Closed captions transcript:

00:00:00
To absolutely stay at home and less It is
absolutely essential to go outside this

00:00:06
is video a new news China expressed
its strong opposition Tuesday to u.s.

00:00:12
President Donald Trump using the term
Chinese virus to refer to the novel

00:00:17
coronavirus that has spread to more than
$150.00 countries around the world Chinese

00:00:22
Foreign Ministry spokesman Jane Shuang
said Mr Trump's language stigmatizes the

00:00:26
Chinese President Trump tweeted Monday
the United States will be powerfully

00:00:31
supporting those industries like airlines
and others that are particularly affected

00:00:35
by the Chinese virus us
Secretary of State Mike Pompei

00:00:39
o told Iraqi prime minister Abdel Abdul
Mahdi on Monday that those responsible for

00:00:44
a deadly attack on

00:00:45
a military base last week must be held
accountable to American service members and

00:00:50
a British medic were killed when Iraqi base
Camp Taji came under rocket attack last

00:00:55
Wednesday at least 14 others were injured.
The International Organization for

00:01:01
Migration reports that despite Yemen's
brutal civil war tens of thousands of

00:01:06
refugees and migrants cross the Gulf of
Aden each year into the conflict ridden

00:01:11
country in hopes of reaching Saudi
Arabia and finding work for v.o.a.

00:01:16
Lisa shrine reports from Iowa headquarters
in Geneva the United Nations considers

00:01:22
Yemen the world's worst humanitarian
catastrophe despite this to status of her

00:01:27
situation migrants from the Horn of Africa
remain undeterred in their determination

00:01:33
to reach Yemen and then to
Saudi Arabia and to hope for

00:01:36
a better life last year the International
Organization for Migration reports more

00:01:42
than 138000 people cross the Gulf of Aden
to Yemen it says an agreement last year

00:01:48
between Saudi Arabia in Ethiopia that
allows 100000 Ethiopian workers to travel

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legally to Saudi Arabia for work has been
successful and the agency calls for it to

00:02:00
be extended Lisa shrine for v.o.a.

00:02:03
News Geneva for more on this story
visit our website at v.o.a.

00:02:07
News dot com the world of United States
Sports was shaken to the hilt earlier today

00:02:13
his legendary New England Patriots quarterback
Tom Brady an ounce that he will not

00:02:18
be returning to the Patriots for the 2020
season no word yet as to which team he'll

00:02:23
likely sign up with few even passive
sports fans can imagine that quarterback

00:02:28
arguably the best ever and not too much
argument that wearing any other uniform but

00:02:34
the New England red white and blue of
course Mr Brady is not the 1st nor even the

00:02:39
2nd or 3rd for that matter when considering
that Babe Ruth Michael Jordan Joe

00:02:44
Montana and Brett Farve all departed the
teams they made famous late in their

00:02:49
career hard as it is to believe Babe Ruth
the greatest of all sports icons in the

00:02:54
United States of America was

00:02:56
a one time Boston Braves.
I'm Joe Palca. Today

00:03:17
is Tuesday March 17th and this is via ways
international edition I'm Steve Miller

00:03:23
in Washington the world continues to an
extractor guidelines to prevent the spread

00:03:28
of covert 19 avoid gathering in groups
of more than 10 people plus Americans

00:03:33
cautiously go to the polls voting isn't
really the major concern for most people

00:03:38
right now in the middle of this emergency
and Hollywood technology comes to your

00:03:42
smartphone Those stories
and more are next.

00:03:57
The number of people who contracted the
covert 19 virus outside China is now

00:04:02
greater than the cases of
the disease in China with

00:04:06
a novel coronavirus was 1st identified the
coronavirus Cove in 1000 global cases

00:04:11
system run by John Hopkins
University near Washington d.c.

00:04:15
Is tracking at least 182000 cases around
the world Europe is now the center of the

00:04:22
global pandemic Italy is the hardest
hit when adding Spain Germany France

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Switzerland bred in the Netherlands Norway
Sweden Belgium Austria and Denmark that

00:04:33
accounts for over 62000 cases now to put
that into perspective China has just over

00:04:40
81000 cases the escalating threat from
covert 19 is forcing governments to take

00:04:46
action the Philippine Stock Exchange has
shut down operations indefinitely the 1st

00:04:52
stock exchange in the world to stop trading
amid the economic fallout caused by the

00:04:57
novel coronavirus pandemic the decision to
close the exchange comes as the capital

00:05:02
of Manila has been placed under

00:05:04
a virtual lockdown and it is in reaction
to daily losses. Sustained in the global

00:05:10
financial markets as
every day life grinds to

00:05:12
a halt in practically every country and
major city in an effort to halt the spread

00:05:17
of the virus other in Asia other Asian
markets ended mostly up for the day European

00:05:23
shares retreated after an initial bounce
as the damage to companies and economies

00:05:28
across the globe grows and keeps
financial markets on edge u.s.

00:05:33
Markets are up in early trading after losing
about 12 percent in value Monday this

00:05:39
is after u.s.

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President Donald Trump announced that
for the next 15 days the United States

00:05:44
government wants Americans to avoid gathering
in groups of more than 10 schooling

00:05:49
should be at home and discretionary travel
should be avoided wiil way White House

00:05:54
bureau chief Steve Herman has the details
the president in the White House briefing

00:05:59
room also said people should not
patronize bars or restaurants and not

00:06:03
unnecessarily socialize as we come back
the virus each and every one of us says

00:06:09
a critical role to play it's upping the
spread in transmission of the writers as

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the president spoke of the Dow Jones
Industrial Average closed down 13 percent its

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worst performance since the start of the
coronavirus crisis asked about the plunge

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Trump said markets will boom again once the
pandemic passes but he acknowledged in

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the meantime they have come to me could
go into a recession Steve Herman v.o.a.

00:06:37
News at the White House

00:06:38
a new Gallup poll showed some 60 percent
of Americans are now very or somewhat

00:06:43
worried that they or

00:06:45
a family member will be exposed to the
coronavirus up from 36 percent in February

00:06:50
confidence in the government's ability
to respond has fallen sharply Poland's

00:06:54
government was under quarantine Tuesday
after one minister tested positive for the

00:06:58
novel coronavirus as authorities introduced
sweeping measures to combat the spread

00:07:03
of the disease the European Union's
external borders will be closed to

00:07:07
non-essential travel for. 30 days as of
Tuesday to fight the spread of cover 19

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while France is following
Italy and Spain in imposing

00:07:16
a nationwide lockdown for at least 15
days Lisa Bryant has more the Countrywide

00:07:22
school shutdown will last at least
15 days for all French educational

00:07:27
establishments from kindergartens to
universities it counts among the most drastic

00:07:33
of the new measures French President
Emanuel might call announced in

00:07:37
a nationwide address to fight close to
3000 coronavirus cases here here insert

00:07:43
Michael act in French fade under my call
and called on elderly citizens with health

00:07:48
problems to stay home announced help for
businesses to cope with coronavirus

00:07:54
related losses and urged bosses to let
their employees work at home when possible

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major events are cancelled but mean

00:08:03
a simple elections taking place over the
next 2 Sundays will go ahead for now my

00:08:09
call called the battery
of prevention measures

00:08:12
a way to gain time so hospitals do
not become overloaded he urged civic

00:08:18
responsibility here insert Michael
Act 3 in French fade under in an

00:08:25
apparent response to the Trump administration's
temporary travel ban on most of

00:08:30
Europe McCall said Nationalism is not the
answer to the corona virus outbreak sense

00:08:36
it respects no borders he also called for

00:08:39
a united and strong European response to
deal with the virus and its financial

00:08:44
fallout beyond fiscal stimulus measures
announced Thursday by the European Central

00:08:49
Bank here insert ambient of Renzi
in French Feet Under France

00:08:56
has one of Europe's highest coronavirus
caseload although its numbers are still

00:09:01
a fraction of those in neighboring Italy
however speaking on French radio Friday

00:09:07
former Italian minister Mateo. Renzi said
the nation wide lockdown in Italy now

00:09:12
faces risk becoming the rule across Europe
he urged France to move quickly to take

00:09:18
Italy's path reactions to my calls
announcements have been mixed including not

00:09:24
surprisingly from his political opponents
the French employers Union saluted them

00:09:30
here insert. Act in French fade
under stiff and close shave general

00:09:36
secretary of the se un s
teachers union told French t.v.

00:09:41
That the nationwide school shutdown was
unexpected French authorities he said had

00:09:46
previously insisted that wouldn't
happen Lisa Bryant for v.o.a.

00:09:51
News Paris us Health officials say the
1st human trial has begun to test an

00:09:57
experimental corona virus vaccine that
scientists race to find treatments for the

00:10:02
pandemic scientists at the Kaiser
Permanente Washington Research Institute in

00:10:07
Seattle give the 1st shots Monday to a
small group of healthy people the u.s.

00:10:12
National Institutes of Health said the
trial would involve 45 healthy adult

00:10:16
volunteers between the ages of 18 and
55 who would be given the experimental

00:10:21
vaccine over

00:10:22
a 6 week period it is one of many studies
of experimental vaccines that will take

00:10:27
place around the world in the
coming months to try and find

00:10:31
a way to protect people against
covert 19 scientists say

00:10:35
a vaccine will likely not be available
for widespread use for at least

00:10:39
a year as all potential vaccines must go
through several phases of testing to prove

00:10:45
that they work and are safe elsewhere
on Monday Colombia enacted

00:10:49
a complete ban on entering use of nonresidents
but tens of thousands of people from

00:10:54
neighboring Venezuela cross into Colombia
each day seeking food and medical

00:10:58
supplies in addition more than 1700000
Venezuelans are living in Colombia after

00:11:04
fleeing economic and political upheaval
in their home country for more of the

00:11:08
potential if. Of Columbia's decision on
Venezuelan migrants to view ways Jason

00:11:12
particular and spoke earlier to
journalist Megan Jeanette's. It was

00:11:17
a closure that we expected
because Colombia is also facing

00:11:21
a medical crisis it especially on the
borders and large part to the Venezuelan

00:11:26
migration their hospitals are very very
overwhelmed so like last night said we are

00:11:32
facing one of the biggest challenges in our
history which is pretty significant for

00:11:36
a country with half of century civil war
behind them but I think I think the

00:11:40
scariest thing about the border being
closed with Venezuela is just the

00:11:44
humanitarian

00:11:45
a fax and migrants being pushed into
clandestine means of you know surviving

00:11:52
so obviously there's been. A huge migration
of people moving from them as well into

00:11:59
Colombia due to the political unrest in the
humanitarian situation in Venezuela how

00:12:04
this closure of borders affects those people
thousands of people leave the country

00:12:10
every single day and many more I would say
about 4050000 people cross by land to

00:12:17
get supplies like food medicine so
even like basic medical services

00:12:24
in Colombia because Venezuela is so
collapsed at this moment so that that's the

00:12:29
context like there

00:12:30
a lot of people are already relying on these
borders and what everyone pretty much

00:12:34
expects is that more desperate migrants
will be pushed into these things called

00:12:38
Treacherous which are informal pathways
along the border where they have to get

00:12:42
small gold over and those
can be very dangerous and

00:12:46
a lot of times it's migrants that are
then victimize that sounds like there's

00:12:51
really not

00:12:51
a way to actually close the border it
sounds like it's just closing the official

00:12:56
crossings but the border is in no way
sealed that's not actually something that

00:13:00
will stop people from coming from Venezuela
and so Colombia No No And I mean you

00:13:05
see that everywhere there's so many people
just flowing. Over and you even see that

00:13:10
with the illegality the aspects of the
border with Colombia you know there are

00:13:14
a lot of armed groups that run along the
Colombia Venezuela border between the 2

00:13:20
countries because it's kind of just

00:13:22
a porous and fairly large border
so while you can create these

00:13:29
migratory restrictions people are going to
keep coming what does that mean for the

00:13:35
health migrants and refugees who are already
people are already pretty much on able

00:13:41
to get food and basic supplies like hand
sanitizer and Mike it's get it's really

00:13:47
really hard to self isolate like if you
look at for instance Venezuela and across

00:13:52
the region many are like homeless living
on the streets having in shelters living

00:13:55
in homes with like 12 different people
it just makes the challenges for these

00:14:02
people so much higher and what about for
Venezuela Venezuela is obviously suffering

00:14:09
quite

00:14:10
a bit of the political unrest in our people
over the last few years with this border

00:14:15
being closed what will that mean for
potentially getting medical supplies into that

00:14:19
country I have met so many people about
it rely on Colombia and even other

00:14:25
countries to bring back supply is to sustain
their family if it continues on the

00:14:29
pace that it's going out in terms
of closures it's going to be

00:14:34
a lot harder and have

00:14:36
a lot more negative implications for an
already desperate population and Venezuela

00:14:42
that was making Jeanette's journalist amid

00:14:45
a Columbia she spoke to our own Jason
Patinkin there is significantly more covert

00:14:50
1000 related information available via

00:14:53
a News dot com. Turkish

00:15:03
French German and British
leaders are holding

00:15:05
a video summit to address the migration
crisis. Summit comes after Turkey opened

00:15:10
its European borders to refugees saying
it can no longer cope with over 3000000

00:15:15
refugees mainly from Syria
Grizz move comes as a Fear is

00:15:20
a new exodus from Syria as government
forces prepare to seize the last rebel

00:15:25
stronghold in limbo the video summit is
expected to discuss both it live and

00:15:29
Turkey's European Union refugee deal for
more I spoke with reporter Dorian Jones in

00:15:35
Istanbul Well I think the. Discussion
will focus on this crisis on the

00:15:42
Greek area in border with Turkey with migrant
over the last few weeks are going to

00:15:47
Aus and NZ tens of thousands of migrants
trying to enter into Greece primarily off

00:15:52
to take its open door policy to Europe for
refugees and migrants in his country I

00:15:58
think that will be

00:15:58
a key area of discussion on earth side
they will be pressing all reexamination

00:16:05
a new deal migration refugee to deal
with the European Union there was

00:16:10
a feeling 2015 that to be ended

00:16:13
a mass exodus of refugees into Europe
1000000 or so people entered followed that

00:16:19
deal those numbers drastically fell but
on Cross says the terms of that deal was

00:16:24
fulfilled on the European side

00:16:26
a question of money they're looking for
around $3000000000.00 more Euro Zone they

00:16:30
also want to

00:16:31
a new deal going full now that will be
another area of tool and also will be the

00:16:36
face of the situation in Italy this theory
improv in the last help by rebels that

00:16:42
currently under siege
by Damascus forces it's

00:16:45
a very tentative ceasefire but Uncle realizes
that the thought is unlikely they are

00:16:51
looking for support for
their idea of creating

00:16:53
a safe haven they're protected by no fly
zone or will be looking to it's told the

00:16:59
key NATO members to back that going
forward which they feel would prevent

00:17:03
a new exodus of refugees into speaking of
refugees this is all happening. Under the

00:17:10
umbrella of the worldwide pandemic of the
krona virus covered 19 What concerns are

00:17:16
the parties discussing in terms of humanitarian
relief well I think that because of

00:17:21
the new dimension on the already extremely
difficult situation there is the concern

00:17:26
that taking

00:17:27
a clip of this virus spread to create
another humanitarian crisis on top of the

00:17:32
already existing one we have already very
little health infrastructure and what

00:17:37
there is is being targeted by the mask

00:17:39
a school says serious is given
the fact that there is a around

00:17:42
a 1000000 refugees already on Turkey border
if the riots could too cold and there

00:17:48
was the situation would be catastrophic
that there were already warnings from the

00:17:51
u.n.

00:17:52
. So I think the crew will be using that as
another argument for creating that faith

00:17:59
that are allow some kind of medical
infrastructure to be created there to prevent

00:18:04
that catastrophe which is how uncle described
this and also many international aid

00:18:08
agencies on top of that the fact that that
these refugees seeking to enter Iraq is

00:18:13
another concern that the fear that many
of them possibly could be carrying the

00:18:17
virus given the fact that quite

00:18:18
a lot of them are rainy and
refugees in them does have

00:18:22
a major problem with the virus as well so
this will all add and I think focus the

00:18:26
minds on resolving this why the problem
of breathy cheated given the fact that

00:18:30
these people will find it more difficult
to access help they are seen as

00:18:34
a primary concern of many aid agencies so
I think that this is another factor and I

00:18:40
think that we are seeing already the
situation on the Greek and very important

00:18:45
situation does seem to be resolving itself
we're getting reports it's much karma

00:18:48
that the report is that taking the refugees
away from the border back into the main

00:18:54
that was to be the gesture by Ankara ahead
of the talks so I think that that is

00:19:00
enough of primary fear and concern among
those talking today in resolving this

00:19:05
migration crisis that was Dorian Jones in
Istanbul. The internationally condemned

00:19:11
ritual of female genital mutilation is
practiced in the least $92.00 countries

00:19:15
according to a new study released
by 3 advocacy groups despite

00:19:19
a decline in its prevalence in recent
decades there are still millions of girls

00:19:23
around the world subjected to the
painful and dangerous practice the u.n.

00:19:28
Estimates that more than 200000000 girls
have undergone the ritual in 32 countries

00:19:33
in recent decades the us government
considers female genital mutilation

00:19:38
a serious human rights abuse and

00:19:40
a form of gender based violence and child
abuse in 2015 un members set eradication

00:19:47
of f g m as one of their sustainable
development goals for 2030 but

00:19:52
a 2800 United Nations Population Fund
report warned that if current population

00:19:56
trends hold at least 68000000 more girls
will face f g m by 2030 with the number of

00:20:03
victims rising to 4600000 per year and
still to come voting is that really the

00:20:10
major concern for most people right now
in the middle of this emergency if you're

00:20:13
listening to v.o.a.

00:20:15
News.

00:20:21
17 or 6180.

00:20:31
Paper in say home St Patrick's Day is
named guys in the Irish village and other

00:20:36
authorities say happened on this day
more than 3 decades later for 93

00:20:41
a day 2003 President George w.

00:20:45
Bush gives an ultimatum to Iraq's dictator
Saddam Hussein and his 2 sons Saddam

00:20:50
Hussein and his sons must leave
Iraq within 48 hours. Their

00:20:57
refusal to do so will result in
military conflict commenced at

00:21:02
a time of our choosing days later the
American led invasion of Iraq begins toppling

00:21:07
Saddam as brutal regime from power. Today
in History March 17th Mike Ross to the

00:21:13
Associated Press.

00:21:22
Tuesday in primary elections to pick the
Democratic Party's presidential candidate

00:21:27
despite worries about the krona virus
outbreak that forced one state to postpone

00:21:31
its voting going into Tuesday for. Former
Vice President Joe Biden leads for months

00:21:38
Senator Bernie Sanders 898 to
745 in pledged delegates v.o.a.

00:21:44
Skein Farah Bol is covering the primaries
and I asked him how things are going as

00:21:49
Ohio Illinois Florida and Arizona However
in the late hours Monday night into

00:21:55
Tuesday Ohio is post quoting its primary
election so that's leaving voters going to

00:22:01
the polls now it's 3 states Illinois Arizona
and Florida you know I think I said

00:22:08
Chicago instead of Florida that my in the
1st part of that sorry I just start over

00:22:12
again it's all right one of those days
Steve Yeah yeah. Well the week began there

00:22:18
was meant to be voting in 4 states and
that would have been Ohio Illinois Arizona

00:22:23
and Florida but in the late hours of
Monday into Tuesday morning and really

00:22:28
throughout the weekend officials in Ohio
have been trying to delay or postpone

00:22:32
Ohio's primary and Ohio's primary at least
as it stands right now is not occurring

00:22:37
but the primary elections in the other
3 states Illinois Florida Arizona are

00:22:41
underway you're out there in Illinois and
you went out to polling places today what

00:22:46
did you see and are voters coming out in
the normal numbers or is the concern about

00:22:53
the covert one team coronavirus affecting
voter output Well the concern is already

00:22:58
taken hold and really the week leading up
to the primary election here in Illinois

00:23:02
there were many polling precincts or polling
locations inside nursing homes in my

00:23:07
particular community and those were some
of the 1st polling location that had to be

00:23:11
moved elsewhere in order to maintain
safe distances from some of the elderly

00:23:17
population who are most susceptible to
the cook at my iris so there's been

00:23:21
a little bit of confusion as to where some
of the polling locations have shifted to

00:23:25
in order to keep them out of nursing homes
in areas where the elderly are the most

00:23:30
at risk and the congregate so that's
started out when I went to the polls this

00:23:35
morning I'm in an area right
now that does not yet have

00:23:37
a confirmed case of Coke at 19 in the state
of Illinois so but turnout here I would

00:23:44
say is that we were among some of the only
voters at our polling location in our

00:23:49
precincts when I looked at the registration
at least in the ballot box and we put

00:23:54
our ballot in the box it looks like there
might have been 21 voters in my present

00:23:58
for us I think that's down

00:24:01
a little bit but I think the real
understanding of how this is impacting voter

00:24:05
turnout won't be known
until we start to see

00:24:07
a lot more of the real numbers trickle
in here towards the end of the day if we

00:24:11
take

00:24:11
a look forward there has been some discussion
of whether or not there will be. Political

00:24:16
conventions this summer to formally
choose the nominees for the Democrats and

00:24:20
Republican parties have voters' expression

00:24:23
a kind of concern about what impact the
coronavirus may have on the electoral

00:24:27
process it's already changing this electoral
process dramatically I mean neither

00:24:33
Right now it's really

00:24:34
a 2 way race between former Vice President
Joe Biden and provide Senator Bernie

00:24:39
Sanders for the Democratic nomination.
President Donald Trump is the presumed

00:24:43
Republican nominee so right now neither
Biden nor Sanders can really get out and

00:24:50
campaign in person and or standards in
particular large rallies were sort of

00:24:55
a hallmark of his campaign at least leading
up to this call that 19 emergency if he

00:25:01
can't do that anymore and he is the candidate
trailing Joe Biden so if he is going

00:25:05
to increase voter turnout I mean

00:25:07
a primary election in the weeks ahead
rallying his voters and getting them out to

00:25:14
vote for him which is something he needs
to do and he previously had done that by

00:25:18
these big rallies and motivating people in
these large crowds that was feeling his

00:25:22
cane Farrah Barr a trial opened in the
Netherlands on Monday of 3 Russians and

00:25:28
a Ukrainian over the downing of Malaysia
Airlines Flight 172014 orders Lauren

00:25:34
Anthony reports the China full fugitive
suspects over the downing of Malaysian

00:25:39
Airlines Flight 17 started in Amsterdam on
Monday more than 5 years after the plane

00:25:44
came down in Ukraine prosecutors say 3
Russians and Ukrainians will be tried in

00:25:49
absentia charged with murder and they're
accused of helping to arrange the Russian

00:25:54
missile system it used to shoot down the
passenger jet ski the suspects still at

00:25:58
large I believe to be in Russia. And

00:26:01
a 17 was traveling from Amsterdam to
Kuala Lumpur in 2014 when it was hit by

00:26:06
a surface to air missile aisle old 298
passengers and crew were killed on Sunday

00:26:13
some of the victims' families protested
outside the Russia. Embassy in The Hague

00:26:17
and his house empty chairs to represent
those who died. The idea of the action is

00:26:22
sure to make perfectly clear to the Russian
state that they have to cooperate with

00:26:28
you 1st occasion you know up till now the
Russians should have obstruct It's the

00:26:34
investigation. Or at least they
didn't didn't cooperate with the

00:26:39
a 1st edition of the joint investigation
team the defendants Russians say see I

00:26:44
like. Ken and Ukrainian. Had senior positions
in pro Russian militias in eastern

00:26:50
Ukraine back in 2014 they are presumed
innocent until proven guilty back and has

00:26:57
said rebels were not responsible for the
plane's Downing and declined the comments

00:27:01
the across Downing lets

00:27:02
a sanctions against Russia by the European
Union and high since tensions between

00:27:06
Russia and Western policy play meds for
the disaster that was Warners reporter

00:27:10
Lauren Anthony Iraq's military
said Tuesday 2 rockets struck

00:27:14
a base south of Baghdad hosting u.s.

00:27:16
Led coalition troops and NATO trainers the
statement did not include any mention of

00:27:21
casualties the rockets hit the bus Maya
base where there are coalition troops from

00:27:26
Spain as part of the mission to combat
the Islamic state militant group

00:27:30
a rocket attack last week at Camp Taji
north of the Iraqi capital killed 2 u.s.

00:27:35
Service members and a British medic
Well wounding 14 others the u.s.

00:27:40
Has blamed such attacks on
already and proxies in Iraq u.s.

00:27:44
Forces carried out where you tell

00:27:46
a story of strikes Thursday on Friday
against weapons depots of Iranian backed

00:27:50
group Taiba Hezbollah. And that's going
to do it for us today until next time I'm

00:27:57
Steve Miller in Washington have

00:27:58
a great day. Good

00:28:16
evening everyone I'm Nina and
welcome to help get this there were

00:28:22
212000000 malaria cases walled wide
in 2015 These songs are all making

00:28:28
right however the World Health Organization
says the answer depends of malaria has

00:28:33
decreased in the world by 21
percent between 2010 and 2015

00:28:40
most victims of malaria are children and
at the age of 5 will live in sub-Saharan

00:28:46
Africa pregnant women are also very vulnerable
to the muscular bone disease we will

00:28:52
discuss malaria on the program today and
joining us via phone from Baltimore

00:28:57
Maryland outside of Washington d.c.

00:29:00
Is Elaine Roman project director
with the top project transforming

00:29:06
i.p.t.

00:29:07
For optimal Pregnancy Project that's what
tipped up stands for Ms Roman Welcome to

00:29:14
the show thank you for having me and we
also have with us on the phone joining us

00:29:20
from Baltimore is Dr Emmanuel De Paul also
Lauren He's senior regional technical

00:29:26
and programatic advisor of tiptop in Nigeria
thank you so much Dr oldest daughter

00:29:31
Lauren for joining us. Thank you for having
me so let's stop discussing malaria in

00:29:37
a moment but 1st here is a report it's
being called the malaria parasites

00:29:42
a key lease heal

00:29:44
a protein that the parasite Plasmodium
falciparum uses to infect red blood cells by

00:29:50
blocking the protein called p.f. A.p.

00:29:53
To the malaria parasite cannot enter the
cells where it replicates billions of

00:29:59
times before bursting forth into the
bloodstream the hallmarks symptoms of malaria

00:30:05
including high fever and chills come in
waves every 48 hours each time the parasite

00:30:11
reproduces halting the so-called invasion
phase according to lead researcher men

00:30:16
well you Nuss could potentially
stop the infection offering

00:30:20
a cure invasion has been for

00:30:23
a long time considered you know one
of the key parasite specific process

00:30:30
sees that if inhibited would prevent
the full blown mass of infections that

00:30:37
one normally gets you know skin colleagues
at Pennsylvania State University have

00:30:41
identified and characterized p.s.

00:30:44
a P 2 I finding that it regulates more
than $150.00 parasitic genes nearly 20

00:30:51
percent of which are known to be involved
in Red Cell invasion the findings are

00:30:55
reported in the journal Cell host and
microbe for the past 50 years enough says

00:31:02
researchers have been trying to find

00:31:04
a way to attack the invasion phase typically
with vaccines that harness the immune

00:31:09
system because the parasite has dozens of
mechanisms that pull it into red blood

00:31:14
cells after attaching to their surface
enough says it's hard to raise an immune

00:31:19
response to block the mall says a compound
that interferes with the parasites p.f.

00:31:25
A.p. To I protein has the
potential to stop invasion in

00:31:29
a single action you will ultimately impact.
A very large number of genes that are

00:31:35
involved in invasion but you always need
to target one protein specifically and

00:31:39
that's a p.

00:31:40
2 I protein because if it doesn't function
properly it's never turning on this

00:31:45
large set of invasion genes that are
required for that process to actually ever

00:31:49
occur he now says the next
step is to actually develop

00:31:53
a drug the targets the parasitic
protein in addition to

00:31:57
a possible cure an agent
that blocks p.f.a.

00:32:00
P 2 I has the potential to break the
transmission cycle since there would be few

00:32:05
with any daughter parasites in the bloodstream
to infect biting mosquitoes there

00:32:11
are an estimated $212000000.00 cases of
malaria each year and the disease kills

00:32:16
429000 people most of them young children
in sub-Saharan Africa Jessica Berman

00:32:23
v.o.a.

00:32:24
News Washington some Israel man and thank
you so much again for joining us on

00:32:31
House chat today let me start with
you Dr autonomy and can give us

00:32:35
a sense of the issue of malaria we know
that sub-Saharan Africa is very vulnerable

00:32:42
children under the age of 5 as I mentioned
earlier definitely most of the victims

00:32:47
can you give us

00:32:48
a sense of what is happening on the continent
thank you very much well the problem

00:32:54
is that many. One in every
kid. I was taught me

00:33:02
most of those times. That
I. Didn't buy it but that.

00:33:10
And then one did by the audience
that. The people that you. Meet the.

00:33:18
Leno the boss of the world's
money. Needed it. But because we

00:33:25
would have other battlements cried out on
the top of the template and call it good

00:33:31
bleeding. Because. The translation that.

00:33:39
Low cost solution will. Cause the
most important is to prevent

00:33:46
people by gene pool through
the use of. That but net.

00:33:55
Enough operates so not. So. Big

00:34:02
because of a show on the
sobbing for more than

00:34:04
a. Mosque on. Net distribution we also

00:34:11
have big with assets will drugs be used
to treat those who have Monday or however

00:34:18
beginning to see

00:34:19
a decline but the decline is fast enough.
To Blow better very quickly to leave

00:34:25
a nation of the cogs in the continent
continent and I mean it's.

00:34:32
It's incredible to know that different
ways that prevention can be empty mantid

00:34:38
However so many people

00:34:40
a victim exec's especially children and
pregnant women middle men would you please

00:34:45
tell us about how men are even affecting
pregnant women Thank you yes pregnant

00:34:51
women are particularly vulnerable to
the infection and what Malaria does in

00:34:58
Craig and c.

00:34:59
Is that lend to increase the rate severe
maternal anemia which lead to low

00:35:05
birth weight babies and so we really see

00:35:08
a trickle of negative down. From the
mother to her fetus to the newborn and

00:35:15
to Dr o.

00:35:17
To learn with. Saying we really want to aim
to prevent malaria and pregnancy so it

00:35:23
doesn't affect the mother or her newborn
baby Ok so when we look at prevention as

00:35:30
looking at specifically in the case of
pregnant women what are we saying in terms

00:35:36
of what is being suggested but I won't
have organization know if then your

00:35:42
organization what are the steps that are
recommended for pregnant women Thank you

00:35:49
well the good news is that we do have the
tools for prevention the World Health

00:35:53
Organization record then
just prior go promote

00:35:58
a 3 pronged approach in pregnancy where
women are living in moderate to high in the

00:36:04
area transmission area and then generally
they are in Africa so the 1st which was

00:36:10
mentioned earlier making sure that the
pregnant woman is sleeping under an infected

00:36:15
treated bed nets the 2nd one is giving her

00:36:18
a full treatment of an anti malarial
at least 3 times during her

00:36:25
pregnancy beginning is their earliest
possible in the 2nd trimester and we call

00:36:30
that interim it can preventive treatment.
And then in addition to that we want to

00:36:36
make sure that any pregnant woman who has
signs or symptoms of malaria immediately

00:36:43
seek care for diagnosis and if she can
repeat appropriate treatment. And not

00:36:50
to. Can you expand a little
more on the enter a mutant

00:36:54
a preventive treatment what how often do
pregnant women have to take this treatment

00:37:00
what type of treatment I was talking
about and how much access do they have

00:37:05
especially in remote said things like
villages. Ok let me just 1st of all explain

00:37:12
what happens when my area. Pregnant
with the parts I generally

00:37:19
go to the site of the. Debate and this is

00:37:24
a very important as possible for the child
found food and not to gain from the

00:37:29
mother or the baby to allow for the baby
to grow no money but in the case of

00:37:35
malaria. Parasite block the. Company bury

00:37:41
the child so the babies end
up not getting on food t.v.

00:37:47
But they tend not to go very well
and so. Nobody will. Require

00:37:54
some of them. For delivery of. So
what you are trying to do with

00:37:59
a preventive treatment is you that
everybody bathroom does have malaria

00:38:07
and they get. Drugs with the. Name. That

00:38:13
draws the every month onto the. Far Side

00:38:20
from the from the blog as
well as from the. I read use.

00:38:28
Of this by their own people so
we know that the women receive

00:38:33
a least reduce the chances of having
very the anemia and the mother or heart

00:38:40
in

00:38:41
a baby being born small on. 3
tiers why didn't they look on

00:38:48
. The entire leg is that not everything is
not to Mungo so that you that that's the

00:38:54
. Plan to get. So we're trying to
increase access by reaching out to

00:39:00
women and I think then to go to the event
that they may when. Possible so that the

00:39:08
treatment can be. In the 2nd silent.
Treatment in every month they

00:39:14
surely do not have the
most benefit. So does

00:39:21
it mean that in between the treatment given
that the treatment is not continuous

00:39:28
austerity when in case someone gets infected
with malaria there will not develop

00:39:34
the disease is that. They are
likely to develop because one is

00:39:41
drug like the lot they blow up
about it Mark. Ok Ok so so then

00:39:48
let's talk about access and I know that
we will definitely talk about the tiptop

00:39:54
project. Supported project and you can

00:40:01
tell me more about Roman before we talk
so talk about this specific project how

00:40:07
it's helping out pregnant women I wanted
to to know at this point what type of

00:40:14
improvement you have seen parents Ms Roman
you can comment on that we talked about

00:40:20
the improvement there is there has been

00:40:22
a reduction in the rate of malaria
in general according to the w.h.o.

00:40:27
What about for improvement have we seen as
and if we've seen and if we not talking

00:40:32
specifically about pregnant women but
looking at the general picture we know that

00:40:37
children in

00:40:37
a 5 are also very much the most affected
population so what do we know what

00:40:44
have we seen and what needs to be stepped
up if we don't necessarily talk about

00:40:49
pregnant woman right now well you know
well you're seeing here with really been

00:40:54
remarkable and learned quite

00:40:56
a bit you're reducing the malaria
more. Cross the world has been. An

00:41:03
introduction of new tools to fight malaria
This includes infected site treated bed

00:41:09
net and even the more acceptable to
pregnant women and young children as well

00:41:15
family and also the introduction of rapid
diagnostic tests that give clinicians and

00:41:22
health care provider the tools
to be able to quickly die.

00:41:29
Where microscopy is no Michael are not
available you know to be introduction

00:41:36
of better drug combination drugs or what
we call Artemisinin combination therapy

00:41:42
all of these things really lead to
great readout. Ssion in the morbidity

00:41:48
and. Of malaria for pregnant women
specifically we've also seen.

00:41:56
Good progress across country especially in

00:42:00
a think Erna. We need in
the 5 to 10 year increase

00:42:07
coverage of intermittent preventive treatment
so when they are not there yet and I

00:42:11
do you think it really comes down to access.
We know that pregnant women will come

00:42:18
for and needle care services often one over
90 percent of pregnant women in Africa

00:42:24
will come in at least one during
their pregnancy but then we see

00:42:28
a really drastic sharp drop after that and
through part of the sort of what we need

00:42:34
to be thinking about going forward and
what were the projects that we support is

00:42:40
how do we increase that are and how do we
ensure that the pregnant woman had every

00:42:47
opportunity to get the interment
preventive treatment. During

00:42:53
a pregnancy access is such an important
company and complain and on and on of this

00:43:00
and we are going to talk more about
addressing malaria and we'll talk about the

00:43:05
tiptop project and look at what is being
done when we're coming from and where we

00:43:11
are going in terms of fighting malaria
will continue our discussion in

00:43:14
a moment it's time for

00:43:15
a short break news room and. Stick
around we'll be right back this is

00:43:21
a message of interest from. Libya
kills thousands of people.

00:43:28
But there are some simple things you can
do to protect your family if you can.

00:43:40
If you go outside. And. Especially when it

00:43:47
is dark. After

00:43:51
a train all containers of.
Water in just one. Can

00:43:57
become

00:43:58
a breeding ground for. Anything that.

00:44:12
Livestock drink from
regularly. In the public

00:44:19
interest from. Africa. To
dealing with footballers like

00:44:26
Steven we are speaking out
to well Larry Larry is

00:44:30
a very memorable Computerworld undervalued
60 said he did mosquito net every.

00:44:36
Health Center at the 1st sign of people
for testing and treatment let's do it we

00:44:42
can keep malaria.

00:44:52
Welcome back for those of you joining us
late tonight we are discussing malaria and

00:44:57
our guests are Ellen Roman she is project
director with the tiptop transforming

00:45:03
i.p.t.

00:45:04
For optimal pregnancy project and up to
manual author Lauren his senior regional

00:45:09
technical and problematic advice
and before the break we talked

00:45:15
a lot about our pregnant woman and what.
The situation what is being done and

00:45:22
miserable and I would urge you to tell
us more about the project and help us

00:45:28
understand how these disapproved which is

00:45:32
a new program to be implemented in the next
5 year will help in curbing the answer

00:45:38
dense of malaria among pregnant women.
Sure thank you let me start by building

00:45:45
on what we were talking about earlier
in terms of access which is has been

00:45:51
a real challenge in women.
Accessing comprehensive a.n.c.

00:45:58
When we think about malaria in
pregnancy we are really thinking about

00:46:04
a component of comprehensive care for that
pregnant woman during her pregnancy so

00:46:11
it's very important that we think of
it in the context of comprehensive

00:46:15
reproductive health services because
malaria embracing you see is really

00:46:20
a maternal

00:46:21
a new born health disease and so what
tipped off the transforming intermittent

00:46:27
preventive treatment for optimal pregnancy
project is aiming to do is we're able to

00:46:33
significantly reduce malaria in pregnancy
by giving women more opportunity to

00:46:39
access back care and how are
we doing that and really just

00:46:44
a simple approach we're introducing i.p.t.

00:46:49
At the community level in in
addition to anti needle care so it's

00:46:55
giving the pregnant woman the opportunity
to receive IP team at community as well

00:47:02
as that in needle care services and what's
exciting to me about this project is the

00:47:08
5 year project covering 4
countries Nigeria dearer Congo

00:47:14
Mozambique and not

00:47:16
a gas car is it also can project you don't
have the opportunity to really build it

00:47:23
and look at how how an approach will work
and so what tipped off is doing is number

00:47:29
one we are generating the evidence through
this project for the World Health

00:47:35
Organization to be able to review their
malaria and Craig and see color scheme 5

00:47:40
years and cost about. Update their approach
our policy for Internet and preventive

00:47:45
treatment in addition unsung genies see we
are introduced in that this approach in

00:47:51
countries act meaning

00:47:53
a level and really studying the states
1st countries to be able to scale the

00:47:58
approach as well as the data and the 3rd
piece of this that's so important it's

00:48:04
introducing

00:48:04
a. Quality ensured the docs and permits
and then which is the drug that we use

00:48:11
for interment preventive treatment and
creating more demand for the drug x.

00:48:17
And 3 levels among providers as well as
pregnant women I also just want to mention

00:48:22
our partners that we're working with
working with the Barcelona Institute for

00:48:28
Global Health who are supporting us on
the research side and we're also working

00:48:33
very closely in collaboration with the
World Health Organization who's really

00:48:38
helping to foster the partnership between
reproductive health and malaria control

00:48:42
partners and then also malaria from that
would then sure you would helping us to

00:48:49
ensure that the product is available act
country level and supporting increasing

00:48:56
demand Ok now tell us
how where the countries

00:49:00
a chosen to participate
in this program. That's

00:49:06
a great question so we had we had selection
criteria all countries need to have

00:49:12
national policies in place that
were in line or harmonized with w

00:49:17
h O's current policy countries also had
to have community programs in place

00:49:24
no country right now is
implementing community i.p.t.

00:49:30
But they did have to have a community
health worker program in place and also

00:49:35
a real cornerstone of selection was the
ministry of health not just fine for the

00:49:42
projects but really their support in
leadership because from the beginning we are

00:49:48
thinking about setting the stage for
sustainability and scale up as I said before

00:49:53
and so our position is very much to support
ministries of health to drive their

00:49:58
programs and so they are really in the
leadership position to drive this project

00:50:04
and we are providing the technical
support to them so that was

00:50:07
a big part of that as well you know kind
of another piece that was critical was

00:50:12
because this project is generating evidence
through research we who want to ensure

00:50:18
that the country selection will be able
to produce the evidence that w.h.o.

00:50:25
Will need to be able to assess the evidence
so that's why we have some countries

00:50:31
that have

00:50:32
a large population some countries cover
smaller population and we are also looking

00:50:37
at geographical diversity as well Ok now
let's go to Lauren tell us about the m.

00:50:43
Dementation the project on the ground
where you want. The region your

00:50:49
cover. So this really meant
that is to create these.

00:50:56
Spaces one is one each of the countries
would be selected from districts. We to be

00:51:03
recruiting pregnant women and also identifying
community has work. To be trained

00:51:10
in the community health workers
on the. Area in pregnancy

00:51:16
particularly the IP g.p.

00:51:19
Which is the access to the special drugs
cause I don't think by the mathematics. Of

00:51:26
lovely we will need to have 100 percent of
all pregnant women have been asked to do

00:51:32
scrub but we only have one. Body in many
of these countries and they won't lend us

00:51:38
that one and that. This is why we're taking
the drugs today in the community whilst

00:51:44
also encouraging them to come to the
health facility. Vision identity.

00:51:52
As you know in many of our countries in
Africa many women do not go to the. Time

00:51:59
they go or maybe late last month of pregnancy
6 months of pregnancy and therefore

00:52:05
they will love me the opportunity of
getting medications much. Money area may

00:52:11
become evident that. Constantly
we men importance of working.

00:52:20
In the 2nd trimester I would like to be
after the 3rd month of pregnancy so that

00:52:25
they can come. To me and those who
are unable to come and are eligible

00:52:33
all receiving the p.p.p.

00:52:35
Drugs they will be given the drugs in the
community. They don't need to highly

00:52:41
recommend. That we need about 8
months early each pregnancy I think

00:52:48
the clinic or the house so. This
pregnant women come to the.

00:52:56
Beginning to get the benefits so I
think one of. Which is about 2 years

00:53:04
we will be putting about $10000.00 pregnant
women in each country and making sure

00:53:10
that in the back lead read those
you. Draw and then we look at the

00:53:17
evidence that we generated and then expand
to additional districts in the space to

00:53:24
get so that we can demonstrate
that. This. Given is one.

00:53:32
In

00:53:32
a. Distinct being each country so
this is how we are planning to

00:53:39
do the 2 paid. So when when
does this start exactly it has

00:53:46
already started. With you know all the
countries that started the project

00:53:54
some studies now lag in some. Mental
health facility to the time in the.

00:54:01
Late in s.

00:54:02
To provide the money that.
Will be doing the households

00:54:09
of the. House most of the time

00:54:12
a well you're starting from what proportion
of women have received at least $1.00

00:54:18
to $3.00 doggie's out of the medication
this is would be at baseline and after

00:54:26
2 years we could meet line. Find out
where the creed the proportion of women

00:54:33
receiving the minimum of 3 days and
then at the end of the. Line of.

00:54:40
So this started where did all the all of
these studies collecting that doesn't know

00:54:46
where we are. Studying that ventures and
shortly we'll be doing training of.

00:54:53
The city to. Walk us through with
the part by the committee held.

00:55:01
There will also be committed to what we
call get out Ok and Mr Rahman how well do

00:55:08
you measure impact and determine
success for this project. That's

00:55:14
a great question so what we want to achieve
by the end of 5 years in the areas that

00:55:20
we're working in countries the sites that
we're working we want to and we want to

00:55:25
see at least 5050 percent
of pregnant women

00:55:32
achieving i.p.p.

00:55:33
3. In their sights and then we are pregnant
women receiving 3 days' says of i.c.t.

00:55:41
In addition to that we want to make
sure that into needle care attendance.

00:55:47
Maintains or goes up and we expect that
it will actually go up given the approach

00:55:52
that we are using In addition
because tiptop is supporting

00:55:57
a preventative measure for malaria and
pregnancy we expect that it will contribute

00:56:03
to reducing maternal mortality
in the sites that we are working

00:56:10
Dr Toller in men's room and we're getting
ready to rock but before we finish let me

00:56:14
have your final parting with you Mr
Rahman thank you so much it was really

00:56:19
a pleasure and delight to speak with
you today and grant the importance of

00:56:24
addressing the Larry and pregnancy which
really devastating consequences for

00:56:29
pregnant women and their young babies I'd
also like to thank our donor unity for

00:56:36
their support and commitment
in partnership with us by

00:56:40
a go to really make an impact in the
lives of women and there may be

00:56:46
great pinned up alone in any finalists.
Yes thank you very much well my

00:56:53
kids too many women you know. Look
well. And I think I just want to quote

00:57:00
a dog of

00:57:00
a man on level. If you didn't. Look. Now

00:57:08
I already do. Fantastic and I'm totally
are in Rome and thank you so much for

00:57:15
joining us today thank you and that's all
the time we have for these edition of

00:57:20
health facts we thank our guests and
Roman project director with the tip top

00:57:25
project and Dr Emmanuel artillery and his
senior regional technical and programatic

00:57:31
advisor of tiptop which is
a project managed by j.

00:57:35
Pagel We thank all of you for listening
to today's Health chat for more on the

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topic and today's show we're not done to
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slash health tax until next time I'm your
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forit take care be well and strive
to make every day and healthy day.

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