World Malaria Report 2018: World looks away as malaria bounces back

December 7, 2018

Covers of the last four World Malaria Reports. World Health Organization (WHO)

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 Release

Maputo/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).


Nobel prizes grow in U.S. public schools

October 4, 2017

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

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.

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:

Save

Save

Save

Save

Save


Mozambique uses 4 million mosquito nets in turn from pesticide, in war on malaria

June 20, 2017

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’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.

Save

Save

Save


Malaria uptick in Botswana: No, more DDT can’t help

March 28, 2017

Health workers in Botswana use a cell phone to report malaria diagnoses and commencement of treatment, enabling real-time tracking of malaria outbreaks and rapid public health service responses. Photo from MalariaNoMore.
Health workers in Botswana use a cell phone to report malaria diagnoses and commencement of treatment, enabling real-time tracking of malaria outbreaks and rapid public health service responses. Photo from MalariaNoMore.

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)

Save


WHO’s World Malaria Report 2016 shows great progress, but funding slowdown hurts the fight against malaria

December 13, 2016

Promotional poster for the World Malaria Report 2016, from WHO

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.

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.

WHO’s press release:

 

Malaria control improves for vulnerable in Africa, but global progress off-track

News release

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?

Save


September 23, 1858: DON’T wash your hands!

September 23, 2015

Ignaz Semmelweiss

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, 1858

Semmelweiss’ 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.

Yes, this is mostly an encore post. Fighting ignorance requires patience.


Bill Gates agrees: We can eliminate malaria in a generation

January 9, 2015

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.

Gates Foundation image: A nurse dispenses a malaria drug to treat an infected child in Tanzania.


Want to do a good turn? Nothing But Nets needs you to save a kid from malaria. It’s cheap.

December 30, 2014

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,

We have 6,000 nets left to reach our 60,000 goal to protect refugee children and their families in Cameroon from malaria!

But I still need your last-minute help to hit our target before the December 31 deadline.

That’s why a generous donor has extended his extraordinary $500,000 matching gift campaign until midnight, December 31.

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

Chris Helfrich
Director, Nothing But Nets

P.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.

Donate Now | View in browser

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.


Does “Twitchy” really just mean “knee jerk?” Correcting the record, deflecting the hoaxes, propaganda and Mau-Mauing about Rachel Carson and DDT

June 1, 2014

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:

  1. DDT is toxic to almost all living things, a long-lived and potent poison (which is why DDT was used to kill harmful insects and other vermin). While bed bugs and mosquitoes have evolved resistance and total immunity to the stuff, few other creatures have.
  2. Rachel Carson told all the truth about DDT that was known at the timeHer accuracy was confirmed by a panel of the nation’s top scientists, who reviewed her work for errors, and federal policy for usefulness and safety.  Since the 1962 publication of Silent Spring, and since Carson’s untimely death from cancer in 1964, we’ve learned that DDT is a carcinogen (though, we hope, a weak one); we’ve learned that DDT is an endocrine disruptor that fouls up sex organs and sexual maturity in more animals than anyone can count, including humans; and we’ve learned that  DDT causes birds to lay eggs with shells so thin the chicks cannot survive, even if the DDT doesn’t kill the chick outright.
  3. Carson didn’t urge a ban on DDT, nor did it happen until eight years after her death.  As I explain below, Carson fought to stop DDT abuses, to preserve DDT’s utility in the fight against disease.  She lost that fight, and as a resul tof DDT abuse by DDT advocates, the World Health Organization (WHO) had to scrap it’s ambitious program to eradicate malaria from the Earth — just as the campaign got to tropical areas of Africa.  DDT was banned for crops in the U.S. (health uses have never been banned here), after two different federal courts ordered EPA to do something because under the existing law they’d be required to ban DDT completely if EPA didn’t act, and after a rather adversary administrative law hearing that lasted nine months, featured testimony and document submissions from more than 30 DDT manufacturers, and compiled a record of DDT’s benefits and harms nearly 10,000 pages long.  It was science that got DDT banned, not Rachel Carson’s great writing.
  4. Almost every year since EPA banned DDT use on crops in the U.S., worldwide malaria deaths dropped, from peak-DDT use years (circa 1958-1963) levels of approximately 4 million deaths per year, to 2013’s approximately 627,000 deaths.  It’s unfair and grotesquely inaccurate to claim a reduction in deaths of about 84% is, instead, an increase.  Malaria was not close to eradication in 1965 when WHO stopped its campaign on the ground, nor in 1969 when WHO officially abandoned eradication as a goal, nor in 1972 when the U.S. banned DDT use in the U.S., and dedicated all U.S. production of DDT to export, mostly for fighting insects that cause disease.

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 of a child sleeping under an insecticide treated bednet (ITN) to prevent bites from malaria-carrying mosquitoes.

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.

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.

[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.

Sometimes I unload.  I was on hold for a more than an hour on a couple of phone calls that day.  Some guy working the handle OmaJohn took great exception to something I said — I think his complaint was that thought I knew what I was talking about — and of course, he knew better!  How dare I refer to facts!

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.

More:

  • David Burge, Iowahawk, whose post started the Twitchy twitches, several years ago revealed that a young boy his family had been sponsoring in Africa through a private charity, had died from malaria.  Death from malaria is a tragic reality.  Burge urged people to speak out for more DDT, and to donate money to Africa Fighting Malaria.  Readers of my blog may recall that AFM is the astro-turf organization founded by Roger Bate years ago, from all appearance to pay Roger Bate to say nasty things about Rachel Carson.  We could find on their IRS 990 form no evidence that the organization does anything to fight malaria, anywhere.  One might wonder how much anti-malaria activity Roger Bate’s $100,000/year salary would have purchased, in any of the several years he headed the non-help group, or since.  Adding insult to tragedy, Burge noted at his blog that “environmental groups” opposed Indoor Residual Spraying in Africa, and especially the use of DDT.  But it turns out that the chief opposition at that time came from tobacco growers and tobacco organizations — the groups from whom Roger Bate solicited money to start up AFM.  Wouldn’t it be easier just to stick with the facts?
  • If you want to do something, to save a life from malaria, send $10 to Nothing But Nets.  In stark contrast to AFM, NbN sends almost all its money to buy bednets to give away to people in malaria-endemic areas of Africa.  While AFM ridicules nets, they are much more effective at preventing malaria than IRS, especially IRS with DDT alone.  Nets are much cheaper, too.  NbN acts in partnership with the NBA and the United Methodist Church in the United States, and is one of the most upstanding charities anywhere.  They do not say nasty things about Rachel Carson — probably wouldn’t if they thought to, because they are so busy fighting malaria.

Got questions about ObamaCare? Check out this site

June 24, 2013

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.:

The White House, Washington

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 House

P.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.

Visit WhiteHouse.gov

[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?

More:

Screenshot of HealthCare.gov. Click to visit the site.

Screenshot of HealthCare.gov. Click to visit the site.


Resources for World Malaria Day 2013

April 25, 2013

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.

More:

Mother and son under a protective bednet, the most efficient method to prevent malaria.  Columbia University MVSim image

Mother and son under a protective bednet, the most efficient method to prevent malaria. Columbia University MVSim image


April 25 is World Malaria Day — right, Bill?

April 24, 2013

He’s absolutely right.

English: World Malaria Day Button (english)

English: World Malaria Day Button (english) (Photo credit: Wikipedia)

What are you doing to fight malaria today?

More:


National Infant Immunization Week, April 20-27, 2013

April 23, 2013

National Infant Immunization Week:  Find out about the power to protect with immunizations on http://www.vaccines.gov/

This week is National Infant Immunization Week designated by the U.S. Centers for Disease Control (CDC).  Vaccinations worked miracles in extending human lifespans, and in making childhood much safer from disease, for those children who get vaccinated.

Information following comes directly from the CDC:

Protect Your Baby with Immunization

Photo: A mother and childImmunization is one of the best ways parents can protect their infants from 14 serious childhood diseases before age two. Check to see if your baby is up to date on immunizations.

It is important for children to be fully immunized. Diseases that can be prevented with vaccines can be very serious – even deadly – especially for infants and young children. For example, children younger than 2 years old are at the highest risk for serious pneumococcal disease like pneumonia, blood infection (sepsis), and meningitis. Before the pneumococcal vaccine was used routinely, an estimated 17,000 cases of severe types of pneumococcal infection, like meningitis, occurred each year.

Immunization. Power to Protect.

Immunizations have helped to greatly improve the health of children in the United States. Most parents today have never seen first-hand the devastating consequences that vaccine-preventable diseases have on a family or community. While most of these diseases are not common in the United States, they persist around the world. It is important that we continue to protect our children with vaccines because outbreaks of vaccine-preventable diseases can and do occasionally occur in this country.

For example, in 2010, there were 27,550 people reported to have “whooping cough” (pertussis) in the United States. Twenty-seven deaths were reported – 25 of these were in children younger than 1 year old. In 2011, 222 people were reported to have measles in the United States – that’s more than any year since 1996. Measles is brought into the United States by unvaccinated U.S. residents and foreign visitors who get infected when they are in other countries. Measles is still common in many parts of the world, including Europe, Asia, the Pacific, and Africa. In fact, in France alone, more than 15,000 people were reported to have measles in 2011. Measles spreads easily, and it can be serious, causing hospitalization and even death. Young children are at highest risk for serious complications from measles.

Vaccinating your baby according to the recommended immunization schedule gives him or her the best protection against 14 serious childhood illnesses – like measles and whooping cough – before he is two years old. The recommended schedule is designed to protect infants and children early in life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases.

Vaccine Information for ParentsVisit CDC’s vaccine website for parents.

The Diseases Vaccines Prevent

The recommended immunization schedule for babies includes vaccination protection against all of the following diseases:

Vaccinate On Time, Every Time

Even though the United States experiences outbreaks of some vaccine-preventable diseases, the spread of disease usually slows or stops because of immunization. If we stopped vaccinating, even the few cases we have in this country could very quickly become tens or hundreds of thousands of cases. Fortunately, most parents choose to vaccinate their children and immunization rates in this country are at or near record high levels. In fact, less than 1% of children do not receive any vaccines. However, some children have not received all of their vaccines and therefore are not fully immunized. It’s important that children receive all doses of the vaccines according to the recommended immunization schedule. Not receiving all doses of a vaccine leaves a child vulnerable to catching serious diseases.

That’s why it’s important to make sure that your child is up to date on his or her immunizations. Call your pediatrician to find out if your child is due for any vaccinations. Or, you can use this online tool to enter your child’s current record and quickly see if any doses have been skipped or missed. It is important to your child’s health to be up to date on immunizations.

Paying for Immunization

Photo: A babyMost health insurance plans cover the cost of vaccinations, but you should check with your insurance provider before going to the doctor. If you don’t have health insurance, or if your insurance does not cover vaccinations, the Vaccines for Children (VFC) program may be able to help with the cost.

The VFC program helps families of eligible children who might not otherwise have access to immunization. The program provides vaccinations at no cost. Children younger than 19 years of age are eligible for VFC vaccines if they are:

  • Medicaid-eligible
  • Uninsured
  • American Indian or Alaska Native,
  • Underinsured and vaccinated in Federally Qualified Health Centers or Rural Health Clinics.

Parents of uninsured or underinsured children who receive vaccines at no cost through the VFC Program should check with their health care providers about possible administration fees that might apply. These fees help providers cover the costs of giving the vaccines, including storing the vaccines and paying staff members to give vaccines to patients. However, VFC vaccines cannot be denied to an eligible child if a family can’t afford the fee.

Have Questions about Immunization?

  • Talk with your child’s health care professional, contact your local or state health department, or call the CDC at 800-CDC-INFO (800-232-4636).
  • Visit CDC’s vaccine website for parents

More Information

CDC works 24/7 saving lives and protecting people from health threats to have a more secure nation. A US federal agency, CDC helps make the healthy choice the easy choice by putting science and prevention into action. CDC works to help people live longer, healthier and more productive lives.

Last syndicated: April 19, 2013
This content is brought to you by: Centers for Disease Control and Prevention (CDC)

More:


Obamacare: Still the better way, still saving money, still a good deal

January 20, 2013

A guy named William Duncan at a blog called Sensible Thoughts posted something I found inherently unsensible a while back.  He listed six reasons why he thought the Affordable Care Act should be repealed. (“A while?” “Yeah, July 2012 is ‘a while.'”)

His sixth point was the old canard about Congress and the President being exempt.  Of course they are not exempt, and so I told him.

Your sixth reason is in error. There is no provision to exempt either the president or Congress from the act. There is no language in the bill such as you describe. Language from page 114 can be found here:

https://timpanogos.wordpress.com/2012/04/17/obamacare-making-stuff-up-to-complain-about/

At some length, Mr. Duncan removed that point, but said he still thinks the law should be repealed on the other five points I hadn’t dealt with.

Ed:
Thank you for the correction on point #6. I have gone back and looked at this, and you are absolutely right. Although the Wall Street Journal and folks like Sean Hannity reported that the President and members of Congress are exempt from participation in the Affordable Care Act, in the end that did NOT make it into the language of the legislation. I have deleted point #6 from the post as a result. Thank you for the correction. Now, if you copuld only prove me wrong on the rest of the points listed…. Unfortunately, this remains a bill the the American public did not want, and was purchased by shenanigans that the Administration should be ashamed of.

A quick and dirty response; we may need to put more meat on these response bones in the next couple of months, because the opposition to ObamaCare relies on severely distorted claims about the law and what it actually does.  Much if not most of the good stuff in the law is completely ignored by these critics, and we should point that out, too.

I responded (images added here):

Disproof?

What makes you think Americans didn’t want it? There was a whale of an anti-health care campaign after the act passed, but when it passed, it enjoyed a majority of support. And, when we take each provision of the bill and ask people about that provision, they approve overwhelmingly.

English: Depiction of the House vote on H.R. 3...

Depiction of the House vote on H.R. 3590 (the Patient Protection and Affordable Care Act) on March 21, 2010, by congressional district. Democratic yea, dark blue; Democratic nay, light blue; Republican nay, red; No representative seated, white. Image from Wikipedia

For example, not even you are opposed to continuing the Reagan-era program that encourages medical schools to train more general practitioners. No one seriously objects to the provisions that pay physicians to practice in under-served areas, like West Texas, Iowa, and West Virginia. No one objects to the provisions that train more nurses. Only the most rabid racists complain about continuing and expanding the health care clinics on Indian reservations.

The law has dozens of provisions like those, and no one in their right mind objects to them.

Your other five points?

  1. The Supreme Court killed that one for you. They said that, even if you call it a fine, it’s a tax. And at that, it’s a helluva bargain. For those who do not purchase health insurance because they can’t afford to, they must pay $695 additional tax, per year. That’s about what I’d pay monthly on the open market.In any case, there are no fines, according to the Supreme Court.

    English: Depiction of the Senate vote on H.R. ...

    Depiction of the Senate vote on H.R. 3590 (the Patient Protection and Affordable Care Act) on December 24, 2009, by state. Color code is difficult to decipher; let it suffice that if there are two Democratic yea votes, the state is colored deep blue; if two Republican nay votes, very red. Image from Wikipedia

    But I can’t imagine why you oppose bargains in health care, especially when they lower the costs of health care to the insured, who will no longer pay the 15% to 25% premium to cover indigent care.

  2. With all the “new taxes,” CBO, the non-partisan group that scores these issues for Congress, projects the bill will decrease federal spending and cut the deficits annually, when fully enacted in 2014 and all out years.Do you oppose deficits or not?All the other taxes are fair, strike only the tippy-top income tiers, and are cheap at that.These taxes make the system more fair. It’s stacked against anyone making less than $150,000 a year, now. That’s most of us. I don’t like it when government helps the rich, at the expense of the poor — that’s contrary to moral standards my church holds, for example, and it tends to damage the economy.So I think more fair taxes, and lower costs, will be quite popular, once we see them.So, new taxes aren’t a good justification to oppose the law.
  3. Speaking of fallacious accounting — CBO, the group you cite, says the bill will reduce the deficits. You assume the Law won’t work, while small portions of it have already slashed inflation in health care costs, from 20% in 2009 to 4% in 2011 and 2012.But, what about repeal? CBO looked at that, too — repeal of the law will increase deficits, not decrease them. It’s only $109 billion increase in deficits, but these number directly refute all claims that repeal would be cheaper. See the analysis gateway here: http://www.cbo.gov/publication/43471
  4. This Medicare issue was hashed out, accurately and well I thought, in the campaign. Medicare costs will be reduced by holding costs down — benefits will not be reduced. Eric Cantor and Paul Ryan ran into some difficulty with this, because their budget plans assumed the savings from the Affordable Care Act, while eliminating the law that produced the savings.I’m sure there will be some adjustments required. Medicare seems a little ham-fisted when it comes to dealing with local and regional cost differences, but nationwide, over the past 40 years, enormous savings have been realized by reducing some reimbursements for procedures that once were uncommon and expensive, to a less expensive rate, now that they are more common. On the whole, over 40 years, over thousands of procedures, physicians have changed their expectations, and things have worked fine. Oh, there have been grumblings, I know. But the cuts in costs, without cuts in benefits, have stuck.Under the Affordable Care Act, we hope a lot more people will move to company plans from Medicare, or at least to the exchange plans offered in each state.One of the changes already introduced is working [link added here]. Rather than pay providers for each procedure, Medicare now reimburses hospitals for effective hospitalization — that is, when a patient is discharged and then re-enters a hospital for the same complaint, the hospital will lose money. Hospitals are keeping patients a few days longer on many procedures, to insure that one hospitalization is all that is required. Savings are already being made in costs, while improvements have resulted in the health care – better health in the patients!In all, CBO says costs will come down with the Affordable Care Act, as advertised, and costs will rise and deficits will rise if the Act is repealed.
  5. Your abortion argument is too metaphysical, and not enough real-world. Do you want to reduce the number of abortions? Then provide health care, make sure contraception is freely available (not for free, but freely), and stand back. Those two things reduce abortions, as they did during the Clinton administration.Restrictions on abortion, on the other hand, make it more likely a woman will choose to terminate a pregnancy under a number of circumstances: She doesn’t have health care coverage, her coverage does not cover pre-natal care, her coverage won’t cover a new infant, the pregnancy is unplanned due to lack of good information on family planning or lack of access to affordable contraception.You can choose: Restrict abortions and increase the number of abortions, or provide health care, and reduce the number of abortions.It may be a bit counter-intuitive, but you’d better study the issue. The Affordable Care Act’s provisions, Obamacare, have over the years reduced abortions where applied; cutting off that care has increased the number of abortions.My advice would be, don’t kill the babies to make a political point.

I am concerned that you don’t appear much familiar with what the bill actually does. Here are a few reasons to keep the law.

  1. We need more physicians, and the bill provides them.
  2. We need more physicians in underserved areas, and the bill provides them.
  3. We need more nurses, and the bill provides them.
  4. We need more community clinics in underserved urban areas [link added here], where illnesses and injuries frequently go untreated until extreme trauma results, and the victim must get extremely expensive care in an emergency room. This will be one of the biggest cost savers — and the law provides those clinics.
  5. The law will cut the private bureaucracy, and completely dismantle the private death panels set up by insurance companies, saving at least 10% of every health care dollar, applying that money to care instead of bureaucracy. This is already occurring.
  6. Preventive care under the Act is greatly encouraged — if we can boost flu vaccines by another 10%, it will save thousands of lives annually, and millions of dollars in hospitalization costs. Flu shots came with no co-pay this year — did you notice? — so that anyone with any insurance at all could drop by any pharmacy offering flu shots and get one with no out-of-pocket expenses.
    This is huge. Everyone agrees the cheapest health care is for healthy people. The Affordable Care Act changes the way health care is delivered, to emphasize prevention of disease and injury, instead of triage. Prevention usually costs about 10% what the triage would cost.
  7. Removing the lifetime cap on insurance payments, per patient, will save a few thousands of lives, annually. It should kill the phenomenon where many families, hit with a costly disease or accident, had to declare bankruptcy as a result. A significant portion of all bankruptcies have been “not adequately-insured” cases. Those should almost disappear.
  8. Allowing children to stay insured, on a parent’s plan, for those critical years after high school and college and into the second job, with benefits has already benefited millions of Americans, saving millions of dollars and probably a few lives.

I cannot imagine why anyone would want to go back to 20% annual health care cost inflation, the highest per capita health care costs in the world by a factor of two, while leaving one out of every seven people uninsured even though we were paying amounts more than the insurance would have cost.

Obamacare reduces the deficits, and puts our health system on the path to catch up to the rest of the industrialized world, with better care for less cost.

I’ll keep it, thank you.

(See this, too: “More good news about Obamacare: CBO says it will save money”

More:


V for Vaccine: A slightly rude film with a powerful point

January 10, 2013

A couple of kids in the Dallas area have died already from influenza — neither had been vaccinated against it.  Deaths have occurred across the nation, frequently in young, otherwise healthy people.

Nasty flu bugs going around this year, and the every-year epidemic has hit about two months early.  One part of the good news is that the vaccines this year are especially well-suited to target the viruses that cause the trouble.  The vaccines work well every year, but especially well in 2012 and 2013.

The bad news is that millions of people haven’t bothered to get vaccinated. That’s not good.

  1. Under Obamacare, there’s no copay for insurance for a flu shot.  It’s “free” if you have any kind of insurance. In addition, county health offices offer the vaccines for free to any comers.  A couple of weeks ago at the pharmacy I stood behind a woman who confessed she’d not gotten a flu shot (pharmacies are pushing vaccinations these days, to promote their mini-clinics).  “I’ve got that crappy teachers’ insurance,” she told the technician.  “It never pays for anything like that.”  The tech looked it up, and told her that her copay was zero, and her insurance paid for it — essentially a free shot, to her.  On the way into the clinic she said, “I’ve never gotten a flu shot before.”  Oy.
  2. Think Herd Immunity:  Are you usually healthy?  Great.  But if you’re pregnant, or you work around people who are or may be pregnant, or if you’re over 60, or if you have any chronic condition like diabetes, high blood pressure, chronic sinusitis, or a raft of other things, you’re at risk, and you put others in those risk categories at risk.  My grandfather worked at a hospital while my mother and my oldest brother were living with him; after a week of my grandfather’s working in the polio ward, my brother came down with the disease.  Of course we don’t know for sure, but my grandfather kicked himself for 40 years, until his death, because he thought he’d brought home the disease my brother caught.  With vaccines, those incidents become much more rare.

Risking this blog’s G rating, I’m going to post this film, “V for Vaccine.”  Found it at New Anthropocene.  Turn up your offense filter, or ignore the language — but pay attention to what this guy says, PowerM1985:

Is it worth getting your children vaccinated if it risked them becoming autistic? In this video I give a short demonstration of why I personally believe that even if there was a risk of my child becoming autistic (AND THERE IS NOT!) I would still get them vaccinated.

You should probably know that the work of the Centers for Disease Control to correctly predict which strains of the viruses will be most prevalent, and get vaccines that will fight those viruses, has been very, very good this year.

  • Influenza A (H3N2), 2009 influenza A (H1N1), and influenza B viruses have all been identified in the U.S. this season. During the week of December 23-29, 2,346 of the 2,961 influenza positive tests reported to CDC were influenza A and 615 were influenza B viruses. Of the 1,234 influenza A viruses that were subtyped, 98% were H3 viruses and 2% were 2009 H1N1 viruses.
  • Since October 1, 2012, CDC has antigenically characterized 413 influenza viruses, including 17 2009 influenza A (H1N1) viruses, 281 influenza A (H3N2) viruses and 115 influenza B viruses.
    • All 17 of the 2009 influenza A (H1N1) viruses were characterized as A/California/7/2009-like. This is the influenza A (H1N1) component of the Northern Hemisphere vaccine for the 2012-2013 season.
    • Of the 281 influenza A (H3N2) viruses, 279 (99%) were characterized as A/Victoria/361/2011-like. This is the influenza A (H3N2) component of the Northern Hemisphere influenza vaccine for the 2012-2013 season.
    • Approximately 69% of the 115 influenza B viruses belonged to the B/Yamagata lineage of viruses, and were characterized as B/Wisconsin/1/2010-like, the influenza B component for the 2012-2013 Northern Hemisphere influenza vaccine. The remaining 31% of the tested influenza B viruses belonged to the B/Victoria lineage of viruses.

What are you waiting for?  Go get a flu shot!

More:

English: This is CDC Clinic Chief Nurse Lee An...

This is CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. (Photo credit: Wikipedia)

Graphic on influenza, 2013 - Flu.gov

Information from Flu.gov; click image to get to active Flu Vaccine Finder


%d bloggers like this: