1 HI-STAR Health Improvements through Space Technologies

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HI-STAR Health Improvements through Space Technologies And Resources 2

HI-STAR Logo 3

Mission Statement Our mission is to develop and promote a global strategy to help combat malaria using space technology 4

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 Malaria 1. 08 M Schisto-somiasis 50, 000 Dengue Fever 12, 000 Lymphatic Filariasis 0 Million 5 RBM/WHO 2001

Life cycle of Malaria Parasites multiply in human liver and bloodstream INFECTED MOSQUITO BITES A HUMAN MOSQUITO BITES INFECTED HUMAN Parasites multiply in mosquito 6

Geography Tropic of Cancer Tropic of Capricorn Area where malaria transmission occurs Area with limited risk No malaria (WHO, 2001) 7

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 8

HI- STAR SPACE TECHNOLOGIES MIS DISSEMINATION STRATEGY 9

Ecological Parameters for Monitoring or Prediction of Malaria Distribution • 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 • High prevents parasite & vector development increases mortality of the vector • Low Humidity Short mosquito’s lifespan • Rainfall Breeding sites for mosquitoes 10

Space Technologies for Malaria g sin en te S o m Re Co mm un ica tio GNSS n SSP 02 Student 11

Remote Sensing Ecological Parameters Monitored using Space Technologies Vegetation type Deforestation Surface Water Flooded areas Soil Moisture Climate (Temp. , Hum. , Rain. ) 12

Vegetation & Land Cover Changes Seasonal Changes of NDVI World land cover map from MODIS (Terra), Source NASA, earth observatory Deforestation (IKONOS-2, Space Imagine) 13

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

Moran et al. 1998 Soil Moisture SAR Images 15

Climate Factors Surface Temperature Rainfall Source NASA, earth observatory 16

Global Navigation Satellite Systems • GPS Major Roles: • To locate infected areas and treatment facilities • To collect ground truth data • To help mapping activities 17

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 18

Remote Sensing & other Space Applications Monitoring environmental conditions Mosquitoes distribution Information gathered Valuable Input to the Malaria Information System 19

HI- STAR SPACE TECHNOLOGIES MIS DISSEMINATION STRATEGY 20

Malaria Information System (MIS) Spatial Data Non Spatial Data RS Data: - Soil Moisture - Vegetation Index - Deforestation - Wetlands etc. Ground based Data: - Health Facilities - Population distribution - Reported Malaria Cases - etc. Land IS MIS Database Additional information e. g. # of bednets in a malaria risk area etc. Metadata Water IS Agricultural IS 21

MIS outcomes Statistics Assessment maps MIS Database Analysis and visualization Risk maps Early warning/ prediction Reports Main goal of MIS: identify areas of risk and to assist decision makers in directing resources and strategies 22

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 23

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 24

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) 25

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MIS Product Dissemination Flow of MIS information Processing centers Health authorities Affected population Regional officers 27

MIS Product Dissemination Application of Satellite Telecom System Tools Actors Processing Centers: Delivery of MIS products (risk maps) to health authorities National health authorities: Delivery of simplified MIS products to Regional health officers Feedback to MIS processing centers Communications to affected population Regional health officers/managers: Inputs to MIS and feedback to health authorities Web Phone / VSAT TV/Radio Video Broadcasting Conference X X X X 28

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 29

MIS Product Dissemination Opportunity of Satellite Telecom establishment in Developing Countries: • Integration with telecommunication / teleeducational and broadcasting systems • Development of telecommunications in countries with low developed ground infrastructure • Investments 30

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 31

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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. 33

Major Anti-Malaria International Initiatives Roll Back Malaria Program Needs • Risk Monitoring • Communications Infrastructure Multilateral Initiative on Malaria • Availability of Prevention Measures • Locally Adaptive Strategies • Measurements of Program Effectiveness • Health Care Infrastructure Special Program for Research and Training in Tropical Diseases • Social Coordination and Education • Financial Support • Political Will • Favorable Laws and Policies 34

Programs Using Space Technology to Combat Vector-borne Diseases CHAART MARA Satel. Life MEDSAT EMERCASE MALSAT Healthy Planet 35

The HI-STAR Strategy: a Two-phase Approach Phase 1: Phase 2: Development and Qualification Phase Operational Phase • Pre-Development to elaborate the business plan • Development and Qualification of MIS and its dissemination system • Promotion to obtain funding and convince national governments to implement HI-STAR • Operations in the targeted countries Effectiveness Measures 36

Integrating MIS and its Dissemination System by Using the Expertise and Resources of Existing programs ratio n of ma l Genera rk ramewo f ps Dis se m sy inat ste i m on MALSAT Gen e te- fts o em ecra r st pac co w- ing s Lo ns se Gro un coll d data ecti on MEDSAT EMERCASE + Innovations + Improvements 37

The HI-STAR Implementation (1) P 1: Development and Qualification Phase • Collaborative structure: Organizational, Structure, - Policy-level health organization: WHO Legal, Political Aspects - 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 38

The HI-STAR Implementation (2) P 2: Operational Phase Organizational, Structure, Legal, Political Aspects Technical Issues • 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 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 39

Implementation Timeframe 40

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 41

The Plan for Kenya • Limited space infrastructure • Financial restrictions • Existing malaria control programs • International Cooperative studies for malaria control planning 42

The Plan for India • Extensive space infrastructure • Population • Existing malaria control programs • Governmental support of $40 million per year to combat malaria 43

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 44

Finance 45

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 46

Investment Cost Distribution • 2 New MIS centers • 2 Shared centers 47 • 1266 Dissemination points

Operation Cost Distribution • 1266 Dissemination points • 12 Reports per telephone 48

Cost Benefits • 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 49

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Californian Legislative Assembly Vote 52