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Precautionary measures
Major African campaigns targeting malaria and HIV could help millions, but key concerns over their long-term effects should not be forgotten.
13 November 2013

The success seen in the clinical trials, however, is not guaranteed as the programme is scaled up to cover possibly more than 20 million children in parts of Africa. Six nations started giving antimalarials this year, but treated just a fraction of their intended recipients because of funding and organization problems. This raises concerns that the programmes will not carry out the ancillary monitoring efforts needed to ensure success. Funding must be provided to track whether the large-scale prevention campaign reduces the number of malaria cases as hoped, and to ensure that resistant forms of the parasite do not spread more quickly than anticipated. The problem is that funders are typically less interested in supporting follow-up studies than in testing ideas and carrying out interventions. And monitoring has long been a weak point for malaria: global surveillance catches just 10% of the estimated global malaria cases each year.


Just as with the preventive malaria drugs, there must be sufficient monitoring to track whether circumcision is as effective at reducing HIV transmission as it was during the smaller trials. Early signs are positive, and that is good news for millions of African men and women.

Malaria: A race against resistance
Several African nations could strike a major blow against malaria by sacrificing the efficacy of some older drugs. Can they make it work?
Amy Maxmen 13 November 2013

AIDS prevention: Africa's circumcision challenge
To combat the spread of HIV, health officials plan to circumcise 20 million men in Africa, but some have concerns about the aftermath.
Catherine de Lange 13 November 2013