HI-STAR Health Improvements through Space Technologies And Resources

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Mission Statement Our mission is to develop and promote a global strategy to help combat malaria using space technology

Malaria - A Dangerous Disease Causes more than 300 million acute illnesses per year Causes at least 1 million deaths per year 40% of the world’s population is at risk of Malaria Slows economical development of countries Deaths caused by vector-borne diseases in 2000 Schisto-somiasis 50,000 Malaria 1.08M Dengue Fever 12,000 Lymphatic Filariasis 0 Million RBM/WHO 2001

Life cycle of Malaria Parasite INFECTED MOSQUITO BITES A HUMAN MOSQUITO BITES INFECTED HUMAN Parasites multiply in human liver and bloodstream Parasites multiply in mosquito HUMAN    MOSQUITO

Geography Area where malaria transmission occurs Area with limited risk No malaria Tropic of Cancer Tropic of Capricorn (WHO, 2001)

Malaria - A Global Problem Disease is spreading geographically Parasite is becoming multi-drug resistant Increasing travel infections in developed countries Global climate change alters the epidemic potential ­ ­ El Niño ­ ­ Global warming

HI- STARSPACETECHNOLOGIES MIS STRATEGY DISSEMINATION

Vegetation/crop type  Breeding/resting/feeding habitats; Deforestation  Open sunlit pools for breeding Flooding  Mosquito habitat and Breeding Wetlands & Soil moisture  Mosquito and Vector breeding habitat Temperature Low  prevents parasite & vector development High  increases mortality of the vector Low Humidity  Short mosquito’s lifespan Rainfall  Breeding sites for mosquitoes Ecological Parameters for Monitoring or Prediction of Malaria Distribution

Space Technologies for Malaria Remote Sensing GNSS Communication SSP02 Student

Remote Sensing Vegetation type Deforestation Vegetation type Deforestation Soil Moisture Surface Water Flooded areas Surface Water Flooded areas Climate (Temp., Hum., Rain.) Climate (Temp., Hum., Rain.) Ecological Parameters Monitored using Space Technologies

Vegetation & Land Cover Changes Seasonal Changes of NDVI World land cover map from MODIS (Terra), Source NASA, earth observatory  Deforestation ( IKONOS-2, Space Imagine)

Surface Water & Flooded Areas Flooding on Elbe River, Landsat 7 (ETM+) Source, NASA August 14,2002 August 20,2002

Soil Moisture Moran et al SAR Images

Climate Factors Source NASA, earth observatory Surface Temperature Rainfall

Global Navigation Satellite Systems GPS  Major Roles: To locate infected areas and treatment facilities To collect ground truth data To help mapping activities

Communication Satellites For Transmitting Ground Data In situ Ground Measurements The use of specialized sensors Real time Transmission The use of existing communication sats Mobile sensors using Argos, Orbcomm

Remote Sensing & other Space Applications Monitoring environmental conditions  Mosquitoes distribution Information gathered  Valuable Input to the Malaria Information System

HI- STARSPACETECHNOLOGIES MIS STRATEGY DISSEMINATION

Malaria Information System (MIS) Agricultural IS Water IS Land IS RS Data: - Soil Moisture - Vegetation Index - Deforestation - Wetlands etc. Ground based Data: - Health Facilities - Population distribution - Reported Malaria Cases - etc. Spatial Data Additional information e.g. # of bed- nets in a malaria risk area etc. Metadata Non Spatial Data MIS Database

MIS outcomes Analysis and visualization MIS Database Statistics Assessment maps Risk maps Early warning/ prediction Reports Main goal of MIS: identify areas of risk and to assist decision makers in directing resources and strategies

Malaria Early Warning System 1997/98 El Nino & East Africa 10 months early warning (maximum) NOAA, July 11, 2002 — It's now official: El Niño is back

Malaria Early Warning Activities Pre-rainy season activities Updating of malaria risk maps - malaria case rates - low immunity areas - population migration Seasonal climate forecast Rainy and malaria season monitoring Seasonal climate forecast update Weather monitoring (national level) Local environmental monitoring Monitoring of malaria morbidity Population movement monitoring Sea surface temperature and weather monitoring on the global level

MIS conclusions MIS integrates remote sensed and ground based datasets MIS enables to visualize malaria risk 3-10 months Malaria Early Warning is reality with space technologies MIS maps and reports for different user groups (officials, researchers, health personnel)

SPACETECHNOLOGIES MIS STRATEGY DISSEMINATION HI- STAR

Health authorities Processing centers Affected population Regional officers Flow of MIS information MIS Product Dissemination

Tools Actors WebPhone / Video Conference VSATTV/Radio Broadcasting Processing Centers:  Delivery of MIS products (risk maps) to health authorities XXX National health authorities:  Delivery of simplified MIS products to Regional health officers  Feedback to MIS processing centers  Communications to affected population XXX XXX X Regional health officers/managers:  Inputs to MIS and feedback to health authorities XXX Application of Satellite Telecom System MIS Product Dissemination

Possible solutions for the Telecom Systems Establishment : – –Leasing of existing/foreseen capacities of commercial GEO telecommunication satellites – –Operation of country or regional owned small GEO satellites – –Use of portable autonomous terminals (VSATs) together with the two above options MIS Product Dissemination

Opportunity of Satellite Telecom establishment in Developing Countries: Integration with telecommunication / tele- educational and broadcasting systems Development of telecommunications in countries with low developed ground infrastructure Investments MIS Product Dissemination

And challenges : Policy and Regulatory Frame work for ground and satellite communications varies from one developing country to the other Monopoly of the telecommunication sector by state owned carriers and licensing fees

SPACETECHNOLOGIES MIS STRATEGY DISSEMINATION HI- STAR

The HI-STAR Strategy Space technology: a useful technology in the fight against malaria. What about the political, legal and financial aspects? Gap between the health and space worlds. How to meet the funding, promotion and education challenges? Need for a global strategy integrating MIS and other space technologies into current efforts.

Risk Monitoring Communications Infrastructure Availability of Prevention Measures Locally Adaptive Strategies Measurements of Program Effectiveness Health Care Infrastructure Social Coordination and Education Financial Support Political Will Favorable Laws and Policies Major Anti-Malaria International Initiatives Roll Back Malaria Multilateral Initiative on Malaria Special Program for Research and Training in Tropical Diseases Program Needs

Programs Using Space Technology to Combat Vector-borne Diseases EMERCASE MEDSAT CHAART SatelLifeMARA MALSAT Healthy Planet

The HI-STAR Strategy: a Two-phase Approach Phase 1: Development and Qualification Phase Pre-Development to elaborate the business plan Development and Qualification of MIS and its dissemination system Phase 2: Operational Phase Promotion to obtain funding and convince national governments to implement HI-STAR Operations in the targeted countries Effectiveness Measures

Integrating MIS and its Dissemination System by Using the Expertise and Resources of Existing programs MALSAT EMERCASE MEDSAT Ground data collection Dissemination system Low-cost remote- sensing spacecrafts Generation of maps General framework + Innovations + Improvements

The HI-STAR Implementation (1) P1: Development and Qualification Phase Organizational, Structure, Legal, Political Aspects Collaborative structure: - Policy-level health organization: WHO - Technical space-related expertise: space agencies Technical Issues Different time constraints: Early warning system Real-Time monitoring maps Promotion and Funding Pilot programs Conferences and workshops Diversified funding Education and Training UN education centers Staff provided by the local organizations

The HI-STAR Implementation (2) P2: Operational Phase Organizational, Structure, Legal, Political Aspects Administered by RBM-WHO with technical support from space agencies Participation of the WHO member states and NGOs Commitment of the partner countries European GMES-like Relationships Technical Issues Number and location of MIS databases: distributed or centralized system? Promotion and Funding Industries or foundation funding International organizations Reduction of data acquisition and processing costs Education and Training Collection & communication data Processing/distribution/ interpretation of data Creation of specific departments in charge of MIS

Implementation Timeframe

Summary of the HI-STAR Strategy Integrates the expertise and resources of the major existing programs optimally, while bringing improvement and innovative approaches Promotes a high level of cooperation and coordination between health organizations (familiarity with realities on the ground) and space organizations (knowledge of technical limitations) Bases its funding on various sources, depending on the implementation phase Ensures a step-by-step implementation of MIS and its dissemination system

The Plan for Kenya Limited space infrastructure Financial restrictions Existing malaria control programs International Cooperative studies for malaria control planning

The Plan for India Extensive space infrastructure Population Existing malaria control programs Governmental support of $40 million per year to combat malaria

Conclusions Initially the costs are high but a significant economic benefit can be realized with the implementation of MIS MIS initiation provides opportunities enhancing existing health care infrastructure MIS stimulates education MIS is effective in combating malaria

Finance

Cost of implementing MIS at the source Another space project ? Yes, but this time – –Clear defined objectives – –Based on mainly existing technologies – –Results, not questions

Investment Cost Distribution 2 New MIS centers 2 Shared centers 1266 Dissemination points

Operation Cost Distribution 1266 Dissemination points 12 Reports per telephone

Reduce the negative impact on our economy – –No more panic (loss of labor) – –Back to normal level of health care costs – –Recovery of tourism industry Local benefits at the source – –More efficient distribution and use of prevention resources – –Concentrating resources in problem areas (e.g. spraying where needed, etc) – –The negative impact on economies will decrease Cost Benefits

SPACETECHNOLOGIES MIS STRATEGY DISSEMINATION HI- STAR

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