HI-STAR

Health Improvements through

Space Technologies And Resources

HI-STAR Logo

Mission Statement

Our mission is to develop and promote aglobal 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

0 0.2 0.4 0.6 0.8 1 1.2

Millions

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 riskNo 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- STAR

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• 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

Mosquito.swf

Remote Sensing

Vegetation type DeforestationVegetation type Deforestation

Soil MoistureSoil 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 ChangesSeasonal 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

Mo

r an

et

al.

1 99 8

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 timeTransmission

• 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- STAR

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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 System1997/98 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)

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Health authorities

Processing centers

Affected population

Regional officers

Flow of MIS information

MIS Product Dissemination

Tools

Actors

Web Phone / Video

Conference

VSAT TV/Radio

Broadcasting

Processing Centers:

Delivery of MIS products (risk maps) to health authorities

X X X

National health authorities:

Delivery of simplified MIS products to Regional health officers

Feedback to MIS processing centers

Communications to affected population

X X X

X X X

X

Regional health officers/managers:

Inputs to MIS and feedback to health authorities

X X X

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

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

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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.

• 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

SatelLife

MARA

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

Dis

sem

inat

ion

syst

em

Low-cost remote-

sensing spacecraftsGeneration 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 IssuesNumber 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

Nigeria: Total Investment Cost is US$ 3.9 Million (including dissemination network)

Set-up cost Facilities in

Existing Shared Centers

4%

Set-up cost MIS Centers

32%

Dissemination Network Cost

55%

Development cost8%

Set-up cost Global Center

1%

Investment Cost Distribution

• 2 New MIS centers

• 2 Shared centers

• 1266 Dissemination points

Nigeria: Total Operation Cost is US$ 1.4 Million (including dissemination network)

Dissemination Cost47%

Share of the Global Center

Cost8%

Depriciation Initial Investment

29%

Data Cost12%

Downlink Cost0%

Cost of MIS Centers

3%Cost of Shared

Centers1%

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

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HI- STAR

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