1. Doctors For Life International: An NGO’s perspective on Malaria in Southern Africa Bola Omoniyi, Ph.D. http: www.doctorsforlifeinternational.comwww.doctorsforlifeinternational.com

2. Doctors For Life (DFL) International Who we are NGO, NPO NGO, NPO Founded in 1991 Founded in 1991 Over 1300 Medical professionals Over 1300 Medical professionals 75% Africa based 75% Africa based HQ: South Africa HQ: South Africa Operations in SADC countries Operations in SADC countries What we do Malaria R & D (Artemisia) Malaria R & D (Artemisia) Access to Medicines Access to Medicines Care of Orphans & Vulnerable Children Care of Orphans & Vulnerable Children Home Based (AIDS) Care Home Based (AIDS) Care Life Skills Education Life Skills Education WorkPlace AIDS Programs WorkPlace AIDS Programs Care of Abused Women Care of Abused Women

3. Caring for Orphans and Vulnerable Children

4. Reaching People With No Access to Medical Care

5. Taking Medical Care to AIDS Patients at Home

6. Education Life Skills Based HIV/AIDS Prevention

7. Developing Artemisia for Treatment of Malaria in Poor and Rural Communities

8. Malaria – Southern Africa South Africa: Decreasing incidence of malaria South Africa: Decreasing incidence of malaria Mozambique: Primary cause of ill health. Mozambique: Primary cause of ill health. 40% of outpatients, 60% of pediatric patients 40% of outpatients, 60% of pediatric patients One third of all hospital deaths One third of all hospital deaths More than 90% of children infected in most areas More than 90% of children infected in most areas Significant contributor to high infant & under- 5 mortality Significant contributor to high infant & under- 5 mortality 15-30% deaths in pregnant women. 15-30% deaths in pregnant women. Poor rural communities with little medical access most affected. Poor rural communities with little medical access most affected. Angola: Number one killer Angola: Number one killer

9. Malaria Map – Southern Africa Department of Health RSA

10. Plasmodium Falciparum Majority of cases in South Africa Majority of cases in South Africa Most South Africans are non-immune Most South Africans are non-immune Low altitude areas of NE S. Africa Low altitude areas of NE S. Africa P. vivax and P.ovale are rare P. vivax and P.ovale are rare Seasonal Transmission: Oct - May Seasonal Transmission: Oct - May

11. Available Anti-Malarials Quinine Quinine Artemisinin derivatives Artemisinin derivatives Mefloquine Mefloquine Tetracyclines Tetracyclines Clindamycin Clindamycin Chloroquine Chloroquine Halofantrine Halofantrine

12. Choice of Treatment Severity of malaria Severity of malaria Resistance pattern Resistance pattern Parasite species Parasite species Patient characteristic – age, pregnancy Patient characteristic – age, pregnancy Geography; Kwazulu-Natal, Limpopo, Mpumalanga Geography; Kwazulu-Natal, Limpopo, Mpumalanga

13. Products under Development Doctors For Life International (DFL): Artemisia Doctors For Life International (DFL): Artemisia South African Traditional Medicines Group (SATMERG): Screening of Plant extracts. 25/500 plants with anti- malarial activity identified. South African Traditional Medicines Group (SATMERG): Screening of Plant extracts. 25/500 plants with anti- malarial activity identified. National Bioproducts Institute (BPI): Rapid malaria diagnostic kit ( designed for use in rural areas) National Bioproducts Institute (BPI): Rapid malaria diagnostic kit ( designed for use in rural areas) Ongoing Research: South African Malaria Initiative (SAMI): drug discovery, diagnostics and epidemiology South African Malaria Initiative (SAMI): drug discovery, diagnostics and epidemiology National Institute of Communicable Diseases (NICD): Insecticide resistance National Institute of Communicable Diseases (NICD): Insecticide resistance University of Cape Town (UCT): Mechanism of chloroquine resistance reversal University of Cape Town (UCT): Mechanism of chloroquine resistance reversal

14. Doctors For Life: Malarlife Artemisia based product Artemisia based product Capsules Capsules Under preclinical and clinical development Under preclinical and clinical development Pilot study in the DRC Pilot study in the DRC

15. Mozambique: Improving Malaria Prevention in Rural Areas

16. Mozambique: Decreasing Malaria Related Mortality in Children

17. Mozambique: Health Education and Access to Medicines

18. Angola – Reaching People in War Ravaged Areas

19. Angola – Tackling Malaria in Rural Areas

20. Doctors For Life: Future Goals Development of effective and affordable artemisia-based treatment for Malaria Development of effective and affordable artemisia-based treatment for Malaria Combining artemisia with other effective and affordable products to tackle recrudescence Combining artemisia with other effective and affordable products to tackle recrudescence Establish a permanent presence in Mozambique and Angola Establish a permanent presence in Mozambique and Angola Expand care of orphans and vulnerable children Expand care of orphans and vulnerable children Expand HIV prevention programs Expand HIV prevention programs Increase effective collaboration with other organizations and international agencies working on Malaria & HIV/AIDS Increase effective collaboration with other organizations and international agencies working on Malaria & HIV/AIDS