outbreaks (pdf) highlighted the importance of detecting dengue swiftly, alerting state actors and municipal authorities, and communicating with the public. The latest dengue response plan from Queensland, Australia, also details how to target resources to hard-hit areas – suppressing the mosquito population, tracking case numbers and preparing hospitals for an imminent uptick in caseload. This kind of painstaking planning takes time and investment. The Zika outbreak has, quite rightly, spent a long time in the spotlight. But we can’t simply move the attention away from Zika and on to the next new story. We can’t afford to narrow our focus to one particular disease or outbreak. Innovative mosquito control measures could help to curb the number of people who become infected, while research on new treatments for one disease can often turn up leads in the fight against another. We want to encourage cases of positive deviance where people behave differently to others in their communities and avoid local infections and illnesses. An example would be Ma Su Lei Yee, a 25-year-old farmer who lives in Sein Pan Kone village, Hinthada, in south-west Myanmar. She and her family have never had dengue despite living in a community that has a high risk of transmission. She understands that dengue is caused by mosquitoes that bite during the day. To prevent mosquito bites, she always wears long-sleeved clothes and sleeps under mosquito nets during the day time as well. She always covers the big water containers, changes water in small containers every 2-3 days and changes her Buddha flower vase regularly to prevent mosquito larvae from forming. She cleans the household surroundings and fills in the ditches with sand, especially in the rainy season, to avoid larvae breeding. She removes empty cans, coconut shells and turns extra containers upside down to avoid larvae growth. She recognises the signs and symptoms of dengue and goes for early diagnosis if she has a fever. “If a patient does not get an early diagnosis from a health facility, he or she can die with dengue fever,” she said. Disease surveillance tools can prove invaluable in mapping cases worldwide and providing authorities and NGOs with valuable information to help reduce the spread of the disease. Let’s take this opportunity to put the spotlight on all the major challenges posed by other diseases and to further develop tools such as Dengue Track that will help us overcome them as a group. We can do this if we do it together. Gary Finnegan is editor in chief at Break Dengue. Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter.

Kallander K.,Malaria Consortium Africa | Tibenderana J.K.,Malaria Consortium Africa | Akpogheneta O.J.,Malaria Consortium | Strachan D.L.,University College London | And 5 more authors.
Journal of Medical Internet Research | Year: 2013

Background: Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low-and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low-and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. Objective: Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low-and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. Methods: In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low-and middle-income countries and community health workers. Results: The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low-and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. Conclusions: With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low-and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems. © Filippo Castiglione.

Banek K.,Uganda Malaria Surveillance Project | Kilian A.,Malaria Consortium | Allan R.,MENTOR Initiative
Malaria Journal | Year: 2010

Background. By 2008, the WHO Pesticide Evaluation Scheme (WHOPES) recommended five long-lasting insecticidal nets (LLINs) for the prevention of malaria: Olyset®, PermaNet 2.0®, Netprotect®, Duranet® and Interceptor®. Field information is available for both Olyset® and PermaNet®, with limited data on the newer LLINs. To address this gap, a field evaluation was carried out to determine the acceptability and durability of Interceptor® LLINs. Methods. A one-year prospective field study was conducted in eight rural returnee villages in Liberia. Households were randomized to receive Interceptor® LLINs or conventionally treated nets (CTNs). Primary outcomes were levels of residual alpha-cypermethrin measured by HPLC and participant utilization/acceptability of the ITNs. Results. A total of 398 nets were analysed for residual alpha-cypermethrin. The median baseline concentrations of insecticide were 175.5 mg/m2 for the Interceptor® LLIN and 21.8 mg/m2 for the CTN. Chemical residue loss after a one year follow-up period was 22% and 93% respectively. Retention and utilization of nets remained high (94%) after one year, irrespective of type, while parasitaemia prevalence decreased from 29.7% at baseline to 13.6% during the follow up survey (p = < 0.001). Interview and survey data show perceived effectiveness of ITNs was just as important as other physical attributes in influencing net utilization. Conclusion. Interceptor® LLINs are effective and desirable in rural communities in Liberia. Consideration for end user preferences should be incorporated into product development of all LLINs in the future, in order to achieve optimum retention and utilization. © 2010 Banek et al.

Ye Y.,ICF International | Patton E.,ICF International | Kilian A.,Malaria Consortium | Dovey S.,ICF International | Eckert E.,U.S. S President Malaria Initiative USAID
Malaria Journal | Year: 2012

Background: Insecticide-treated nets (ITNs) are effective tools for malaria prevention and can significantly reduce severe disease and mortality due to malaria, especially among children under five in endemic areas. However, ITN coverage and use remain low and inequitable among different socio-economic groups in sub-Saharan Africa, particularly in Nigeria. Several strategies have been proposed to increase coverage and use and reduce inequity in Nigeria, including free distribution campaigns recently conducted by the Nigerian federal government. Using data from the first post-campaign survey, the authors investigated the effect of the mass free distribution campaigns in achieving equity in household ownership and use of ITNs. Methods. A post-campaign survey was undertaken in November 2009 in northern Nigeria to assess the effect of the campaigns in addressing equity across different socio-economic groups. The survey included 987 households randomly selected from 60 clusters in Kano state. Using logistic regression and the Lorenz concentration curve and index, the authors assessed equity in ITN coverage and use. Results: ITN ownership coverage increased from 10% before the campaigns to 70%-a more than fivefold increase. The campaigns reduced the ownership coverage gap by 75%, effectively reaching parity among wealth quintiles (Concentration index 0.02, 95% CI (-0.02; 0.05) versus 0.21 95%CI (0.08; 0.34) before the campaigns). ITN use (individuals reporting having slept under an ITN the night before the survey visit) among individuals from households owning at least one ITN, was 53.1% with no statistically significant difference between the lowest, second, third and fourth wealth quintiles and the highest wealth quintile (lowest: odds ratio (OR) 0.87, 95% confidence interval (CI) (0.67; 1.13); second: OR 0.85, 95% CI (0.66; 1.24); third: OR 1.10 95% CI (0.86; 1.4) and fourth OR 0.91 95% CI (0.72; 1.15). Conclusion: The campaign had a significant impact by increasing ITN coverage and reducing inequity in ownership and use. Free ITN distribution campaigns should be sustained to increase equitable coverage. These campaigns should be supplemented with other ITN distribution strategies to cover newborns and replace aging nets. © 2012 Ye et al; licensee BioMed Central Ltd.

Kunutsor S.K.,Malaria Consortium | Powles J.W.,University of Cambridge
Cardiovascular Journal of Africa | Year: 2010

Introduction: Associations between ambient temperature and blood pressure have been demonstrated in countries where the temperature varies between the seasons. This phenomenon has been overlooked in blood pressure surveys in sub-Saharan Africa. We assessed the effect of ambient temperature on blood pressure in an adult population in a West African country. Methods: A cross-sectional survey was carried out on a rural Ghanaian population, investigating the effect of ambient temperature on blood pressure in 574 randomly sampled adults aged between 18 and 65 years. Results: There was a significant inverse relationship between ambient temperature and systolic (SBP) (p < 0.019) and diastolic blood pressure (DBP) (p < 0.036). SBP fell by 5 mmHg per 10°C rise in ambient temperature. Conclusion: Higher ambient temperatures are associated with lower blood pressures. To enhance comparability of data from epidemiological surveys, ambient temperature should be recorded for each blood pressure reading and findings standardised to a fixed ambient temperature.

News Article | September 15, 2016

Malaria remains one of the world’s leading causes of mortality in developing countries. Last year alone, it killed more than 400,000 people, mostly young children. This week in ACS Central Science, an international consortium of researchers unveils the mechanics and findings of a unique “open science” project for malaria drug discovery that has been five years in the making. The current gold standard antimalarial treatments are based on artemisinin, a compound developed in the 1970s in China, combined with a partner drug. Yet, resistance to artemisinin and its partners has already emerged in some parts of the world. If the resistance spreads, there are no viable replacement treatments. Given the lack of commercial incentive for industry to develop drugs for neglected diseases such as malaria, and because academic researchers often lack resources to move compounds forward, there is a clear need for new approaches. In response, Matthew Todd from the University of Sydney together with the not-for-profit research and development organization Medicines for Malaria Venture proposed an “open source” solution akin to the open source concept used in software development. More than 50 researchers from 21 organizations in eight countries added their research to the project, which started with a large set of potential drug molecules made public by the company GlaxoSmithKline. Anyone willing to contribute — anywhere in the world — was welcome to share data and collaborate by adding comments to an electronic notebook as part of the Open Source Malaria Consortium. Some scientists designed and synthesized new generations of the antimalarial compounds; others ran assays and interpreted results. Several rounds of research were conducted, addressing water solubility and structural issues, with all the data being made public in real time. A wide array of scientists, from professors to undergraduates, participated by choice, agreeing that no one would individually seek patents to protect their contributions. The authors note that the current results, while promising, are merely the beginning of the story. They continue to welcome additional contributions, also researched openly and collaboratively.

News Article | October 27, 2016

(—A team of researchers with members from the U.S., the West Indies, Canada and Brazil has conducted a survey of research efforts looking into the effectiveness and safety of releasing guppies to reduce the number of mosquitoes and report that evidence supporting such use is lacking—they also note that guppies can become an invasive species putting other species at risk. In their paper published in the journal Biology Letters, the team describes their research and why they believe that guppies are not an effective tool for fighting the spread of infectious diseases. As the researchers note, humans have been tossing guppies into lakes, streams and other places where there is standing water to reduce mosquito populations for centuries. Once released, they eat mosquito larvae that lie on the surface, preventing them from growing to maturity and biting people. Most such instances have been in response to outbreaks of mosquito-borne diseases—locals have used the practice in the studied regions very recently to slow the spread of the Zika virus, for example. But such a tactic, the researchers contend, is not only unproven, but harmful to other animal species in the same water. Curious about the practice of using guppies to control mosquitoes, the researchers combed multiple studies in the areas of conservation, epidemiology, evolution and ecology—looking for those that included guppies. In so doing, they found scant evidence supporting the notion that using guppies to control mosquitoes actually works. They found much more evidence that suggested that guppies should be classified as an invasive species when introduced outside of its native environment. They found instances of the fish reproducing so rapidly and consuming so much of the local food sources that other animals living in the same water died out. They suggest that the use of guppies to control mosquitos for any purpose be abandoned or that its use be used "much more rigorously." Not everyone is likely to agree with this assessment, however, as some researchers such as those working for the Malaria Consortium have found that putting guppies in water tanks in tropical areas helps reduce the spread of dengue fever in places like Viet Nam—with such an approach, they claim, there is no chance of the fish invading an established ecosystem. More information: Rana W. El-Sabaawi et al. Biodiversity and ecosystem risks arising from using guppies to control mosquitoes, Biology Letters (2016). DOI: 10.1098/rsbl.2016.0590 Abstract Deploying mosquito predators such as the guppy (Poecilia reticulata) into bodies of water where mosquitoes breed is a common strategy for limiting the spread of disease-carrying mosquitoes. Here, we draw on studies from epidemiology, conservation, ecology and evolution to show that the evidence for the effectiveness of guppies in controlling mosquitoes is weak, that the chances of accidental guppy introduction into local ecosystems are large, and that guppies can easily establish populations and damage these aquatic ecosystems. We highlight several knowledge and implementation gaps, and urge that this approach is either abandoned in favour of more effective strategies or that it is used much more rigorously. Controlling mosquitoes does not need to come at the expense of freshwater biodiversity.

News Article | February 15, 2017

Abt Associates has established a new regional structure to improve company support to its international health projects and appointed two new regional managing directors. Catherine Thompson will serve as regional managing director for Eastern, Central and Southern Africa and Cristine Betters will serve as regional managing director for West Africa, Middle East, Asia/Near East, and Latin American and the Caribbean. “This regional management structure will increase our health impact around the world by fostering greater collaboration and efficiency across country projects, as well as between bilateral and global project teams at the regional and country-level,” said Diana R. Silimperi, MD, division vice president for International Health. “We look forward to leveraging this structure to deliver deeper insights about regional needs and innovative solutions for our clients.” Catherine Thompson is an expert in infectious diseases and HIV and AIDS who has more than 30 years of public health experience, including 18 years living in Eastern and Southern Africa and four years in South Asia. She currently manages health projects for Abt Associates in Mozambique, Zimbabwe, and Namibia, as well as regional programs in Kenya, Rwanda and Uganda and leads infectious disease work. Thompson holds a Masters of Public Health, International Population and Family Health from Columbia University and her Bachelors of Science in Nursing from New York University. Cristine Betters joins Abt Associates from the Malaria Consortium, a British organization specialized in diagnosing, preventing and treating malaria; controlling neglected tropical diseases; and promoting maternal and child health. She spent the past four years as the Malaria Consortium’s Director of Africa Programs, based in Kampala, Uganda. In that role, she substantially increased revenue and profitability in the region, won a number of large-scale, innovative grants and contracts and expanded its geographic footprint. Betters has more than two decades of international public health and management experience, having worked in approximately 30 countries on four continents. She holds a Masters of Public Health and a Masters of International Affairs from Columbia University. Abt Associates is a mission-driven, global leader in research, evaluation and program implementation in the fields of health, social and environmental policy, and international development. Known for its rigorous approach to solving complex challenges, Abt Associates is regularly ranked as one of the top 20 global research firms and one of the top 40 international development innovators. The company has multiple offices in the U.S. and program offices in more than 40 countries.

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