Lesson 5 Resources 1-3 Blue by The Royal Commonwealth Society

Co mm on we al th SC HO OL RE SO UR CE S » Lesson 5 » The Commonwealth, Development and Global Health: The Problem of Malaria Note - This lesson could be split into two for students to have more time to prepare and discuss: activities 1 and 2 in the first lesson, and activities 3 and 4 in the second lesson.

Lesson aims/key questions

Learning outcomes and key processes

1 » What is malaria? Where and why is malaria a problem? 2 » How can malaria be prevented and treated? 3 » How are diseases and development related? Students will be able to: a » Describe three facts about malaria. b » Explain two reasons why malaria is a problem around the world. c » Formulate and justify an opinion on the best methods to prevent malaria. d » Analyse how diseases and development are related. Key processes: Critical thinking; research; empathising with others; advocacy and representation; discussion and debate; communicating ideas; listening to others; critically assessing your own view and others’ viewpoints; presenting a persuasive case for action; working with others to solve problems.

Key words/

concepts / terms

Summary of

Activity 1 (starter): Five things I know about malaria…

a»

b»

Activity 2: Create an Expert Report for the Commonwealth Health Ministers

c»

d»

Activity 3: Presentations to the Commonwealth Health Ministers

c»

d»

Activity 4 (plenary): Vote and closing session

c»

d»

activities and links to learning outcomes

Assessment

opportunities

Differentiation

» Activity 1 (starter) can include informal assessment of individual feedback to class. » Activity 3 and Activity 4 (plenary) can include student peer-to-peer feedback and could also include formal assessment of group presentations. » Activity 1 (starter) and Activity 4 (plenary): level and challenge of questioning during feedback can be pitched to needs of individual students. » Activity 2: The Malaria Prevention student briefing sheets (5r2) present differing levels of complexity: Briefings A to C contain more accessible material and Briefings D to F contain more challenging material.

LESSON 5 PAGE 1 OF 4 © Royal Commonwealth Society | www.thercs.org/youth

5 89

Co mm on we al th SC HO OL RE SO UR CE S » Lesson 5 » The Commonwealth, Development and Global Health: The Problem of Malaria continued...

Homework or

» Research more about malaria (online or in textbooks or newspapers) and investigate the reasons why medicines and treatments may not be readily available in some countries (for example, inequalities in access to healthcare and shortages of healthcare workers; discrimination; funding problems for the distribution of medicines and nets; and the controversial issues around the protection of intellectual property and restrictive patenting of drugs by some pharmaceutical companies). More information can be found at the following websites: World Health Organisation: www.who.int/topics/malaria/en Wellcome Trust: http://malaria.wellcome.ac.uk/ United Nations: www.un.org/millenniumgoals/aids.shtml Malaria No More: www.malariapolicycenter.org/index.php/resources/malaria_facts » Examine Millennium Development Goal 6 (Combat HIV/AIDS, Malaria and Other Diseases) and evaluate the likelihood of achieving Target 6.c: “Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases”. You can download the most recent Millennium Development Goals Progress Report from the United Nations website www.un.org/millenniumgoals/reports.shtml, which is also a useful source for monitoring the indicators on each goal. » Write a written report as a Commonwealth Health Minister about the meeting in Activity 3 to take back to their government, explaining the key messages of the session and recommendations for the government » Write a newspaper article, from the perspective of a journalist attending the Commonwealth Health Ministers’ meeting (Activity 3), explaining what was discussed and the decisions ministers made. » Write to their own political representative (e.g. their Member of Parliament or Health Minister) asking them to do more to help deal with the problems of malaria around the world.

Resources needed

» Activity 1 (starter): Teacher Briefing resource links www.who.int/mediacentre/factsheets/fs094/en http://malaria.wellcome.ac.uk); Malaria Introductory Powerpoint (5r1), if needed. » Activity 2: Malaria Prevention Student Briefing Sheets (5r2) (based on the above sources) (one sheet for each group where class divided into six groups) » Activity 3: Student Feedback Sheets (5r3) (one each) (if required); Stopwatch / Timer

extension tasks

1 r2

5 90

LESSON 5 PAGE 2 OF 4 © Royal Commonwealth Society | www.thercs.org/youth

Co mm on we al th SC HO OL RE SO UR CE S » Lesson 5 » Suggested time allowance for activities

» Activity 1 (starter): Five things I know about malaria…

0-10m

Working individually or in pairs, challenge students to write down five facts that they know about malaria. They have three minutes! When time is up, ask students to feed back some of their ideas to the class. Encourage students to explain what they say and ask the rest of the class whether they agree. Where students give incorrect information, provide the correct information yourself where you can (the Teacher Briefing resource links and Malaria Introductory Powerpoint (5r1) may help with this). If you can, encourage students to think about the causes, symptoms, and impact of malaria. If students find it difficult to think of facts about malaria, you could go through the Malaria Introductory Powerpoint (5r1) with them and discuss whether each slide relates to a cause, a symptom, an impact or a potential remedy for malaria.

5 r1

» Activity 2: Create an Expert Report for the Commonwealth Health Ministers Split the class into six groups. Distribute the Malaria Prevention Student Briefing Sheets (5r2), one to each group. Ask students to imagine that they have been selected as malarial experts to speak to the next meeting of the Commonwealth Health Ministers. This meeting is an opportunity for the Ministers from a range of different countries around the Commonwealth to hear about different methods of malarial prevention, and consider which methods their governments should invest in (within their own countries or through aid to other countries). Each group will make a three minute presentation, outlining the prevention method they have been given.

10 25m

They must: » Introduce the prevention method » Explain how/why it works (how does it prevent/reduce illness or deaths) » Outline its benefits and disadvantages (e.g. effectiveness, ease of use, cost) » Give one main reason why combating malaria will contribute to development (e.g. think about how such problematic diseases might affect the workings of the health and education systems of a country) Explain to students that there is information to help them on the briefing sheets (5r2). However, not all the points are useful and relevant – they need to use this briefing sheet as a starting point rather than a complete text to read out. As they prepare their speeches, encourage students to consider: » The most appropriate form of speech for a meeting of international politicians (for example, they should use formal language) » How they can ensure that they are clear and informative » How they will split the presentation within the group (will they choose a lead spokesperson or take turns presenting part of their speech?) The above instructions are also outlined on the briefing sheets (5r2). Students have ten minutes to prepare their speeches. If you have more time and access to the internet, give students time to carry out their own research for their speeches – the World Health Organisation, Wellcome Trust and UN Millennium Development Goal 6 websites are a good place to start. They could think about the potential effects of malaria and other diseases on some of the following issues of local and global concern: politics; economics; media; business; community; families; relationships; environment; religion; culture; globalisation; travel; education; law; international relations; science; technologies; communications; infrastructure; architecture; employment; r2 and demographics (population).

LESSON 5 PAGE 3 OF 4 © Royal Commonwealth Society | www.thercs.org/youth

5 91

Co mm on we al th SC HO OL RE SO UR CE S » Lesson 5 » Suggested time allowance for activities

» Activity 3: Presentations to the Commonwealth Health Ministers You may want to rearrange the furniture to represent a meeting of the Commonwealth Health Ministers, with a space for presentations at the front of the room and the audience facing this area. As each group presents, the rest of the class will form the audience of Health Ministers. If you have time, you could assign each student a different country to represent as Health Minister. You could also give out the student feedback sheets (5r3) if you think you will have time at the end of the lesson for students to feed back to each other about their presentations. The teacher (or a selected student) will act as chair, and should open the meeting in role – welcoming the Health Ministers and explaining the aim of the session. Each group in turn will then give their presentation. Make sure you time the presentations to no more than three minutes, if lesson time is limited!

10-25m

5 r3

» Activity 4: Vote and closing session The chair draws the presentations to a close, thanking the speakers and explaining that: »H ealth Ministers will now be asked to vote on the method of prevention they will recommend their government invests in (within their own country or for other countries in the form of aid) »M inisters have one vote, which they can use for any of the 6 methods, or for a 7th category: ‘a mixed approach’. »W hatever they vote for, Ministers must be prepared to justify their choice. If they choose a mixed approach they will need to be able to explain which mix of methods they would invest in and why.

50 60m

Ask students to vote, and then encourage a range of Health Ministers (students) to feed back their reasons (and distribution, if mixed approach). You could pick names out of a hat to decide who to call on, ask for volunteers, or ask one student per group. If there is time, follow up by asking individual Ministers to respond to some closing questions, for example: » Why do you think it is important to invest in malarial prevention? » How is malaria (and other diseases) linked to development? » What can we do to help with this global problem? Finally, if you have time, you could ask students to constructively feed back to each other on the group presentations using the student feedback sheets (5r3) as a prompt.

5 r3 View p26

CommonGround guide

5 92

LESSON 5 PAGE 4 OF 4 © Royal Commonwealth Society | www.thercs.org/youth

Ma la ria Int ro du ct or y Po we rp oin t » Resource 5r1 » Please view powerpoint presentation supplied on resource disk

» Malaria an introduction powerpoint presentation

RESOURCE 5r1 PAGE 1 OF 1 © Royal Commonwealth Society | www.thercs.org/youth

5 r1 93

» Resource 5r2 s et She ing ief Br nt de stu ion ent ev pr ia Malar » A: Mosquito nets

GROUP A

Commonwealth Health Ministers

You have been selected as malarial experts to speak to the next meeting of the Commonwealth Health Ministers. This meeting is an opportunity for the Ministers from a range of different countries around the Commonwealth to hear about different methods of malarial prevention, and consider which methods their governments should invest in (within their own countries or through aid to other countries). Your group will make a three minute presentation outlining the prevention method detailed on this briefing sheet: mosquito nets. YOU MUST:

• Introduce the prevention method • Explain how/why it works (how does it prevent/reduce illness or deaths) • Outline its benefits and disadvantages (e.g. effectiveness, ease of use, cost) • Give one main reason why combating malaria will contribute to development (e.g. think about how such problematic diseases might affect the workings of the health and education systems of a country) The information below should be used as a starting point but you should not simply read it out: your speech should be well-structured and persuasive. As you prepare your speech, think about: • The most appropriate form of speech for a meeting of international politicians (for example, you should use formal language) • How you can ensure that your presentation is clear and informative • How you will split the presentation within the group (will you choose a lead spokesperson or each have a turn presenting part of the speech?)

Mosquito nets

• Only female mosquitoes drink blood, to fuel the production of eggs. Female mosquitoes usually bite between sunset and sunrise, when people are often sleeping, so a net provides protection. • 60 out of 400 species of Anopheles mosquitoes (the main type of mosquito that carries malaria) are malarial vectors (they carry the disease between organisms including humans). • Mosquito nets are one way of controlling the vector, by providing a physical barrier that helps prevent exposure to infected mosquito bites. ‘Vector control’ is the only intervention that can reduce malaria transmission from very high levels to close to zero. • To be truly effective, mosquito nets need to impregnated with insecticides, which reduce the lifespan of the mosquitoes that come into contact with it. Nets can be relatively expensive and require regular re-treatment.

5 r2 94

RESOURCE 5r2 PAGE 1 OF 6 © Royal Commonwealth Society | www.thercs.org/youth

» Resource 5r2 s et She ing ief Br nt de stu ion ent ev pr ia Malar » B: Insecticide

GROUP B

Commonwealth Health Ministers

Insecticide

• Insecticides can be used in a number of ways. For example, they can be used to impregnate mosquito nets so that they are more effective and they can be sprayed onto the inside of homes. • 60 out of 400 species of Anopheles mosquitoes (the main type of mosquito that carries malaria) are malarial vectors (they carry the disease between organisms including humans). • Using insecticide is one way of controlling the vector. ‘Vector control’ is the only intervention that can reduce malaria transmission from very high levels to close to zero. • Mosquitoes are becoming resistant to some types of insecticide which are heavily used. The development of new, alternative insecticides is an expensive and long-term endeavour. • Only female mosquitoes drink blood, to fuel the production of eggs. Female mosquitoes bite usually between sunset and sunrise, when people are often sleeping, so spraying nets with insecticide provides good protection. • Spraying the inside of homes can be effective for 3-6 months, depending on the insecticide used and the type of surface onto which it is sprayed. It is most effective when at least 80% of houses in a targeted area are sprayed. • Insecticides can be expensive and harmful to people.

RESOURCE 5r2 PAGE 2 OF 6 © Royal Commonwealth Society | www.thercs.org/youth

5 r2 95

» Resource 5r2 s et She ing ief Br nt de stu ion ent ev pr ia Malar » C:Vaccine

GROUP C

Commonwealth Health Ministers

Vaccine

• No malaria vaccines are available, although several are under development and testing. • Research into a vaccine is extremely expensive, but if successful the disease could be completely eradicated (wiped out). • A vaccine improves the body’s immunity to a disease by enabling the immune system to recognize and destroy the disease-causing micro-organism (in this case, the malaria parasite). • The body’s immune response to malaria is complex and not well understood. • A vaccine needs to work in few doses, be cheap to make and easy to administer.

5 r2 96

RESOURCE 5r2 PAGE 3 OF 6 © Royal Commonwealth Society | www.thercs.org/youth

» Resource 5r2 s et She ing ief Br nt de stu ion ent ev pr ia Malar » D: Education Initiatives

GROUP D

Commonwealth Health Ministers

Education Initiatives

• People need to be educated about the range of measures they can take to protect themselves from being bitten by infected mosquitoes. For example: wearing light-coloured clothes which mosquitoes are less attracted to and keeping covered up with long trousers and shirt sleeves. Adding window screens to houses can also make a difference. • Mosquito nets are only effective if people are taught to use them properly. • Some of the most effective measures to prevent malaria are mosquito nets and insecticide spraying. Without funding and organised programmes for distributing these, education alone may have limited impact. However, education helps to demonstrate the importance of malaria prevention to the population, and they can then lobby their governments to provide more funding for such resources. • People can be encouraged through education to make changes to their local environment to control the Anopheles mosquito, which is the main vector for malaria (a vector is an organism that carries a disease between different organisms including humans) and breeds in shallow collections of freshwater such as puddles and ponds.

5 r2 97

» Resource 5r2 s et She ing ief Br nt de stu ion ent ev pr ia Malar » E: Prophylactic (prevention) drugs

GROUP E

Commonwealth Health Ministers

Prophylactic (prevention) drugs

• Prophylactic drugs suppress the human blood stage of the parasite’s life cycle and so prevent the individual becoming ill with the disease, even if they get bitten and infected by mosquitoes. • When an infected mosquito bites a human to drink blood, parasites are injected into the bloodstream. The parasites infect the liver and then red blood cells. The classic symptoms of malaria consist of bouts of fever that coincide with the parasites bursting out of the red blood cells. Infected red blood cells can also clump together, blocking blood flow and damaging internal organs, including the brain. • Prophylactic drugs are relatively expensive and it would be financially and logistically difficult to distribute such drugs to everyone living in an infected area throughout their lives. • Prophylactic drugs can be a good solution for travellers to an infected area. • Adults living in areas of moderate or intense transmission of malaria develop natural immunity to malaria over years of exposure, although this never gives complete protection. As a result, most malaria deaths in Africa occur amongst young children who have not yet built up their own immunity. These children might therefore be the priority cases for the use of prophylactic drugs. However, if they use the drugs, they may be less likely to build up their own natural immunity. • The parasite develops resistance to antimalarial drugs rapidly. In many parts of the world it has become resistant to chloroquine, the most commonly used and most affordable antimalarial drug.

5 r2 98

» Resource 5r2 s et She ing ief Br nt de stu ion ent ev pr ia Malar » F: Treatment of the disease

GROUP F

Commonwealth Health Ministers

Treatment of the disease

• Once an individual becomes ill with malaria, they can take drugs (similar to those used for prevention) to suppress the blood stage of the malarial life cycle. The drugs do not necessarily prevent an infected person from contracting the disease itself (getting ill), but they do help to prevent deaths and serious disabilities resulting from the disease. • Treatment drugs can also reduce the chances of the parasite being passed on to other people by mosquitoes that bite infected people. • Early and effective treatment of malaria can shorten the duration of the infection and prevent further complications including the great majority of deaths. If people do not seek medical help early, there is less chance of the drugs being effective. • When an infected mosquito bites a human to drink blood, parasites are injected into the bloodstream. The parasites infect the liver and then red blood cells. The classic symptoms of malaria consist of bouts of fever that coincide with the parasites bursting out of the red blood cells. Infected red blood cells can also clump together, blocking blood flow and damaging internal organs, including the brain. • Combination therapy is often used to prolong the useful life of these drugs, which means two or more drugs are taken together to reduce the chances of the parasite building up resistance. • Some of the drugs used are effective very quickly. However, this means that patients might stop taking them too early, leaving parasites in their blood. This can lead to parasites building up resistance to the treatment. • The first widely used antimalarial drug treatment, quinine from Peruvian bark, was discovered long before anyone knew what caused malaria.

5 r2 99

St ud en t Fee db ac k Sh ee ts » Resource 5r3 » Feed back to your fellow Health Ministers!

Health Feed back to your fellow

wn your Use this sheet to write do tation, sen feedback about each pre . and your final decision

Name: Group: Presentation Group

Ministers!

What was good about the presentation?

How could the presentation have been improved?

A: Mosquito nets

B: Insecticide

C: Vaccine

D: Education Initiatives E: Prophylactic (prevention) drugs F: Treatment of the disease

• Which malaria prevention

method did you choose?

• Why? make • Was it easy or difficult to

your decision – and why do

thing you have • What is the most interesting

5 r3 100

you think this is?

development? found out about malaria and