Explanation from the Bill & Melinda Gates Foundation:
See the Gates Foundation site, “Can we really eradicate malaria?”
How many times do they call for a return to DDT?
What do you think?
Eradicate malaria – here’s how
May 24, 2009
3 Comments | 
Africa, Asia, Disease, Health care, Malaria, Politics, Public health | Tagged: Africa, Gates Foundation, Health care, Malaria, Politics, Public health | 
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Posted by Ed Darrell
War on malaria: Wall Street Journal and bloggers side with malaria
May 24, 2009It’s spring. Each of the past four years, spring has been the time that the anti-Rachel Carson, anti-environmental protection, anti-environmentalist, pro-DDT groups throttle up their campaigns to impugn Carson and environmentalists, and argue that all we need to do is poison Africa to make the world safe from malaria.
Here’s where Col. Renault joins us from Casablanca to say “Round up the usual suspects.” It’s spring 2009. Henry I. Miller of the Hoover Institution could be along any moment to say we need DDT to fight West Nile Virus, though DDT is not the pesticide of choice even among pesticide professionals.
The Wall Street Journal has become a favorite venue for these poison-the-Earthers as it has left rational policy decisions behind, at least in the editorial and op-ed pages. Steven Milloy’s got a book out slandering environmentalists, Green Hell, and a new blog to promote the book. No doubt someone will trot out Gordon Edwards’ Lyndon-Larouche-tainted claims against Rachel Carson, though none of them check out.
Sure enough, Green Hell blog picks it up repeating the old canard about how a day without DDT is like a day of genocide. You can’t teach a stupid dog new tricks, you know. In a post title that drips with calumny, Milloy says “Greens re-boot African genocide.” They have no case; smears must do the work.
Let’s dissect the WSJ piece, eh?
In 2006, after 25 years and 50 million preventable deaths, the World Health Organization reversed course and endorsed widespread use of the insecticide DDT to combat malaria. So much for that. Earlier this month, the U.N. agency quietly reverted to promoting less effective methods for attacking the disease. The result is a victory for politics over public health, and millions of the world’s poor will suffer as a result.
So much error in so little space! The error-to-word ratio may be a new land speed record.
Were there 2 million deaths per year from malaria, we could say malaria killed 50 million people in the last 25 years. But for many, or most of the past 35 years, the death rate has hovered around 1 million, sometimes lower. That’s still too high for those of us who think malaria should be beaten, but it’s not 2 million a year. WSJ exaggerates the death figures — what else do they exaggerate? If they have a case, why do they need to exaggerate?
WHO never abandoned DDT for specific uses. There was no policy for WHO to reverse in 2006. WHO made it clear that they would continue to use DDT where appropriate, and where local governments would allow. WSJ, new to the business of caring about Africans afflicted by malaria, doesn’t know the history.
DDT’s effectiveness against malaria-carrying mosquitoes began to wane by 1950. By the mid-1960s, many populations of mosquitoes had developed resistance and even immunity to DDT. That was why the World Health Organization (WHO) abandoned its campaign to eradicate malaria. Overuse of DDT, especially in agriculture, led to rapid evolution of resistance among mosquitoes. Without a weapon that worked as DDT had worked before resistance, the campaign could not succeed.
The Journal is simply wrong when it says only less-effective methods are left. DDT’s greatly reduced effectiveness is part of the reason; but research over the past five years, in tests run broadly in several African nations, shows that bednets reduce malaria infections by between 50% and 85%. That is much more effective than DDT in broadcast spraying.
One of the things WSJ fails to mention — maybe they don’t know, there is much demonstration of ignorance in the editorial — is that DDT is not used in broadcast spraying to fight malaria. Such campaigns proved disastrous because they killed off the predators of mosquitoes more effectively than they killed the mosquitoes, and because they often produced harmful results in other ways. Along some African rivers, the spraying campaigns killed off a lot of fish local people used for food. The dangers of DDT have been demonstrated in Africa.
WHO had championed a campaign in the late 1950s and 1960s to eradicate malaria. The strategy was to use DDT to knock down local mosquito populations for six months or a year, and in that time treat humans infected with the malaria parasites so that, when the mosquitoes came back, there would be no pool of malaria infection among humans from which to draw malaria to spread.
Alas, the overuse of DDT caused mosquitoes to develop resistance before the malaria-fighters could get into the field in some places and get the health care components of the campaign to work.
Because of the worldwide resistance to DDT among insects, DDT cannot be counted on as a panacea against malaria in any case. While it was never the panacea, never the sole tool to beat the disease, its role has been dramatically reduced by the rise of resistance to the chemical.
The U.N. now plans to advocate for drastic reductions in the use of DDT, which kills or repels the mosquitoes that spread malaria. The aim “is to achieve a 30% cut in the application of DDT worldwide by 2014 and its total phase-out by the early 2020s, if not sooner,” said WHO and the U.N. Environment Program in a statement on May 6.
Citing a five-year pilot program that reduced malaria cases in Mexico and South America by distributing antimalaria chloroquine pills to uninfected people, U.N. officials are ready to push for a “zero DDT world.” Sounds nice, except for the facts. It’s true that chloroquine has proven effective when used therapeutically, as in Brazil. But it’s also true that scientists have questioned the safety of the drug as an oral prophylactic because it is toxic and has been shown to cause heart problems.
Where was the Wall Street Journal when these studies were proposed, when they were run, and when they were reported? WHO and health care agencies in affected countries carefully worked to find non-DDT solutions to malaria. All programs to fight malaria require good health care systems, to diagnose malaria in victims, accurately as to the form of parasite affecting the victim, and to treat the disease to restore health to the victim and remove that person from the pool of people from whom mosquitoes can draw new malaria to infect others. The results are in. The treatment works. Now comes WSJ to pose questions that have already been answered? They are too late, and wrong.
Most malarial deaths occur in sub-Saharan Africa, where chloroquine once worked but started failing in the 1970s as the parasite developed resistance.
Fascinating. In discussions with the pro-DDTers, resistance of mosquitoes to DDT is generally denied. But here the WSJ cites similar resistance by the parasite. Remember, dear reader, that the DDTers are selective in their use of evidence.
Even if the drugs were still effective in Africa, they’re expensive and thus impractical for one of the world’s poorest regions. That’s not an argument against chloroquine, bed nets or other interventions. But it is an argument for continuing to make DDT spraying a key part of any effort to eradicate malaria, which kills about a million people — mainly children — every year. Nearly all of this spraying is done indoors, by the way, to block mosquito nesting at night. It is not sprayed willy-nilly in jungle habitat.
DDT is more expensive than bednets. DDT is used now only for indoor residual spraying (IRS). Hut walls are treated with DDT to kill or repel mosquitoes after they have already bitten a victim; this prevents the spread of some parasites, at least in the bodies of the mosquitoes killed. IRS requires some expensive work, however. First, analysis of the mosquitoes must be done to be sure DDT is effective; annd second, a professional or highly-trained person must apply the stuff. DDT applications have to be repeated about every six months. They cost about $12.00 each time. IRS may decrease malaria infection by as much as 35% (I’m being liberal).
In contrast, bednets decrease malaria infection by 50% to 85%. They cost about $10.00 for the expensive ones, and they last five years. In tests and in practice in Africa over the past five years, bednets have proven to be a necessary and very effective method to fight malaria. Bednets work without DDT (there are alternative chemicals available for IRS); DDT can’t work without bednets.
There is strong opposition to use of DDT even for IRS, in Uganda, for example, where cotton and tobacco farmers have sued to stop the use. In other areas, local people still fear fish kills. DDT is controversial because of local opposition to it, not because of any environmental group’s action.
And the net result is that DDT is not the cheapest nor most effective method to fight malaria. It is an increasingly expensive, controversial, and decreasingly effective tool.
But here is the bottom line: Unless malaria is wiped out in human hosts, there will always be mosquitoes ready to spread the disease from one infected human to a dozen uninfected humans. The key to eliminating malaria is not killing every mosquito on Earth, as quixotic a goal as that may be; the key is to develop methods of curing humans quickly and well and interrupting the life cycle of the parasite. Drugs are expensive? DDT cannot substitute for drugs, regardless how cheap it is.
WHO is not saying that DDT shouldn’t be used. But by revoking its stamp of approval, it sends a clear message to donors and afflicted countries that it prefers more politically correct interventions, even if they don’t work as well. In recent years, countries like Uganda, Tanzania and Zambia have started or expanded DDT spraying, often with the help of outside aid groups. But these governments are also eager to remain in the U.N.’s good graces, and donors typically are less interested in funding interventions that WHO discourages.
These campaigns have provided little success against malaria — nothing on the scale of success of bednets.
Oddly, one of the greatest roadblocks to the use of DDT in Africa since 2000 was the Bush administration, which refused to allow any U.S. dollars for the purchase of DDT or treatment. There are foggy signs the Bush policies eased in 2008. But again, it may simply be that the opportunity to use DDT is gone. It’s time to move on to fight malaria, and quit tilting at the DDT windmill.
“Sadly, WHO’s about-face has nothing to do with science or health and everything to do with bending to the will of well-placed environmentalists,” says Roger Bate of Africa Fighting Malaria. “Bed net manufacturers and sellers of less-effective insecticides also don’t benefit when DDT is employed and therefore oppose it, often behind the scenes.”
Roger Bate acts as a shill for malaria over recent years. Despite the name of his organization, he stands opposed to any effective means of fighting malaria, and he always stands for poisoning Africa. His claims here are directly contradicted by the results of campaigns run by the Bill and Melinda Gates Foundation, a group which has dedicated its time and an astounding amount of money to beating malaria. Bill Gates has no axe to grind on the issue — the foundation encourages bednets and medical care, and is relatively silent about DDT. The Foundation’s work has saved more lives in the past three years than Roger Bate has in more than a decade of promoting DDT. The Gates Foundation clearly is more credible.
All other serious experts tend to agree with the Gates Foundation path as well.
It’s no coincidence that WHO officials were joined by the head of the U.N. Environment Program to announce the new policy. There’s no evidence that spraying DDT in the amounts necessary to kill dangerous mosquitoes imperils crops, animals or human health. But that didn’t stop green groups like the Pesticide Action Network from urging the public to celebrate World Malaria Day last month by telling “the U.S. to protect children and families from malaria without spraying pesticides like DDT inside people’s homes.”
Pesticide Action Network is probably the only so-called green organization as crazy against DDT as Roger Bate is crazy for DDT. Ignore what they say. Pay attention to what’s really going on. (See comments on PAN.) DDT is dangerous — PAN, for any inaccuracies they may have, are more accurate than the pro-p0ison side.
The National Academy of Sciences did a serious study of DDT in the late 1970s, and in a publication on the future of such chemicals in 1980, NAS said that while DDT was at one time a near-miracle working chemical, it is more dangerous than its benefits justify, and it needs to be eliminated from use. The entire world has been working to protect people from dangerous man-made chemicals. The Persistent Organic Pesticides Treaty of 2001 (POPs) calls for an end to use of dangerous chemicals, and singles out a dozen of the most dangerous. DDT is among the dozen most dangerous. POPs includes a waiver to allow DDT use for fighting disease, so even it does not ban the stuff. History shows that DDT decreases in effectiveness, and we discover new dangers from the stuff almost every year. Since we have effective alternatives, and since DDT use has been hamstrung by litigation in Africa and ineffectiveness in the field, now is a great opportunity to end DDT use with very little harmful effect.
“We must take a position based on the science and the data,” said WHO’s malaria chief, Arata Kochi, in 2006. “One of the best tools we have against malaria is indoor residual spraying. Of the dozen or so insecticides WHO has approved as safe for house spraying, the most effective is DDT.” Mr. Kochi was right then, even if other WHO officials are now bowing to pressure to pretend otherwise.
Kochi was right to call for IRS then — and since we now have effective alternatives to DDT to use in IRS, WHO is right again to call for a reduction in DDT use in 2009. We must take a position based on the science and the data, after all.
DDT is less effective than alternatives, and more expensive. DDT is a killer once released in the wild. DDT is unnecessarily controversial where it might do the most good, and therefore even less effective than it might be. How can the Wall Street Journal come to any different conclusion, if they’re looking at the economics and science? Who would have suspected political string-pulling at WSJ?
Rachel Carson was right. 47 years after Silent Spring is not too soon to eliminate DDT use.
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Here’s one indicator of the silly and bizarre exaggerations pro-DDT people tend to use: This guy claims DDT had eliminated polio. In an otherwise over-the-top claim that Rachel Carson is a mass murderer — a claim that is false in all respects — the author goes even farther, claiming DDT effectiveness as a pharmaceutical against a disease like polio where there is no record for DDT’s ever having been used.
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Even more flight from reality: Climate Change Fraud blog, a site that appears to be a haven for anti-science, reprinted the WSJ editorial and added a bogus history introduction. And another addition to the Wall of Shame: Black and Right.
7 Comments | Africa, Biology, Cost of Green, DDT, Disease, Green Politics, Health care, History, Malaria, Politics, Science | Tagged: Africa, Cost of Green, DDT, Disease, Green Politics, Health care, Malaria, Pesticides, Politics, Rachel Carson, Science, Silent Spring | Permalink
Posted by Ed Darrell
Millard Fillmore's Bathtub 