“When you know more than the doctors who’ve spent their entire careers studying infectious diseases, it’s time for a Dunning-Kruger.”
I wish there were a requirement for inventors of internet memes to sign their work. Who gets credit for this whisky advertising mashup?
Now there’s a video ad, from Dr. Rohin Francis.
Tip of the old scrub brush to Nish Gandhi, DO @supreme_doc.
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121 Merit Badge Club, COVID-19, Dunning Kruger Effect, Dunning-Kruger Effect, Humor, medicine, Politics | Tagged: Dunning-Kruger Effect, Humor, medicine, Politics, Science | 
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Posted by Ed Darrell
Preparing for World Malaria Day the World Health Organization (WHO) put out a fact sheet on malaria and status of current work to fight it. Technically it’s nothing new — but much of the material is news to the general public who get the politicized versions of the stories.
World Malaria Day 2021 logo from Roll Back Malaria via BioMed Central
WHO’s analysis shows malaria declines, but the rates of decline are not so steep as desired. Developed nations get distracted in providing funds to fight malaria. 2020 was an outstanding year of distraction of the malaria fight, now complicated by spread of COVID-19 viruses.
Notable:
The fact sheet:
Key facts
- Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable.
- In 2019, there were an estimated 229 million cases of malaria worldwide.
- The estimated number of malaria deaths stood at 409 000 in 2019.
- Children aged under 5 years are the most vulnerable group affected by malaria; in 2019, they accounted for 67% (274 000) of all malaria deaths worldwide.
- The WHO African Region carries a disproportionately high share of the global malaria burden. In 2019, the region was home to 94% of malaria cases and deaths.
- Total funding for malaria control and elimination reached an estimated US$ 3 billion in 2019. Contributions from governments of endemic countries amounted to US$ 900 million, representing 31% of total funding.
Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected female Anopheles mosquitoes, called “malaria vectors.” There are 5 parasite species that cause malaria in humans, and 2 of these species – P. falciparum and P. vivax – pose the greatest threat.
In 2018, P. falciparum accounted for 99.7% of estimated malaria cases in the WHO African Region 50% of cases in the WHO South-East Asia Region, 71% of cases in the Eastern Mediterranean and 65% in the Western Pacific.
P. vivax is the predominant parasite in the WHO Region of the Americas, representing 75% of malaria cases.
Symptoms
Malaria is an acute febrile illness. In a non-immune individual, symptoms usually appear 10–15 days after the infective mosquito bite. The first symptoms – fever, headache, and chills – may be mild and difficult to recognize as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness, often leading to death.
Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria. In adults, multi-organ failure is also frequent. In malaria endemic areas, people may develop partial immunity, allowing asymptomatic infections to occur.
Who is at risk?
In 2019, nearly half of the world’s population was at risk of malaria. Most malaria cases and deaths occur in sub-Saharan Africa. However, the WHO regions of South-East Asia, Eastern Mediterranean, Western Pacific, and the Americas are also at risk.
Some population groups are at considerably higher risk of contracting malaria, and developing severe disease, than others. These include infants, children under 5 years of age, pregnant women and patients with HIV/AIDS, as well as non-immune migrants, mobile populations and travellers. National malaria control programmes need to take special measures to protect these population groups from malaria infection, taking into consideration their specific circumstances.
Disease burden
According to the latest World malaria report, released on 30 November 2020, there were 229 million cases of malaria in 2019 compared to 228 million cases in 2018. The estimated number of malaria deaths stood at 409 000 in 2019, compared with 411 000 deaths in 2018.
The WHO African Region continues to carry a disproportionately high share of the global malaria burden. In 2019, the region was home to 94% of all malaria cases and deaths.
In 2019, 6 countries accounted for approximately half of all malaria deaths worldwide: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Burkina Faso (4%), Mozambique (4%) and Niger (4% each).
Children under 5 years of age are the most vulnerable group affected by malaria; in 2019 they accounted for 67% (274 000) of all malaria deaths worldwide.
Transmission
In most cases, malaria is transmitted through the bites of female Anopheles mosquitoes. There are more than 400 different species of Anopheles mosquito; around 30 are malaria vectors of major importance. All of the important vector species bite between dusk and dawn. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.
Anopheles mosquitoes lay their eggs in water, which hatch into larvae, eventually emerging as adult mosquitoes. The female mosquitoes seek a blood meal to nurture their eggs. Each species of Anopheles mosquito has its own preferred aquatic habitat; for example, some prefer small, shallow collections of fresh water, such as puddles and hoof prints, which are abundant during the rainy season in tropical countries.
Transmission is more intense in places where the mosquito lifespan is longer (so that the parasite has time to complete its development inside the mosquito) and where it prefers to bite humans rather than other animals. The long lifespan and strong human-biting habit of the African vector species is the main reason why approximately 90% of the world’s malaria cases are in Africa.
Transmission also depends on climatic conditions that may affect the number and survival of mosquitoes, such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees.
Human immunity is another important factor, especially among adults in areas of moderate or intense transmission conditions. Partial immunity is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will cause severe disease. For this reason, most malaria deaths in Africa occur in young children, whereas in areas with less transmission and low immunity, all age groups are at risk.
Prevention
Vector control is the main way to prevent and reduce malaria transmission. If coverage of vector control interventions within a specific area is high enough, then a measure of protection will be conferred across the community.
WHO recommends protection for all people at risk of malaria with effective malaria vector control. Two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying – are effective in a wide range of circumstances.
Insecticide-treated mosquito nets
Sleeping under an insecticide-treated net (ITN) can reduce contact between mosquitoes and humans by providing both a physical barrier and an insecticidal effect. Population-wide protection can result from the killing of mosquitoes on a large scale where there is high access and usage of such nets within a community.
In 2019, an estimated 46% of all people at risk of malaria in Africa were protected by an insecticide-treated net, compared to 2% in 2000. However, ITN coverage has been at a standstill since 2016.Indoor spraying with residual insecticides
Indoor residual spraying (IRS) with insecticides is another powerful way to rapidly reduce malaria transmission. It involves spraying the inside of housing structures with an insecticide, typically once or twice per year. To confer significant community protection, IRS should be implemented at a high level of coverage.
Globally, IRS protection declined from a peak of 5% in 2010 to 2% in 2019, with decreases seen across all WHO regions, apart from the WHO Eastern Mediterranean Region. The declines in IRS coverage are occurring as countries switch from pyrethroid insecticides to more expensive alternatives to mitigate mosquito resistance to pyrethroids.
Antimalarial drugs
Antimalarial medicines can also be used to prevent malaria. For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing malaria disease. For pregnant women living in moderate-to-high transmission areas, WHO recommends at least 3 doses of intermittent preventive treatment with sulfadoxine-pyrimethamine at each scheduled antenatal visit after the first trimester. Similarly, for infants living in high-transmission areas of Africa, 3 doses of intermittent preventive treatment with sulfadoxine-pyrimethamine are recommended, delivered alongside routine vaccinations.
Since 2012, WHO has recommended seasonal malaria chemoprevention as an additional malaria prevention strategy for areas of the Sahel sub-region of Africa. The strategy involves the administration of monthly courses of amodiaquine plus sulfadoxine-pyrimethamine to all children under 5 years of age during the high transmission season.
Insecticide resistance
Since 2000, progress in malaria control has resulted primarily from expanded access to vector control interventions, particularly in sub-Saharan Africa. However, these gains are threatened by emerging resistance to insecticides among Anopheles mosquitoes. According to the latest World malaria report, 73 countries reported mosquito resistance to at least 1 of the 4 commonly-used insecticide classes in the period 2010-2019. In 28 countries, mosquito resistance was reported to all of the main insecticide classes.
Despite the emergence and spread of mosquito resistance to pyrethroids, insecticide-treated nets continue to provide a substantial level of protection in most settings. This was evidenced in a large 5-country study coordinated by WHO between 2011 and 2016.
While the findings of this study are encouraging, WHO continues to highlight the urgent need for new and improved tools in the global response to malaria. To prevent an erosion of the impact of core vector control tools, WHO also underscores the critical need for all countries with ongoing malaria transmission to develop and apply effective insecticide resistance management strategies.
Diagnosis and treatment
Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. The best available treatment, particularly for P. falciparum malaria, is artemisinin-based combination therapy (ACT).
WHO recommends that all cases of suspected malaria be confirmed using parasite-based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment. Results of parasitological confirmation can be available in 30 minutes or less. Treatment, solely on the basis of symptoms should only be considered when a parasitological diagnosis is not possible. More detailed recommendations are available in the third edition of the “WHO Guidelines for the treatment of malaria”, published in April 2015.
Antimalarial drug resistance
Resistance to antimalarial medicines is a recurring problem. Resistance of P. falciparum malaria parasites to previous generations of medicines, such as chloroquine and sulfadoxine-pyrimethamine (SP), became widespread in the 1950s and 1960s, undermining malaria control efforts and reversing gains in child survival.
Protecting the efficacy of antimalarial medicines is critical to malaria control and elimination. Regular monitoring of drug efficacy is needed to inform treatment policies in malaria-endemic countries, and to ensure early detection of, and response to, drug resistance.
In 2013, WHO launched the Emergency response to artemisinin resistance (ERAR) in the Greater Mekong subregion (GMS), a high-level plan of attack to contain the spread of drug-resistant parasites and to provide life-saving tools for all populations at risk of malaria. But even as this work was under way, additional pockets of resistance emerged independently in new geographic areas of the subregion. In parallel, there were reports of increased resistance to ACT partner drugs in some settings. A new approach was needed to keep pace with the changing malaria landscape.
At the World Health Assembly in May 2015, WHO launched the Strategy for malaria elimination in the Greater Mekong subregion (2015–2030), which was endorsed by all the countries in the subregion. Urging immediate action, the strategy calls for the elimination of all species of human malaria across the region by 2030, with priority action targeted to areas where multidrug resistant malaria has taken root.
With technical guidance from WHO, all countries in the region have developed national malaria elimination plans. Together with partners, WHO is providing ongoing support for country elimination efforts through the Mekong Malaria Elimination programme, an initiative that evolved from the ERAR
Surveillance
Surveillance entails tracking of the disease and programmatic responses, and taking action based on the data received. Currently, many countries with a high burden of malaria have weak surveillance systems and are not in a position to assess disease distribution and trends, making it difficult to optimize responses and respond to outbreaks.
Effective surveillance is required at all points on the path to malaria elimination. Stronger malaria surveillance systems are urgently needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences, to track progress, and to hold governments and the global malaria community accountable.
In March 2018, WHO released a reference manual on malaria surveillance, monitoring and evaluation, monitoring and evaluation. The manual provides information on global surveillance standards and guides countries in their efforts to strengthen surveillance systems.
Elimination
Malaria elimination is defined as the interruption of local transmission of a specified malaria parasite species in a defined geographical area as a result of deliberate activities. Continued measures are required to prevent re-establishment of transmission. Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by human malaria parasites as a result of deliberate activities. Interventions are no longer required once eradication has been achieved.
Globally, the elimination net is widening, with more countries moving towards the goal of zero malaria. In 2019, 27 countries reported fewer than 100 indigenous cases of the disease, up from 6 countries in 2000.
Countries that have achieved at least 3 consecutive years of 0 indigenous cases of malaria are eligible to apply for the WHO certification of malaria elimination. Over the last two decades, 11 countries have been certified by the WHO Director-General as malaria-free: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Algeria (2019), Argentina (2019) and El Salvador (2021). The WHO Framework for malaria elimination (2017) provides a detailed set of tools and strategies for achieving and maintaining elimination. In January 2021, WHO published a new manual, Preparing for certification of malaria elimination, with extended guidance for countries that are approaching elimination or preparing for elimination certification.
Vaccines against malaria
RTS,S/AS01 (RTS,S) is the first and, to date, the only vaccine to show that it can significantly reduce malaria, and life-threatening severe malaria, in young African children. It acts against P. falciparum, the most deadly malaria parasite globally and the most prevalent in Africa. Among children who received 4 doses in large-scale clinical trials, the vaccine prevented approximately 4 in 10 cases of malaria over a 4-year period.
In view of its public health potential, WHO’s top advisory bodies for malaria and immunization have jointly recommended phased introduction of the vaccine in selected areas of sub-Saharan Africa. Three countries – Ghana, Kenya and Malawi – began introducing the vaccine in selected areas of moderate and high malaria transmission in 2019. Vaccinations are being provided through each country’s routine immunization programme.
The pilot programme will address several outstanding questions related to the public health use of the vaccine. It will be critical for understanding how best to deliver the recommended 4 doses of RTS,S; the vaccine’s potential role in reducing childhood deaths; and its safety in the context of routine use.
This WHO-coordinated programme is a collaborative effort with Ministries of Health in Ghana, Kenya and Malawi and a range of in-country and international partners, including PATH, a non-profit organization, and GSK, the vaccine developer and manufacturer.
Financing for the vaccine programme has been mobilized through a collaboration between 3 major global health funding bodies: Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid.
WHO response
WHO Global technical strategy for malaria 2016-2030
The WHO Global technical strategy for malaria 2016-2030 – adopted by the World Health Assembly in May 2015 – provides a technical framework for all malaria-endemic countries. It is intended to guide and support regional and country programmes as they work towards malaria control and elimination.
The Strategy sets ambitious but achievable global targets, including:
- reducing malaria case incidence by at least 90% by 2030;
- reducing malaria mortality rates by at least 90% by 2030;
- eliminating malaria in at least 35 countries by 2030;
- preventing a resurgence of malaria in all countries that are malaria-free.
This Strategy was the result of an extensive consultative process that spanned 2 years and involved the participation of more than 400 technical experts from 70 Member States.
The Global Malaria Programme
The WHO Global Malaria Programme coordinates WHO’s global efforts to control and eliminate malaria by:
- setting, communicating and promoting the adoption of evidence-based norms, standards, policies, technical strategies, and guidelines;
- keeping independent score of global progress;
- developing approaches for capacity building, systems strengthening, and surveillance; and
- identifying threats to malaria control and elimination as well as new areas for action.
The Programme is supported and advised by the Malaria Policy Advisory Committee (MPAC), a group of global malaria experts appointed following an open nomination process. The mandate of MPAC is to provide strategic advice and technical input, and extends to all aspects of malaria control and elimination, as part of a transparent, responsive and credible policy-setting process.
“High burden high impact approach”
At the World Health Assembly in May 2018, the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, called for an aggressive new approach to jump-start progress against malaria. A new country-driven response – “ High burden to high impact” – was launched in Mozambique in November 2018.
The approach is currently being driven by the 11 countries that carry a high burden of the disease (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda and United Republic of Tanzania). Key elements include:
- political will to reduce the toll of malaria;
- strategic information to drive impact;
- better guidance, policies and strategies; and
- a coordinated national malaria response.
Catalysed by WHO and the RBM Partnership to End Malaria, “High burden to high impact” builds on the principle that no one should die from a disease that can be prevented and diagnosed, and that is entirely curable with available treatments.
Leave a Comment » | DDT, Disease, History, Malaria, medicine, WHO - World Health Organization, World Malaria Day | Tagged: DDT, Disease, History, Malaria, medicine, WHO - World Health Organization | Permalink
Posted by Ed Darrell
Hand lotion from Salina Drug, in Salina, Utah — long ago.
Utah friends, or anyone who can help: Do you know where to find this great hand lotion?
We nursed this bottle as long as we could. It ran out in January. Where do we get more?
We have not been able to get more in Salina, Utah.
The story: I heard stories about Salina Drug’s great hand lotion on the trail, hiking around Southern Utah. I was always in Salina late at night, or early in the morning, when the drug store was closed — Kathryn and I finally picked up a bottle on a red rock vacation, in 1983
A few drops are all you need. There was eucalyptus, I think, and camphor. A touch of glycerine. Witch hazel? Fantastic stuff. Miracle cure. We rationed the stuff through law school, awaiting a chance to get more.
Finals, a job change or two, a baby, another job change and move to Texas, bar exam, another baby — we didn’t get back to Salina until one Sunday in 1991 or 1992. We got late on a Sunday. Salina Drug was closed.
Was it closed for good? I don’t know. I tried a couple times to phone. No success.
New jobs, kids in school. Our rationing system consisted of putting it in the back of the medicine cabinet and forgetting about it, until you get hands so chapped in desperation you remembered that old hand lotion. Just a few drops. It’s particularly good for hands chapped from climbing red rocks, or bouldering.
It was a formula probably close to a century old in 1983. They brewed and bottled the stuff right there in the pharmacy. Amber bottle, locally-printed stick-on label, a piece of real cork with a slit to dispense, under the cap. But at some point in between 1985 and 2000, Salina Drug slipped away (like Bobbie McGee near Salinas, not to be confused with Salina).
When the drugstore died, did anybody save the recipe? Is anyone selling the stuff now?
More:
5 Comments | History, medicine, Travel, Utah | Tagged: History, Pharmaceuticals, Salina Drug, Travel, Utah | Permalink
Posted by Ed Darrell
Covers of the last four World Malaria Reports. World Health Organization (WHO)
It’s a common tale but true: In any period when nations collaborate to defeat or eradicate malaria, funders of the programs get board and cut funding.
Malaria roars back.
This cycle has nothing to do with pesticides or medicines, mostly. Especially it’s not a problem that can be fixed with more DDT.
When a nation focuses on beating malaria, progress occurs. When nations lose their focus, malaria strikes back.
After great progress reducing malaria infections and malaria deaths between 1999 and 2017, nations including the U.S. lost focus. International donors failed to contribute enough money to keep the fight going.
World Malaria Report 2018 notes the striking back by malaria.
One other thing we can be quite sure of: Almost all mass media will ignore this report.
What will you do to change things?
You can help by donating $10 to a charity that delivers bednets to people who need them in Asia and Africa. You can help by writing letters to your local newspapers, to your Congressional representatives, and to the President. Every little bit helps.
Here’s the press release on World Malaria Report 2018, which was released by the World Health Organization (WHO) on November 19, 2018.
WHO and partners launch new country-led response to put stalled malaria control efforts back on track
19 November 2018
News ReleaseMaputo/Geneva
Reductions in malaria cases have stalled after several years of decline globally, according to the new World malaria report 2018. To get the reduction in malaria deaths and disease back on track, WHO and partners are joining a new country-led response, launched today, to scale up prevention and treatment, and increased investment, to protect vulnerable people from the deadly disease.
For the second consecutive year, the annual report produced by WHO reveals a plateauing in numbers of people affected by malaria: in 2017, there were an estimated 219 million cases of malaria, compared to 217 million the year before. But in the years prior, the number of people contracting malaria globally had been steadily falling, from 239 million in 2010 to 214 million in 2015.
“Nobody should die from malaria. But the world faces a new reality: as progress stagnates, we are at risk of squandering years of toil, investment and success in reducing the number of people suffering from the disease,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We recognise we have to do something different – now. So today we are launching a country-focused and -led plan to take comprehensive action against malaria by making our work more effective where it counts most – at local level.”
Where malaria is hitting hardest
In 2017, approximately 70% of all malaria cases (151 million) and deaths (274 000) were concentrated in 11 countries: 10 in Africa (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Uganda and United Republic of Tanzania) and India. There were 3.5 million more malaria cases reported in these 10 African countries in 2017 compared to the previous year, while India, however, showed progress in reducing its disease burden.
Despite marginal increases in recent years in the distribution and use of insecticide-treated bed nets in sub-Saharan Africa – the primary tool for preventing malaria – the report highlights major coverage gaps. In 2017, an estimated half of at-risk people in Africa did not sleep under a treated net. Also, fewer homes are being protected by indoor residual spraying than before, and access to preventive therapies that protect pregnant women and children from malaria remains too low.
High impact response needed
In line with WHO’s strategic vision to scale up activities to protect people’s health, the new country-driven “High burden to high impact” response plan has been launched to support nations with most malaria cases and deaths. The response follows a call made by Dr Tedros at the World Health Assembly in May 2018 for an aggressive new approach to jump-start progress against malaria. It is based on four pillars:
- Galvanizing national and global political attention to reduce malaria deaths;
- Driving impact through the strategic use of information;
- Establishing best global guidance, policies and strategies suitable for all malaria endemic countries; and
- Implementing a coordinated country response.
Catalyzed by WHO and the RBM Partnership to End Malaria, “High burden to high impact” builds on the principle that no one should die from a disease that can be easily prevented and diagnosed, and that is entirely curable with available treatments.
“There is no standing still with malaria. The latest World malaria report shows that further progress is not inevitable and that business as usual is no longer an option,” said Dr Kesete Admasu, CEO of the RBM Partnership. “The new country-led response will jumpstart aggressive new malaria control efforts in the highest burden countries and will be crucial to get back on track with fighting one of the most pressing health challenges we face.”
Targets set by the WHO Global technical strategy for malaria 2016–2030 to reduce malaria case incidence and death rates by at least 40% by 2020 are not on track to being met.
Pockets of progress
The report highlights some positive progress. The number of countries nearing elimination continues to grow (46 in 2017 compared to 37 in 2010). Meanwhile in China and El Salvador, where malaria had long been endemic, no local transmission of malaria was reported in 2017, proof that intensive, country-led control efforts can succeed in reducing the risk people face from the disease.
In 2018, WHO certified Paraguay as malaria free, the first country in the Americas to receive this status in 45 years. Three other countries – Algeria, Argentina and Uzbekistan – have requested official malaria-free certification from WHO.
India – a country that represents 4% of the global malaria burden – recorded a 24% reduction in cases in 2017 compared to 2016. Also in Rwanda, 436 000 fewer cases were recorded in 2017 compared to 2016. Ethiopia and Pakistan both had estimated decreases of more than 240 000 in the same period.
“When countries prioritize action on malaria, we see the results in lives saved and cases reduced,” says Dr Matshidiso Moeti, WHO Regional Director for Africa. “WHO and global malaria control partners will continue striving to help governments, especially those with the highest burden, scale up the response to malaria.”
Domestic financing is key
As reductions in malaria cases and deaths slow, funding for the global response has also shown a levelling off, with US$ 3.1 billion made available for control and elimination programmes in 2017 including US$ 900 million (28%) from governments of malaria endemic countries. The United States of America remains the largest single international donor, contributing US$ 1.2 billion (39%) in 2017.
To meet the 2030 targets of the global malaria strategy, malaria investments should reach at least US$6.6 billion annually by 2020 – more than double the amount available today.
Editors note
Download the WHO World malaria report 2018 app for an interactive experience with the report’s country data: App Store (iOS devices) | Google Play (Android devices).
Leave a Comment » | DDT, Health care, History, Malaria, medicine, Politics, Science | Tagged: DDT, Health care, History, Malaria, Science | Permalink
Posted by Ed Darrell
I’m an advocate of public schools. I graduated from public schools, I attended two state universities, Universities of Utah and Arizona, graduating from one. My law degree came from a private institution, George Washington University’s National Law Center. I’ve taught at public and private schools.
Public schools are better, on the whole. Public schools form a pillar of U.S. national life that we should protect, and build on, I find.
That’s not a popular view among elected officials, who generally seem hell bent on privatizing every aspect of education. We would do that at our peril, I believe.
We can argue statistics, we can argue funding and philosophy — believe me, I’ve been through it all as a student, student leader, parent, U.S. Senate staffer (to the committee that deals with education, no less), teacher and college instructor. I find fair analysis favors the public schools over private schools in almost ever circumstance.
Though I admit, it’s nice to have private schools available to meet needs of some students who cannot be fit into education any other way. Those students are few in any locality, I find.
There is one area where the quality of U.S. public schools shines like the Sun: Nobel prizes. In the 100+ years Nobels have been around, students out of U.S. public schools have been awarded a lot of those prizes. Public school alumni make up the single largest bloc of Nobel winners in most years, and perhaps for the entire period of Nobels.
I think someone should track those statistics. Most years, I’m the only one interested, and in many years I’m too deeply involved in other work to do this little hobby.
2017 seems to be off to a great start, spotlighting U.S. public school education.
Comes this Tweet from J. N. Pearce, editor of the Salt Lake Tribune:
Followed by a Tweet from a Utah teacher, Tami Pyfer, noting that Kip Thorne is not the only Utah public school kid to win recently:
Two categories of prizes have been announced already in 2017, Medicine and Physiology, and Physics.
In both categories, the prizes went to three Americans. In Medicine or Physiology, for their work on circadian rhythms, the prize went to
Jeffrey C. Hall, Michael Rosbash and Michael W. Young.
Physics Nobel winners Rainer Weiss, Barry C. Barish and Kip S. Thorne. 2017 Physics Laureates. Ill: N. Elmehed. © Nobel Media 2017
In Physics, for work on gravity waves, the prize went to Rainer Weiss, Barry C. Barish and Kip S. Thorne.
Thorne, we already know, was born in Logan, Utah, and graduated from Logan High School. Rainer Weiss was born in Berlin, so it is unlikely he attended U.S. public schools — but I haven’t found a definitive answer to that question. All three of the Physiology or Medicine winners were born in the U.S. Michael Young was born in Miami, but attended high school in Dallas. Oddly, Dallas media haven’t picked up on that yet. Dallas has some good private schools, and some of the nation’s best public schools.
(That article from the Logan Herald-Journal notes Logan High School also graduate Lars Peter Hansen, Nobel Memorial Prize in Economics, in 2013.)
Nobels in Chemistry will be announced Wednesday, October 4; Literature will be announced Thursday, October 5 (this category award often goes to non-Americans); Peace will be announced Friday, October 6 (another category where U.S. kids win rarely); and the Nobel Memorial prize for Economics will be announced next Monday, October 9.
Jeffrey C. Hall, Michael Rosbash and Michael W. Young. Ill. Niklas Elmehed. © Nobel Media 2017.
If you know where any of these winners attended primary and secondary education, would you let us know in comments? Let’s track to see if my hypothesis holds water in 2017. My hypothesis is that the biggest bloc of Nobel winners will be products of U.S. public schools.
As I post this, the Chemistry prize announcement is just a half-hour away. Good night!
A video about the work of Kip Thorne, from CalTech:
1 Comment | medicine, Nobel Prizes, Physics, Public education | Tagged: Education, medicine, Nobel Prize in Medicine, Patriotism, Physics, public schools | Permalink
Posted by Ed Darrell
Mozambique’s National Malaria Control Programme distributed 4 million LLIN, insecticide-impregnated nets, to protect children and others from malaria as they sleep, the time most malaria-infecting mosquito bites occur. Malaria Consortium photo
Mozambique is one of only ten nations still using DDT for Indoor Residual Spraying (IRS) to fight malaria.
But DDT’s effectiveness diminishes rapidly, as does the effectiveness of the other eleven insecticides generally used for IRS against malaria or other vector-borne diseases. Insecticides are sprayed indoors, and not outdoors, to provide protection where humans are most often bitten, and to prevent non-target mosquitoes and other creatures from being exposed to the insecticides. This prevents harmful pests from developing resistance to the insecticides, and diminishes damage to beneficial species, like food fish.
Instead of spraying, malaria fighters turn increasingly to bednets impregnated with insecticide, known as Long-Lasting Insecticide-impregnated Nets (LLIN). A net provides closer to 100% protection from bites than IRS. A net immediately protects anyone sleeping under it, while IRS must treat at least 80% of nearby homes to achieve more than 50 percent prevention.
While still using IRS, Mozambique stakes its future malaria fighting on nets.
The Malaria Consortium aided in the recent distribution of nets.
Malaria Consortium has successfully completed a mass distribution campaign of over four million long-lasting insecticidal nets (LLINs) across Nampula and Niassa provinces in Mozambique. The nets were distributed almost simultaneously across all districts of each province – 23 districts in Nampula in November 2016, and 16 districts in Niassa in May 2017 – using a new operational model aimed at optimising resources.
Throughout the campaigns, Mozambique’s National Malaria Control Programme was responsible for the LLIN acquisition and led overall planning and implementation through the decentralised structures of the health system. Malaria Consortium’s role consisted of operational support, which included financial management, transport, procurement, logistics, training, management of service providers, efficient use of resources and effective coordination at provincial, district and field levels.
Sonia Gwesela, Malaria Consortium Mozambique Country Director said, “In Nampula Province, a major achievement was that 99 percent of households collected their nets. We successfully delivered 98 percent of the nets in both provinces, coming well above the 90 percent target set by the National Malaria Control Programme.
“With the successful completion of the distribution, we can now focus on a post-distribution communications campaign about the correct use of LLINs,” she concluded.
The Malaria Prevention and Control Project is funded by the Global Fund to Fight AIDS, TB and Malaria and supports the efforts of the Mozambican government to reduce malaria throughout the country through scale up of prevention and control efforts with community involvement. Malaria Consortium is working in partnership with World Vision, Fundacao para o Desenvolvimento da Comunidadeo, International Relief and Development, and the Mozambique Ministry of Health.
Bednets can be twice as effective as IRS in preventing the spread of malaria. Beating malaria also requires upgrading health care for quick diagnoses and quick, complete treatment of malaria in humans, and prevention projects to drain mosquito-breeding places within 50 yards of homes; more prevention of bites means less medical treatment is required.
WHO estimated 5 million people died of malaria in the 1950s into the 1960s. WHO’s Malaria Report 2016 reported malaria deaths fell to less than 430,000 world wide, a more than 90 percent reduction since 1963, mostly accomplished without DDT.
Malaria Consortium on Twitter, @FightingMalaria.
3 Comments | Africa, DDT, Health care, Malaria, medicine | Tagged: Africa, bednets, DDT, Health care, Malaria, Mozambique | Permalink
Posted by Ed Darrell
Interested, and interesting, to discover Botswana has a Facebook page where it appears is posted almost every press release or news item from the government.
I found it because some wag claimed on Twitter that Botswana faces a malaria crisis, and therefore DDT should be ‘brought back from the dead.’
Botswana did post about a malaria outbreak, but the nation appears to have good sense about how to fight malaria. The Tweeter missed that Botswana is already doing what a nation would use DDT for, Indoor Residual Spraying (IRS), and that phrase alone means Botswana’s malaria fighters are alert to any need for DDT should it arise, but also to the severe limitations on DDT use. DDT doesn’t work in about 95% of the nations on Earth.
Botswana is among the ten nations remaining on Earth who use DDT when and where they find a population of mosquitoes still susceptible to DDT. Almost all nations on Earth signed the Persistent Organic Pollutants Treaty (POPs, or Stockholm Agreement), which requires annual reporting of DDT use. But there are 11 other pesticides the World Health Organization (WHO) recommends for IRS. Botswana is unlikely to use DDT where it won’t work, which is most places.
Botswana is one of the DDT Ten in 2016, too. But this is down from 43 nations in 2001. DDT’s effectiveness and time as a tool to fight malaria is mostly gone, vanishing quickly.
Botswana has DDT if it can find a use for it; no more DDT is needed. A malaria outbreak in Botswana is no reason to remove the ban on DDT use on U.S. farms.
Here is the story/press release from Botswana’s government:
MALARIA CASES RISE IN OKAVANGO
North West District has been hard hit by a malaria epidemic with 670 recorded cases and five deaths since the beginning of the rainy season.
Head of the District Health Management Team, Dr Malebogo Pusoentsi revealed this at a press conference aimed at evaluating efforts made in the district to control the disease, recently.
A task force was in the district to assess and appreciate the situation as well as discuss what more could be done going forward.
Dr Pusoentsi said the highly affected region was Okavango which recorded over 90 per cent of the cases.
Highly affected areas include Shakawe, Xakao and Seronga in the Okavango District while in Ngami, Tsau and Mababe were the most affected.
Out of the affected people, it was reported that males were mostly affected as compared to females, and that more than 30 per cent of the affected were children. The most affected areas were said to be schools.
Dr Pusoentsi explained that malaria infection in humans was mainly transmitted through the sting of the female anopheles mosquito, adding that the disease in people could present clinically as either uncomplicated, complicated or asymptomatic, especially for people living in malaria endemic areas.
She stated that prevention of malaria remained a priority with strategies aimed at vector control. She said two strategies have been used to control mosquitoes in the area such as indoor residual spraying and the distribution of the long lasting insecticide treated nets. She added that 57 000 nets having been distributed across the country.
Regarding indoor spraying, Dr Pusoentsi revealed that for the transmission period of 2016/17, the district achieved an average of 69 per cent coverage as compared to the 85 per cent target.
Asked if the district was winning the battle, she said they were on the right track as health officials have doubled up efforts to tackle the epidemic.
She said social mobilisation was effective as the community and leadership were taught to make malaria a priority in their agenda, adding that if one member of a family was affected, chances were high that the rest of the family were also at risk.
Furthermore, Dr Pusoentsi explained that many opportunities still existed at community level to effectively control the spread of malaria, citing the cleaning of surroundings to minimise the breeding spaces for the mosquitoes.
Another strategy was to work collaboratively to ensure community knowledge and participation during the epidemic period. She urged the community to visit health facilities if they experience any symptoms of malaria so that they could be assisted on time.
She noted that common signs and symptoms include high temperature, headache and rigors, pallor and vomiting.
Dr Pusoentsi also noted that Botswana was among the countries which were aiming to eliminate malaria by 2018, adding that as part of the strategy, all efforts and investments had been put in place to control the spread.
Effective surveillance mechanism, she said had been put in place to monitor the disease burden and response efficiency at all times.
In addition, she pointed out that case management and drug supply had been strengthened to ensure quality management of cases of malaria to avoid deaths. (BOPA)
Leave a Comment » | Africa, DDT, History, Malaria, medicine, Public health, Science | Tagged: Africa, Botswana, DDT, Malaria, medicine, Science | Permalink
Posted by Ed Darrell
Promotional poster for the World Malaria Report 2016, from WHO; poster shows a woman and her child, protected from mosquitoes behind a bednet.
Incidence of malaria dropped to a new, all-time low in 2016, with reductions in total infections to 212 million, and a drop in malaria deaths to 429,000, worldwide. Malaria fighters had hoped the decreases would be greater.
Cover of World Malaria Report 2016, from the World Health Organization (WHO). The report has been published annually since at least 2008, tracking progress in the fight to control and eradicate malaria, one of the greatest scourge diseases in human history.
This news comes from the World Health Organization’s (WHO) World Malaria Report 2016, released this morning in Geneva, Switzerland.
Of concern to readers here, the report lists ten nations still using DDT, the same number as 2015. Nine African nations and India still find some utility in DDT, though resistance to the long-used pesticide is found in almost all populations of almost all varieties of mosquito.
India remains the world’s heaviest user of DDT and the only place DDT is manufactured. The nine DDT-using African nations are Botswana, Democratic Republic of Congo, Gambia, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe. Due to mosquito and other vector insect resistance to DDT, India will stop using DDT by 2020, and stop manufacturing at the same time.
Insecticide-impregnated bednets now are the chief tool used to prevent spread of new malaria infections. Nets have proven more effective than Indoor Residual Spraying (IRS), which has always been the chief use of DDT in the malaria fight. The report notes that mosquito resistance grows alarmingly to the preferred net pesticides, pyrethroids. Nets provide a physical barrier to mosquitoes, however, and work even when the insecticides wear off.
This years report is shorter than previous years, but still loaded with statistics and policy issues to be unpacked in the next few days.
Malaria control improves for vulnerable in Africa, but global progress off-track
News release
13 December 2016 | GENEVA – WHO’s World Malaria Report 2016 reveals that children and pregnant women in sub-Saharan Africa have greater access to effective malaria control. Across the region, a steep increase in diagnostic testing for children and preventive treatment for pregnant women has been reported over the last 5 years. Among all populations at risk of malaria, the use of insecticide-treated nets has expanded rapidly.
But in many countries in the region, substantial gaps in programme coverage remain. Funding shortfalls and fragile health systems are undermining overall progress, jeopardizing the attainment of global targets.
Scale-up in malaria control
Sub-Saharan Africa carries a disproportionately high share of the global malaria burden. In 2015, the region was home to 90% of malaria cases and 92% of malaria deaths. Children under five years of age are particularly vulnerable, accounting for an estimated 70% of all malaria deaths.
Diagnostic testing enables health providers to rapidly detect malaria and prescribe life-saving treatment. New findings presented in the report show that, in 2015, approximately half (51%) of children with a fever seeking care at a public health facility in 22 African countries received a diagnostic test for malaria, compared to 29% in 2010.
To protect women in areas of moderate and high malaria transmission in Africa, WHO recommends “intermittent preventive treatment in pregnancy” (IPTp) with sulfadoxine-pyrimethamine. The treatment, administered at each scheduled antenatal care visit after the first trimester, can prevent maternal and infant mortality, anaemia, and the other adverse effects of malaria in pregnancy.
According to available data, there was a five-fold increase in the percentage of women receiving the recommended 3 or more doses of this preventive treatment in 20 African countries. Coverage reached 31% in 2015, up from 6% in 2010.
Insecticide-treated nets are the cornerstone of malaria prevention efforts in Africa. The report found that more than half (53%) of the population at risk in sub-Saharan Africa slept under a treated net in 2015, compared to 30% in 2010.
Last month, WHO released the findings of a major 5-year evaluation in 5 countries. The study showed that people who slept under long-lasting insecticidal nets (LLINs) had significantly lower rates of malaria infection than those who did not use a net, even though mosquitoes showed resistance to pyrethroids (the only insecticide class used in LLINs) in all of these areas.
An unfinished agenda
Malaria remains an acute public health problem, particularly in sub-Saharan Africa. According to the report, there were 212 million new cases of malaria and 429 000 deaths worldwide in 2015.
There are still substantial gaps in the coverage of core malaria control tools. In 2015, an estimated 43% of the population in sub-Saharan Africa was not protected by treated nets or indoor spraying with insecticides, the primary methods of malaria vector control.
In many countries, health systems are under-resourced and poorly accessible to those most at risk of malaria. In 2015, a large proportion (36%) of children with a fever were not taken to a health facility for care in 23 African countries.
“We are definitely seeing progress,” notes Dr. Pedro Alonso, Director of the WHO Global Malaria Programme. “But the world is still struggling to achieve the high levels of programme coverage that are needed to beat this disease.”
Global targets
At the 2015 World Health Assembly, Member States adopted the Global Technical Strategy for Malaria 2016-2030. The Strategy set ambitious targets for 2030 with milestones every 5 years to track progress.
Eliminating malaria in at least 10 countries is a milestone for 2020. The report shows that prospects for reaching this target are bright: In 2015, 10 countries and territories reported fewer than 150 indigenous cases of malaria, and a further 9 countries reported between 150 and 1000 cases.
Countries that have achieved at least 3 consecutive years of zero indigenous cases of malaria are eligible to apply for the WHO certification of malaria elimination. In recent months, the WHO Director-General certified that Kyrgyzstan and Sri Lanka had eliminated malaria.
But progress towards other key targets must be accelerated. The Strategy calls for a 40% reduction in malaria case incidence by the year 2020, compared to a 2015 baseline. According to the report, less than half (40) of the 91 countries and territories with malaria are on track to achieve this milestone. Progress has been particularly slow in countries with a high malaria burden.
An urgent need for more funding
Sustained and sufficient funding for malaria control is a serious challenge. Despite a steep increase in global investment for malaria between 2000 and 2010, funding has since flat-lined. In 2015, malaria funding totalled US$ 2.9 billion, representing only 45% of the funding milestone for 2020 (US$ 6.4 billion).
Governments of malaria-endemic countries provided about 31% of total malaria funding in 2015. The United States of America is the largest international malaria funder, accounting for about 35% of total funding in 2015, followed by the United Kingdom of Great Britain and Northern Ireland (16%).
If global targets are to be met, funding from both domestic and international sources must increase substantially.
Note to editors
RTS,S/AS01 malaria vaccine
Last month, WHO announced that the world’s first malaria vaccine would be rolled out through pilot projects in 3 countries in sub-Saharan Africa. Vaccinations will begin 2018. The vaccine, known as RTS,S, acts against P. falciparum, the most deadly malaria parasite globally, and the most prevalent in Africa. Advanced clinical trials have shown RTS,S to provide partial protection against malaria in young children.
WHO multi-country evaluation on LLINs
On 16 November 2016, WHO released the findings of a 5-year evaluation conducted in 340 locations across 5 countries: Benin, Cameroon, India, Kenya and Sudan. The findings of this study reaffirm the WHO recommendation of universal LLIN coverage for all populations at risk of malaria.
Will major media cover this news? Will your local newspapers and broadcast outlets even make note?
Leave a Comment » | DDT, Disease, medicine, Science, WHO - World Health Organization | Tagged: DDT, Disease, Malaria, medicine, Science, World Health Organization (WHO) | Permalink
Posted by Ed Darrell
Dr. Ignaz Semmelweis
This is one of the classic stories of public health, an issue that most U.S. history and world history texts tend to ignore, to the detriment of the students and the classroom outcomes.
This is the story as retold by Christopher Cerf and Victor Navasky in The Experts Speak:
In the 1850s a Hungarian doctor and professor of obstetrics named Ignaz Semmelweis [pictured at left] ordered his interns at the Viennese Lying-in Hospital to wash their hands after performing autopsies and before examining new mothers. The death rate plummeted from 22 out of 200 to 2 out of 200, prompting the following reception from one of Europe’s most respected medical practitioners:
“It may be that it [Semmelweis’ procedure] does contain a few good principles, but its scrupulous application has presented such difficulties that it would be necessary, in Paris for instance, to place in quarantine the personnel of a hospital during the great part of a year, and that, moreover, to obtain results that remain entirely problematical.”
– Dr. Charles Dubois (Parisian obstetrician), memo to the French Academy
September 23, 1858Semmelweiss’ superiors shared Dubois’ opinion; when the Hungarian physician insisted on defending his theories, they forced him to resign his post on the faculty.
Gotta wonder what Dr. Dubois would make of the suits and sanitation procedures required today for health professionals who treat Ebola victims.
More:
Yes, this is mostly an encore post. Fighting ignorance requires patience.
Leave a Comment » | Dunning Kruger Effect, Famous quotes, Health care, History, medicine, Research, Science | Tagged: Dunning-Kruger Effect, Famous quotes, hand washing, History, Ignaz Semmelweis, medicine, Research, Science, Semmelweis Reflex | Permalink
Posted by Ed Darrell
Do we have the will to do it?
More:
Gates Foundation image: A nurse dispenses a malaria drug to treat an infected child in Tanzania.
2 Comments | DDT, Health care, Malaria, medicine | Tagged: DDT, Gates Foundation, Malaria, Malaria No More, Medical Care | Permalink
Posted by Ed Darrell
I get e-mail from the good people fighting malaria, those who can take your ten-spot and save an African kid from death by malaria.
Dear Ed,
But I still need your last-minute help to hit our target before the December 31 deadline.
I can’t think of a more meaningful way to close out the year than by making a life-saving difference for $10.
Contribute now and your tax-deductible donation will have twice the life-saving impact and help Nothing But Nets and our UN partners protect refugees in Cameroon.
Doubled!
That means your year-end donation of $25 will be worth $50, and a generous gift of $50 will be worth $100.
Thank you for caring enough to help us defeat malaria and protect even more lives.
Chris Helfrich
Director, Nothing But NetsP.S. Please don’t wait another moment. Contribute now to our 60,000 net campaign for Cameroon and your donation will be matched by an extraordinary $500,000 matching gift provided by a generous donor—doubling the impact of your life-saving gift. Thank you for whatever you can afford.
1750 Pennsylvania Avenue NW, Suite 300, Washington, DC 20006
© Nothing But Nets
$10 buys one net, delivered to a family in Africa, usually for a child. When the net is suspended over the bed of the child, mosquitoes cannot bite, and malaria transmission can be stopped. Nets help even if a kid already has malaria, because mosquitoes can’t bite him and get malaria parasites to spread.
Studies over the past 20 years show bednets alone are more effective than Indoor Residual Spraying (IRS), with DDT or any of the other eleven pesticides used. To increase effectiveness, nets usually come impregnated with an insecticide, so mosquitoes that try to get to the sleeping people inside will die, too.
With the help of the Bill and Melinda Gates Foundation, millions of nets stopped malaria in its tracks in several different African nations; since the campaign got underway in earnest in 1999, malaria deaths have been cut by 45%, from more than a million each year in 1999 to fewer than 610,000 in 2013, according to the World Health Organization (WHO).
Malaria deaths declined from the 4 million per year at peak DDT use, circa 1958-63, to about 1 million per year in 1999 — a reduction of 75% from peak DDT use. Malaria deaths today may be the lowest in recorded human history.
Got $10 to save a life? Cut that death toll even further.
1 Comment | Africa, DDT, Health care, Malaria, medicine | Tagged: Africa, DDT, Malaria, Medical Care, Nothing But Nets | Permalink
Posted by Ed Darrell
Or is there any “knee” in that at all? Maybe it’s just jerk.
You know the drill. Someone says something nice about Rachel Carson’s great work. Someone on the right can’t stand that a scientist gets spoken of well, comes unglued, and spills every lie about Rachel Carson anyone can find, including the big lie, that “millions of kids died unnecessarily because DDT was banned because Rachel Carson lied about DDT, which is really a lot like sugar water to humans and all other living things.”
For the record, each of those claims is false; in reverse order:
In short, Rachel Carson is exactly as the history books present her, a very good scientist with a special gift for communicating science issues.
That’s exactly the stuff that galls the hell out of self-proclaimed conservatives, especially those who know they are the smartest person in any room, even an internet chat room with a few million people in it. Say something good about a scientist, and they know that statement must be false, and what’s more “. . . let’s see, there should be something bad about this guy on Google . . . um, yeah . . . yessss! here, Lyndon Larouche’s magazine has some guy I’ve never heard of, but he’s smarter than any librul because he agrees with my bias! Take THAT you scurvy dog!” And in short order they’ve scooped up all five or six nuts who said bad stuff about Rachel Carson and cross-cited each other, and they’ve copied the links to the three articles on the internet that obscure groups like CEI and AEI and Heritage have paid to raise in the Google searches, and . . .
Done deal. “Good scientist! Heh! No one will listen to old Rachel Carson any more!”
Unless good people stand up to the reputation lynch mobs, and stop them. That’s why I’m telling you, so you’ll have the stuff you need to stand up. I’m hoping you will stand up.
Shortly after dawn on May 27, Twitchy rose out of the mucky water and lobbed some mud balls at Google and especially Rachel Carson. Twitchy is an interesting site. It’s mostly composed of Tweets that support conservative causes and are snarky enough earn a snicker. In short, there is no fact checking, and biases are preferred — whatever is the imagined conservative bias of the day (oddly enough, never is conservation of soil, water, nor human life ever a conservative-enough issue . . . but I digress).
It’s the nervous twitch of a knee-jerk mind and knee-jerk political mentality.
Twitchy opened up with a straightforward salvo from IowaHawk.
Note that, above, and again below, WHO records show that there were no “millions of malaria victims” of Rachel Carson. IowaHawk, David Burge, assumes — without a whit of real information — that DDT was the key to beating malaria, and so after the EPA ban on DDT, malaria must have risen, and so there must have been millions who died unnecessarily. Challenge the guy to put evidence to any part of that chain, and he’ll demur, probably suggest you’re mentally defective, and cast aspersions on what he assumes your political stand to be. Or, he’ll ignore the challenge in hopes everybody will forget. And another person will retweet Burge’s disinformative bit of propaganda — no facts, but what sounds like a nasty charge at someone who is presumed to be a liberal. Burge’s erroneous Tweet had 504 retweets when I wrote this on June 1, great impact.
Eh. Truth wins in a fair fight, Ben Franklin said. [I’m pretty sure it was Franklin; I’m still sourcing it, and if you have a correction, let me know!]
At length, more people chime in . . . and the level of misinformation in that discourse makes me crazy.
Occasionally I’ll drop in a correction, often a link to contrary information. Then the abuse is astonishing. This conservative “hate information” machine is ugly.
CDC image and caption: How do insecticide-treated nets work? People sleep under ITNs during the time when the mosquitoes that spread malaria like to feed. The insecticide on the nets helps reduce the numbers of mosquitoes that enter the house and works to kill the ones that do enter. In this way, the ITN protects the person or people sleeping under the net. If large numbers of people in the community sleep under an ITN, the numbers of mosquitoes, as well as their lifespan, will be reduced. When this happens, all members of the community receive some protection, whether or not they own or use an ITN.
[Image link failed] From the Wellcome Trust malaria page, an explanation for why it’s so important to stop bites in the home, at night, and why it’s generally not necessary to kill mosquitoes out of doors, in daylight.
Here’s my response. I think OmaJohn may have gotten the message, or rethought the thing.
But others haven’t.
I list his statements, indented; my responses are not indented. Links will be added as I can. All images are added here.
Rachel Carson is still right, still a great scientist and an amazing writer. DDT is still poisonous, still banned for agricultural use in the U.S., and still not the answer to “how do we beat malaria.”
OmaJohn said (double indent), and I responded (single indent):
Always with the crow’s lofty view to try and cherry-pick facts to paint a valid conclusion.
I wouldn’t know, Mr. Corvus. I’ve been looking at DDT professionally for science and policy, and as a hobby, and for law and history courses, for more than 30 years. I’m rather drowning in studies and statistics. A crow might be able to find some information that contradicts Rachel Carson’s writings and EPA’s rulings — but it’s not evident in this data ocean. You see some of those cherries? Do they outweigh the ocean they float in?
I do like how you use blogs to justify your condescension, though. [He complaining that I offered links to answers here, at this blog; how brazenly wrong of me to study an issue!]
I think your denigration of people who actually study a subject is ill-advised behavior. Research papers are printed on paper, just like comic books. It’s up to us to use the information to form cogent ideas about history, science, and make good policy as a result. The blogs I cite are often written by experts in the field — see especially Bug Girl, Tim Lambert and John Quiggen — and they most often provide links to the original sources.
(I gather you didn’t bother to read to see what was actually there. Your loss.)
I don’t like what appears to be your view that your non-informed opinion of something you really know little about is as valid as the work of people who devote their lives to getting the facts right. In the long run, your life depends on their winning that game, and always has.
Without having read a lot, I took a gander at a few of the folks ‘on the other side’ on this, and I was Jack’s complete lack of surprise to see you in here with your head high, throwing around blog references and talking down to people.
Much as you are talking down to me, from your position has head muckraker? I see.
I’m not sure what you mean by “folks on the other side.” If you mean on the other side of Rachel Carson, please note that in 52 years not a single science source she listed has ever been found to be in error, or fading as a result of changing science. Discover Magazine took a look at this issue in 2007, concluding Carson was right, and DDT use should be restricted as it was then and remains. The author wrote this, about claims that Carson erred on damage to birds from DDT:
In fact, Carson may have underestimated the impact of DDT on birds, says Michael Fry, an avian toxicologist and director of the American Bird Conservancy’s pesticides and birds program. She was not aware that DDT—or rather its metabolite, DDE—causes eggshell thinning because the data were not published until the late 1960s and early 1970s. It was eggshell thinning that devastated fish-eating birds and birds of prey, says Fry, and this effect is well documented in a report (pdf) on DDT published in 2002 by the Department of Health and Human Services’ Agency for Toxic Substances and Disease Registry (ATSDR). The report, which cites over 1,000 references, also describes how DDT and its breakdown products accumulate in the tissues of animals high up on terrestrial and aquatic food chains—a process that induced reproductive and neurological defects in birds and fish.
Don’t take my word for it. Go read for yourself. Check out PubMed, and read the first 50 citations you find on DDT and birds, the first 20 on DDT and human health, the first 50 on DDT and malaria. Check out the recent good books on the issue — William Souder’s great biography of Carson last year, On a Farther Shore, or Sonia Shah’s wonderful biography of malaria, [The Fever, How malaria has ruled humankind for 500,000 years].
Get real facts, in other words. Don’t talk down to people who might know what they’re talking about.
You wrote:
DDT use was officially stopped in most countries (perhaps all, I’ve not read anything I’d tout as even remotely conclusive, but I’ve not spent a substantial amount of time on this issue), but quickly (within a decade) was brought back to common use.
You should compost that, but it’s too green to do anything but foul things up indoors, here.
DDT was banned first in Sweden in 1971, then in the U.S. in 1972 — the U.S. ban was on crop use, only. About the only use that actually fell under that ban was cotton crops.
A few other European nations banned DDT.
DDT has never been banned in China, India, nor most of Asia, nor in any nation in Africa. Some African nations stopped using it when it stopped being effective; some African nations stopped using it when DDT runoff killed off food fishes and several thousands starved to death.
The World Health Organization never stopped using DDT, though its dramatic decline in effectiveness, especially in Africa, was key to the collapse and abandonment of WHO’s campaign to eradicate malaria. WHO stopped that campaign in 1965, and officially killed it off at the 1969 WHO meetings. You’ll note that was years before the 1972 ban in the U.S. — so the claims that the U.S. ban prompted a WHO to act is also false just on calendar terms.
If you check with the Wellcome Trust, they have several papers and PowerPoint presentations on the problems with malaria in Mexico, Central and South America — where DDT has been used constantly since 1948, with no ban. Unfortunately, malaria came back. Resistance to DDT in mosquitoes is real, and if malaria is not cured in the humans while the populations are temporarily knocked down, when the mosquitoes come back, they will find those humans with malaria, withdraw some of the parasites from that human, incubate them to the next part of the life cycle, and start a plague within a couple of weeks.
So, no, DDT was never banned in most places. There is a treaty, the Persistent Organic Pollutants Treaty (POPs), which names DDT as one of the dirtiest pollutants in the world. Though every other pollutant on the list is severely restricted or completely banned, DDT has a special carve out (Addenda D, if I recall correctly) which says DDT may be used by any nation to fight any vector-borne disease.
All a nation need do is send a letter to WHO explaining that it plans to use DDT, and when.
And, no, DDT was not brought back in haste to make up for a lack of the stuff.
Not sure where you’re getting your history, but it’s not exactly square with what’s happened.
That’s a pretty huge, expensive policy shift — twice.
Would have been, had it been done as you described. Not so.
There was a lot of pressure to make those changes.
So in the fight on Malaria, I think that scientists and bureaucrats generally agree that DDT plays an important role, particularly after seriously slowing or stopping use for a substantial amount of time.
Read the POPs treaty — go to the WHO site and you can still get some of the deliberative papers.
For almost all uses, DDT has much better alternatives available today.
Malaria is a special case because humans screwed up the eradication campaign, first, by abusing DDT and creating DDT resistance in the mosquitoes, and second, by completely abandoning most other parts of the program when DDT crapped out.
DDT doesn’t cure malaria. All it does is temporarily knock down the mosquitoes that carry the parasite through part of its life cycle. Better medical care is a very important part of beating the disease, and as in the U.S., improving housing cuts malaria rates dramatically, especially with windows that are screened roughly from sundown to early morning.
DDT is one of 12 chemicals WHO approves for use in Indoor Residual Spraying (IRS), in areas where there are outbreaks of the disease. If any one chemical were used alone, it would be ineffective within months, or weeks.
When tobacco farmers in Uganda sued to stop DDT spraying in the early years of the 21st century, WHO issued a press release saying it still believes in DDT. Well, WHO always did. But as of 2010, DDT’s effectiveness is even less, and many nations use only the other 11 chemicals for IRS against malaria.
DDT is still there, if it works, and if it helps; bednets alone are more than double the effectiveness of DDT in preventing malaria. We could probably phase out DDT completely without anyone noticing. DDT is not a panacea. There is no shortage of DDT anywhere today. No one dies for a lack of DDT — though many may die from a lack of bednets or appropriate medical care, problems DDT cannot touch
I believe that Rachel Carson championed her cause very successfully. I believe there was sizeable, if not perfectly tangible, fallout that would only be measurable in human livesand misery thanks to her efforts. And in the end, things were as they should have been, despite her best efforts to force them where they
shouldn’t be.I see. You don’t know what Rachel Carson said about DDT.
Carson said that DDT was — in 1962 — a pesticide without a clear replacement. She said it was absolutely critical to the then-existing WHO campaign to fight malaria.
And because of that, she urged that use of DDT on crops, or to kill cockroaches, or to kill flies at picnic sites, be stopped — because unless it were stopped, the overuse could not fail to leak into the rest of the ecosystem. Mosquitoes would quickly develop resistance to DDT — that had been a key problem in Greece in 1948, and Carson cites several other places where anti-typhus and anti-malaria campaigns were scuttled when the insects started eating DDT — and once that resistance developed, Carson said, beating malaria would be set back decades at a minimum, and maybe centuries.
She wrote that in 1962.
Fred Soper was the super mosquito fighter in the employ of the Rockefeller Foundation who developed the DDT-based malaria eradication program. He was loaned to WHO to take the campaign worldwide. Soper thought Carson was too tough on DDT in her book, but he had already calculated that DDT resistance would develop by 1975. He had just more than a dozen years to eliminate malaria, he wrote. (This is chronicled in Malcom McDowell’s 2001 profile of Soper in The New Yorker; you can read it at McDowell’s website.)
WHO’s campaign had mopped up pockets of malaria left in temperate zone nations; he had massive successes in sub-tropical nations, and he was poised to strike at the heart of malaria country, in equatorial Africa, in 1963.
The first campaign launched there fizzled completely. When they captured some mosquitoes, they found the mosquitoes were highly resistant to DDT already. Turns out that farmers in Africa wanted spotless fruit, too, and were using tons of DDT to get it.
For the health workers, what that meant was they had no tool at all to knock down mosquitoes even temporarily, to then finish the medical care, housing improvement and education components of the malaria eradication campaign.
It is also true that many of those nations had unstable governments. Soper’s formula required that 80% of the homes in an affected area be treated. That required highly trained, very devoted workers, and a willing population. Those things were difficult to find in nations with unstable governments, or worse, civil war. So there were other complicating factors. But Soper had faced those, and beaten them, behind the Iron Curtain, in Asia, in the Pacific and in South America.
When DDT quit on him, as Carson predicted it would without official action to save its potency, Soper called it quits.
Soper ended his campaign without approaching most of equatorial Africa in 1965. WHO officially ended the program in 1969.
Carson died in 1964. She would have been saddened that DDT stopped working in the malaria fight so early. She had written about it occurring in some future year — she probably knew of Soper’s calculation in the 1970s.
The public relations smear campaign against Carson, costing the chemical companies $500,000, generated some doubt among the public, but the President’s Science Advisory Council published its report saying Carson was accurate on the science, and calling for immediate action against DDT — in 1963.
It was 7 years after her death that EPA was organized, and 8 years before EPA moved against DDT.
Carson pleaded for a dramatic reduction in unnecessary DDT use — to make spotless apples, for example — in order to save people from malaria.
What did you think she said? What things were back where they should have been — poor kids dying of malaria is as it should be?
We could have done better, had we listened to Rachel Carson in 1962.
You’ve offered nothing that logically refutes those conclusions.
You should have read those blogs.
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4 Comments | DDT, History, Hoaxes, Malaria, medicine, Rachel Carson, Science | Tagged: DDT, Google Doodle, History, Hoaxes, Malaria, medicine, Rachel Carson, Science, Twitchy | Permalink
Posted by Ed Darrell
I get e-mail; this one may prove useful to more than a few people, especially anyone who owns a small business and has questions about how ObamaCare — the Affordable Care Act — will affect your taxes, your hiring, your expenses, etc.:
Hi, all —
In fewer than 100 days, the new health care reform law takes an important step forward. On October 1, 2013, Health Insurance Marketplaces will open in every state, and millions of Americans will be eligible to apply for coverage. Between now and then, we’re sure that lots of people will be looking for information about the upcoming changes.
That’s why we revamped HealthCare.gov.
On the updated site, you’ll be able to get a personalized list of coverage options, tailored to your situation, and a checklist to help prepare for October 1. You’ll find a rich set of answers to frequently asked questions, powerful search features to help you find the specific information you need, and two great ways to talk to customer service representatives, 24/7: a new 1-800 number (1-800-318-2596) and online chat.
When open enrollment starts on October 1, 2013, you’ll be able to use the site to compare various health care plans side by side to find a plan that fits your life and your budget. You’ll even be able to use HealthCare.gov to apply for coverage or be directed to your own state’s application portal.
We hope you’ll use the site to get answers to your questions about the health care law — and forward this email to your friends so they can do the same.
Thanks!
Tara
Tara McGuinness
Senior Communications Advisor
The White HouseP.S. — Have questions about what else you can expect from health care reform? Click here for a timeline of the key features of the Affordable Care Act.
[My e-mail address cut out ]
The White House • 1600 Pennsylvania Ave NW • Washington, DC 20500 • 202-456-1111
Several people I’ve run into have questions about the program — some of the questions are serious, and difficult for me to answer, and some are silly (“Why do I have to give up my insurance now?” Answer: You don’t.) There’s a great need for answers. Distortions of the plan from the nasty political fights involved, have taken hold in the mind of many as representations of what the plan weill do.
Go try the site. Does it answer your questions? What questions do you have that are not answered by this site?
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Screenshot of HealthCare.gov. Click to visit the site.
1 Comment | Government, Health care, Medicare, medicine, ObamaCare, Politics, President Obama | Tagged: Affordable Care Act "Obamacare, Government, Health care, Health Care Reform, Health Insurance, Patient Protection and Affordable Care Act, Politics | Permalink
Posted by Ed Darrell
Not a word about condemning Rachel Carson. No plea to use DDT to try to poison Africa or Asia to health. That’s a great start.
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Mother and son under a protective bednet, the most efficient method to prevent malaria. Columbia University MVSim image
2 Comments | DDT, Disease, Geography - Physical, Geography - Political, History, Malaria, medicine, Science, World Health Organization (WHO), World Malaria Day | Tagged: Africa, Asia, DDT, Disease, geography, History, Malaria, medicine, Rachel Carson, Science, World Health Organization, World Malaria Day | Permalink
Posted by Ed Darrell
He’s absolutely right.
English: World Malaria Day Button (english) (Photo credit: Wikipedia)
What are you doing to fight malaria today?
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1 Comment | Disease, History, Malaria, medicine, Science | Tagged: April 25, Bill Clinton, Health care, Malaria, medicine, Science, World Health Organization, World Malaria Day | Permalink
Posted by Ed Darrell
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Ed Darrell on Texas's Colorado River
Come on in, the water's fine. Come often: Cleanliness is next to godliness.
Millard Fillmore's Bathtub 