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World Malaria Day was April 25: WHO’s fact sheet

April 26, 2021

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:

No call for DDT; pesticide resistance remains a problem, but it’s a problem DDT cannot solve.
Malaria remains near all-time lows in humans, with 229 million cases worldwide.
Malaria still kills kids predominantly, and African kids make up most of those deaths.
15 years ago there was hope of eradicating malaria from many countries by 2020; that goal will be missed in several nations.

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.

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Posted by Ed Darrell

World Malaria Report 2020: Governments fell short of pledges, malaria poised to make a comeback.

December 1, 2020

World Malaria Report 2020 carries bad news. Despite remarkable progress against malaria, despite being on the verge of beating the disease and eradicating it from the planet, governments stopped supporting anti-malaria work.

Malaria is poised to come roaring back to kill millions.

COVID-19 complicates fighting malaria. But the real enemy of the fight against malaria is apathy, neglect and ignorance.

Cover of World Malaria Report 2020, WHO’s annual accounting of the fight to eradicate malaria.

Below, the full press release from the World Health Organization (WHO) on the 2020 accounting of the war against malaria.

____________________________

WHO calls for reinvigorated action to fight malaria

Global malaria gains threatened by access gaps, COVID-19 and funding shortfalls

30 November 2020

News release

Reading time: 6 min (1645 words)

The World Health Organization (WHO) is calling on countries and global health partners to step up the fight against malaria, a preventable and treatable disease that continues to claim hundreds of thousands of lives each year. A better targeting of interventions, new tools and increased funding are needed to change the global trajectory of the disease and reach internationally-agreed targets.

According to WHO‘s latest World malaria report, progress against malaria continues to plateau, particularly in high burden countries in Africa. Gaps in access to life-saving tools are undermining global efforts to curb the disease, and the COVID-19 pandemic is expected to set back the fight even further.

“It is time for leaders across Africa – and the world – to rise once again to the challenge of malaria, just as they did when they laid the foundation for the progress made since the beginning of this century,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Through joint action, and a commitment to leaving no one behind, we can achieve our shared vision of a world free of malaria.”

In 2000, African leaders signed the landmark Abuja Declaration pledging to reduce malaria deaths on the continent by 50% over a 10-year period. Robust political commitment, together with innovations in new tools and a steep increase in funding, catalyzed an unprecedented period of success in global malaria control. According to the report, 1.5 billion malaria cases and 7.6 million deaths have been averted since 2000.

A plateau in progress

In 2019, the global tally of malaria cases was 229 million, an annual estimate that has remained virtually unchanged over the last 4 years. The disease claimed some 409 000 lives in 2019 compared to 411 000 in 2018.

As in past years, the African Region shouldered more than 90% of the overall disease burden. Since 2000, the region has reduced its malaria death toll by 44%, from an estimated 680 000 to 384 000 annually. However, progress has slowed in recent years, particularly in countries with a high burden of the disease.

A funding shortfall at both the international and domestic levels poses a significant threat to future gains. In 2019, total funding reached US $3 billion against a global target of $5.6 billion. Funding shortages have led to critical gaps in access to proven malaria control tools.

COVID-19 an added challenge

In 2020, COVID-19 emerged as an additional challenge to the provision of essential health services worldwide. According to the report, most malaria prevention campaigns were able to move forward this year without major delays. Ensuring access to malaria prevention – such as insecticide-treated nets and preventive medicines for children – has supported the COVID-19 response strategy by reducing the number of malaria infections and, in turn, easing the strain on health systems. WHO worked swiftly to provide countries with guidance to adapt their responses and ensure the safe delivery of malaria services during the pandemic.

However, WHO is concerned that even moderate disruptions in access to treatment could lead to a considerable loss of life. The report finds, for example, that a 10% disruption in access to effective antimalarial treatment in sub-Saharan Africa could lead to 19 000 additional deaths. Disruptions of 25% and 50% in the region could result in an additional 46 000 and 100 000 deaths, respectively.

“While Africa has shown the world what can be achieved if we stand together to end malaria as a public health threat, progress has stalled,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “COVID-19 threatens to further derail our efforts to overcome malaria, particularly treating people with the disease. Despite the devastating impact COVID-19 has had on African economies, international partners and countries need to do more to ensure that the resources are there to expand malaria programmes which are making such a difference in people’s lives.”

WHO response

A key strategy to reignite progress is the “High burden to high impact” (HBHI) response, catalyzed in 2018 by WHO and the RBM Partnership to End Malaria. The response is led by 11 countries – including 10 in sub-Saharan Africa – that account for approximately 70% of the world’s malaria burden.

Over the last 2 years, HBHI countries have been moving away from a “one-size-fits all” approach to malaria control – opting, instead, for tailored responses based on local data and intelligence. A recent analysis from Nigeria, for example, found that through an optimized mix of interventions, the country could avert tens of millions of additional cases and thousands of additional deaths by the year 2023, compared to a business-as-usual approach.

While it is too early to measure the impact of the HBHI approach, the report finds that deaths in the 11 countries were reduced from 263 000 to 226 000 between 2018 and 2019. India continued to make impressive gains, with reductions in cases and deaths of 18% and 20%, respectively, over the last 2 years. There was, however, a slight increase in the total number of cases among HBHI countries, from an estimated 155 million in 2018 to 156 million in 2019.

Meeting global malaria targets

This year’s report highlights key milestones and events that helped shape the global response to the disease in recent decades. Beginning in the 1990s, leaders of malaria-affected countries, scientists and other partners laid the groundwork for a renewed malaria response that contributed to one of the biggest returns on investment in global health.

According to the report, 21 countries eliminated malaria over the last 2 decades; of these, 10 countries were officially certified as malaria-free by WHO. In the face of the ongoing threat of antimalarial drug resistance, the 6 countries of the Greater Mekong subregion continue to make major gains towards their goal of malaria elimination by 2030.

But many countries with a high burden of malaria have been losing ground. According to WHO global projections, the 2020 target for reductions in malaria case incidence will be missed by 37% and the mortality reduction target will be missed by 22%.

Note to editors

WHO’s work on malaria is guided by the Global technical strategy for malaria 2016-2030 (GTS), approved by the World Health Assembly in May 2015. The strategy includes four global targets for 2030, with milestones along the way to track progress. The 2030 targets are: 1) reducing malaria case incidence by at least 90%; 2) reducing malaria mortality rates by at least 90%; 3) eliminating malaria in at least 35 countries; and
4) preventing a resurgence of malaria in all countries that are malaria-free.

Near-term GTS milestones for 2020 include global reductions in malaria case incidence and death rates of at least 40% and the elimination of malaria in at least 10 countries. According to the report, the 2020 milestones for malaria case incidence and mortality rates will be missed:
– Case incidence: WHO projects that, in 2020, there were an estimated 56 malaria cases for every 1000 people at risk of the disease against a GTS target of 35 cases. The GTS milestone will be missed by an estimated 37%.
– Mortality rate: The estimate for globally projected malaria deaths per 100 000 population at risk was 9.8 in 2020 against a GTS target of 7.2 deaths. The milestone will be missed by an estimated 22%.

WHO African Region – Since 2014, the rate of progress in both cases and deaths in the region has slowed, attributed mainly to the stalling of progress in several countries with moderate or high transmission. In 2019, six African countries accounted for 50% of all malaria cases globally: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Niger (4%), Mozambique (4%) and Burkina Faso (4%). In view of recent trends, the African Region will miss the GTS 2020 milestones for case incidence and mortality by 37% and 25%, respectively.

“High burden to high impact” (HBHI) – Launched in November 2018, HBHI builds on the principle that no one should die from a disease that is preventable and treatable. It is led by 11 countries that, together, accounted for approximately 70% of the world’s malaria burden in 2017: Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda and United Republic of Tanzania. Over the last two years, all 11 HBHI countries have implemented activities across four response elements: 1) political will to reduce the toll of malaria; 2) strategic information to drive impact; 3) better guidance, policies and strategies; and 4) a coordinated national malaria response

Malaria elimination – Between 2000 and 2019, 10 countries received the official WHO certification of malaria elimination: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Kyrgyzstan (2016), Sri Lanka (2016), Uzbekistan (2018), Paraguay (2018), Argentina (2019) and Algeria (2019). In 2019, China reported zero indigenous cases of malaria for the third consecutive year; the country recently applied for the official WHO certification of malaria elimination. In 2020, El Salvador became the first country in Central America to apply for the WHO malaria-free certification

In the six countries of the Greater Mekong subregion – Cambodia, China (Yunnan Province), Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam – the reported number of malaria cases fell by 90% from 2000 to 2019, while P. falciparum (Pf) cases fell by 97% in the same time period. This accelerated decrease in Pf malaria is notable in view of the threat posed by antimalarial drug resistance in the subregion.

A call for innovation – Eliminating malaria in all countries, especially those with a high disease burden, will likely require tools that are not available today. In September 2019, the WHO Director-General issued a “malaria challenge,” calling on the global health community to ramp up investment in the research and development of new malaria-fighting tools and approaches. This message was further reinforced in the April 2020 report of the WHO Strategic advisory group on malaria eradication.

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Posted by Ed Darrell

Sri Lanka declared malaria-free, without DDT

March 6, 2018

Chart from the India Foundation shows the ups and downs of fighting malaria in Sri Lanka in the 20th and 21st centuries. Sri Lanka is malaria-free since 2016.

Sri Lanka pushed malaria out of the country, and is certified by the World Health Organization (WHO) as malaria-free, as of September 2016.

If you follow the fight against malaria, this may not be news to you. If you’re a victim of the pro-DDT, anti-WHO and anti-Rachel Carson hoaxes, you may be surprised.

Sri Lanka once got malaria to almost nothing, with heavy use of DDT in Indoor Residual Spraying. Then the budget hawks stopped the anti-malaria program (“Success!”) to save money. Malaria came roaring back as it will when vigilance relaxes — but by then the mosquitoes were mostly resistant to DDT, and a civil war kept the nation from mounting any public health campaigns in much of the country.

With the advent of new medicines, ABC therapy, and new methods to diagnose the disease, and using bednets and targeted pesticides other than DDT, Sri Lanka beat the disease. The news was carried in Britain’s The Guardian.

The World Health Organisation has certified that Sri Lanka is a malaria-free nation, in what it called a truly remarkable achievement.
WHO regional director Poonam Khetrapal Singh said in a statement that Sri Lanka had been among the most malaria-affected countries in the mid-20th century.
But, the WHO said, the country had begun an anti-malaria campaign that successfully targeted the mosquito-borne parasite that causes the disease, not just mosquitoes. Health education and effective surveillance also helped the campaign.
https://www.theguardian.com/society/2016/sep/05/sri-lanka-malaria-free-world-health-organisation

This is a blow to the anti-WHO pro-DDT forces. Sri Lanka has been a key story in their tales of how only DDT could fix malaria, stories told long after DDT stopped working. One more example shot down.

More:

Tip of the old scrub brush to The Guardian.

Sri Lanka #malaria-free, without #DDT: https://t.co/HZJWeWEHHJ
— Ed Darrell (@EdDarrell) August 17, 2017

3 Comments | DDT, History, Malaria, Public health, WHO - World Health Organization | Tagged: DDT, History, Malaria, Public health, Science, Sri Lanka | Permalink
Posted by Ed Darrell

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; 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.

WHO’s press release:

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.

More about the RTS,S vaccine

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.

More on the evaluation of LLINs

Will major media cover this news? Will your local newspapers and broadcast outlets even make note?

Save

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

Highlights from the World Health Assembly #68, in graphic form

May 26, 2015

World Health Organization (WHO) summary of the World Health Assembly #68, which met in Geneva last, May 18-26.

Not a peep about “more DDT to fight malaria.’

Graphic from the World Health Organization on major actions of the World Health Assembly 68, in Geneva, Switzerland, May 18-26, 2015

Leave a Comment » | DDT, Malaria, Public health, WHO - World Health Organization | Tagged: DDT, Malaria, Public health, WHO, World Health Assembly 68, World Health Organization | Permalink
Posted by Ed Darrell

World Malaria Report 2014: Dramatic progress (no call for DDT)

December 9, 2014

World Malaria Report 2014 dropped this week. It’s the annual report from the World Health Organization (WHO) on the fight against malaria, the problems, critical needs — and this year, wonderful news of progress.

Cover of WHO’s World Malaria Report 2014, a child, and the red blood cells the malaria parasites attack.

Copies of the report in .pdf format come in English, French and Spanish. A host of supplemental materials and statistical compilations accompany the report every year.

The World Malaria Report 2014 summarizes information received from malaria-endemic countries and other sources, and updates the analyses presented in the 2013 report.

It assesses global and regional malaria trends, highlights progress towards global targets, and describes opportunities and challenges in controlling and eliminating the disease. The report was launched in the United Kingdom Houses of Parliament on 9 December 2014.

The press release on the report, from WHO:

Scale-up in effective malaria control dramatically reduces deaths

News release

9 December 2014 ¦ Geneva – The number of people dying from malaria has fallen dramatically since 2000 and malaria cases are also steadily declining, according to the World malaria report 2014. Between 2000 and 2013, the malaria mortality rate decreased by 47% worldwide and by 54% in the WHO African Region – where about 90% of malaria deaths occur.

New analysis across sub-Saharan Africa reveals that despite a 43% population increase, fewer people are infected or carry asymptomatic malaria infections every year: the number of people infected fell from 173 million in 2000 to 128 million in 2013.

“We can win the fight against malaria,” says Dr Margaret Chan, Director-General, WHO. “We have the right tools and our defences are working. But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

Between 2000 and 2013, access to insecticide-treated bed nets increased substantially. In 2013, almost half of all people at risk of malaria in sub-Saharan Africa had access to an insecticide-treated net, a marked increase from just 3% in 2004. And this trend is set to continue, with a record 214 million bed nets scheduled for delivery to endemic countries in Africa by year-end.

Access to accurate malaria diagnostic testing and effective treatment has significantly improved worldwide. In 2013, the number of rapid diagnostic tests (RDTs) procured globally increased to 319 million, up from 46 million in 2008. Meanwhile, in 2013, 392 million courses of artemisinin-based combination therapies (ACTs), a key intervention to treat malaria, were procured, up from 11 million in 2005.

Moving towards elimination

Globally, an increasing number of countries are moving towards malaria elimination, and many regional groups are setting ambitious elimination targets, the most recent being a declaration at the East Asia Summit to eliminate malaria from the Asia-Pacific region by 2030.

In 2013, 2 countries reported zero indigenous cases for the first time (Azerbaijan and Sri Lanka), and 11 countries succeeded in maintaining zero cases (Argentina, Armenia, Egypt, Georgia, Iraq, Kyrgyzstan, Morocco, Oman, Paraguay, Uzbekistan and Turkmenistan). Another 4 countries reported fewer than 10 local cases annually (Algeria, Cabo Verde, Costa Rica and El Salvador).

Fragile gains

But significant challenges remain: “The next few years are going to be critical to show that we can maintain momentum and build on the gains,” notes Dr Pedro L Alonso, Director of WHO’s Global Malaria Programme.

In 2013, one third of households in areas with malaria transmission in sub-Saharan Africa did not have a single insecticide treated net. Indoor residual spraying, another key vector control intervention, has decreased in recent years, and insecticide resistance has been reported in 49 countries around the world.

Even though diagnostic testing and treatment have been strengthened, millions of people continue to lack access to these interventions. Progress has also been slow in scaling up preventive therapies for pregnant women, and in adopting recommended preventive therapies for children under 5 years of age and infants.

In addition, resistance to artemisinin has been detected in 5 countries of the Greater Mekong subregion and insufficient data on malaria transmission continues to hamper efforts to reduce the disease burden.

Dr Alonso believes, however, that with sufficient funding and commitment huge strides forward can still be made. “There are biological and technical challenges, but we are working with partners to be proactive in developing the right responses to these. There is a strong pipeline of innovative new products that will soon transform malaria control and elimination. We can go a lot further,” he says.

While funding to combat malaria has increased threefold since 2005, it is still only around half of the US$ 5.1 billion that is needed if global targets are to be achieved.

“Against a backdrop of continued insufficient funding the fight against malaria needs a renewed focus to ensure maximum value for money,” says Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “We must work together to strengthen country ownership, empower communities, increase efficiencies, and engage multiple sectors outside health. We need to explore ways to do things better at all levels.”

Ray Chambers, who has served as the UN Secretary-General’s Special Envoy for Malaria since 2007, highlights the remarkable progress made in recent years. “While staying focused on the work ahead, we should note that the number of children dying from malaria today is markedly less than 8 years ago. The world can expect even greater reductions in malaria cases and mortality by the end of 2015, but any death from malaria remains simply unacceptable,” he says.

Gains at risk in Ebola-affected countries

At particular risk is progress on malaria in countries affected by the Ebola virus. The outbreak in West Africa has had a devastating impact on malaria treatment and the roll-out of malaria interventions. In Guinea, Sierra Leone and Liberia, the 3 countries most severely affected by the epidemic, the majority of inpatient health facilities remain closed, while attendance at outpatient facilities is down to a small fraction of rates seen prior to the outbreak.

Given the intense malaria transmission in these 3 countries, which together saw an estimated 6.6 million malaria cases and 20 000 malaria deaths in 2013, WHO has issued new guidance on temporary measures to control the disease during the Ebola outbreak: to provide ACTs to all fever patients, even when they have not been tested for malaria, and to carry out mass anti-malaria drug administration with ACTs in areas that are heavily affected by the Ebola virus and where malaria transmission is high. In addition, international donor financing is being stepped up to meet the further recommendation that bednets be distributed to all affected areas.

Note to editors

Globally, 3.2 billion people in 97 countries and territories are at risk of being infected with malaria. In 2013, there were an estimated 198 million malaria cases worldwide (range 124-283 million), 82% of which were in the WHO African region. Malaria was responsible for an estimated 584 000 deaths worldwide in 2013 (range: 367 000 – 755 000), killing an estimated 453 000 children under five years of age.

Based on an assessment of trends in reported malaria cases, a total of 64 countries are on track to meet the Millennium Development Goal target of reversing the incidence of malaria. Of these, 55 are on track to meet Roll Back Malaria and World Health Assembly targets of reducing malaria case incidence rates by 75% by 2015.

The World malaria report 2014 will be launched on 9 December 2014 in the United Kingdom Houses of Parliament. The event will be co-hosted by the All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases (APPMG) and Malaria No More UK.

Contacts for press queries will be found at the link above.

Canadian-educated, Dr. Margaret Chan of the Peoples Republic of China heads the World Health Organization, the world’s leading anti-malaria organization.

You may note that the press release says nothing about DDT, the pesticide most famous in the malaria fight after World War II. WHO abandoned its ambitious campaign to eradicate malaria from the Earth, in the mid-1960s, when it was discovered that mosquitoes in central Africa and other malaria-endemic regions near the tropics were already resistant or immune to the pesticide. DDT had been used by super-mosquito fighter Fred Soper, in campaigns by the Rockefeller Foundation and WHO, to knock down mosquito populations temporarily, to get breathing room to beat malaria. While the populations were temporarily reduced, health workers would frantically work to diagnose and completely treat to a cure, malaria infections in humans. Then, when the mosquito populations came roaring back, the bugs would have no well of disease from which to draw parasites for new infections.

Soper’s methods used DDT sprayed on walls of homes, to specifically get those mosquitoes that bite humans. Anopheles spp. mosquitoes carry malaria parasites through a critical part of the parasites’ life cycle; those mosquitoes typically bite from about dusk to just after midnight. After a blood meal, mosquitoes pause to rest on nearby vertical structures — walls in this case — to squeeze out excess water from the blood they’ve ingested, so they’re light enough to fly. When the mosquito encounters DDT on the walls, the hope is that the DDT kills the mosquito, ending the transmission cycle.

A brutal public relations campaign in Africa, the U.S. and Europe through the late 1990s to now, has vilified science writer Rachel Carson for her indictment of DDT in Silent Spring, her brilliant book on the dangers of indiscriminate use of untested new chemicals.

So it’s important to note that the world’s leading organization that fights malaria makes no call for more DDT. Professional health care workers worldwide have not been hornswoggled by pro-DDT, anti-environment, anti-science, anti-WHO propaganda. That’s good news, too.

More:

1 Comment | DDT, Economics, Health care, Malaria, Science, WHO - World Health Organization | Tagged: DDT, Economics, Health care, Malaria, Science, WHO | Permalink
Posted by Ed Darrell

November is National Malaria Awareness Month in Philippines

November 9, 2014

Education is still a key tool in the fight against malaria. In that spirit, the President of the Philippines declares November as National Malaria Awareness Month.

Philippines President Gloria Macapagal-Arroyo – Wikipedia image

Hope it works.

Proclamation from the President of the Philippines:

MALACAÑANPALACE

MANILA

BY THE PRESIDENT OF THE PHILIPPINES

PROCLAMATION NO. 1168

DECLARING THE MONTH OF NOVEMBER OF EVERY YEAR AS MALARIA AWARENESS MONTH

WHEREAS, Malaria is the 8th leading cause of morbidity in the Philippines, affecting most Filipinos of productive age group, and vulnerable groups which includes pregnant women, children and indigenous population groups, and continue to be a major impediment to human and economic development in area where it persists;

WHEREAS, Malaria remains endemic in 65 of the 79 provinces affecting 12.5 million Filipinos, with pockets of high endemicity along municipal/provincial borders, in far flung remote areas and barangays populated by indigenous cultural groups and areas with socio-political conflicts;

WHEREAS, Malaria, with morbidity rate of 55 per 100,000 population and mortality rate of 0.17 per 100,000 population, has to be reduced and controlled by effective malaria prevention and treatment measures, such as increase in the use of insecticide-treated mosquito nets and early diagnosis and prompt treatment in malaria risk areas;

WHEREAS, Goal six of Millennium Development Goals aims to combat HIV/AIDS, malaria and other diseases, with the target of halting and reversing the incidence of malaria and other diseases by 2015;

WHEREAS, the WHO/UNICEF Regional Child Survival Strategy focuses on the implementation of an Essential Package for Child Survival, one of which is the use of insecticide-treated mosquito nets of children 0-59 months in malarious areas;

WHEREAS, Malaria is one of the 5 diseases to be targeted under the disease-free zones initiative of service delivery component of “FOURmula One for Health”, an implementation strategy for health reforms;

WHEREAS, recent advances in the field of diagnosis, treatment and vector control makes the disease preventable and curable despite increasing trends of drug and insecticide resistance;

WHEREAS, the main strategies to reduce morbidity and mortality against malaria are through early diagnosis and prompt treatment, vector control through the use of insecticide treated mosquito nets supplemented by indoor residual spraying of insecticides, and early detection and management of epidemics;

WHEREAS, Republic Act No. 7160, otherwise known. as the Local Government Code, devolves the provision of basic health services to prevent and control malaria to the local government units. Enhancement on the program management capacity of the LGUs will be one of the major thrusts of the Department of Health and its partners;

WHEREAS, to facilitate program management and inculcate better health-seeking behaviors among the general population especially the high risk population on prevention and control of malaria, the National Malaria Control Program in consultation with the Regional Coordinators, Provincial Health Offices, LGUs, and other stakeholders, recommends that the month of November of every year be declared for the creation of awareness on the prevention and control of malaria.

NOW, THEREFORE, I, GLORIA MACAPAGAL-ARROYO, President of the Republic of the Philippines, by virtue of the powers vested in me by law, do hereby order:

SECTION 1.            Lead agency. — The Department of Health (DOH) shall lead in the implementation of the Malaria Awareness Month every November of the year starting 2006. As such, it shall call upon all government agencies/organizations for assistance in the implementation of this Proclamation, including but not limited to the following:

a.              Department of the Interior and Local Government

b.              Department of Education

c.              Department of National Defense

d.              National Disaster and Coordinating Council

e.              Department of Tourism

f.               Local Government Units/Organizations

1.              Liga ng mga Barangay

2.              League of Municipalities

3.              League of Provinces

g.              Philippine Information Agency

h.              National Commission on Indigenous Peoples

As the lead agency, the Department of Health shall formulate and disseminate guidelines and procedures on the implementation of the campaign, provide technical assistance to LGUs and/or implementing units or organizations, conduct national/regional advocacy and social mobilization in endemic provinces, augment local logistics for malaria prevention and control, and monitor LGU activities in all phases of the campaign. The DOH will also coordinate activities with major donor funded programs such as Global Fund to Fight AIDS, Tuberculosis and Malaria — Malaria Component and Australian Agency for International Development — WHO-RBM [Roll Back Malaria] projects.

SECTION 2.            Responsibilities of the. Department of the Interior and Local Government (DILG). — The DILG, through its Secretary, shall issue and disseminate appropriate memorandum, circulars to all local chief executives, mobilize field offices, and assist in the supervision and monitoring of malaria awareness campaign and other prevention and control activities.

SECTION 3.            Responsibilities of the Department of Education (DepEd). — The DepEd, through its Secretary, shall incorporate or integrate malaria prevention and control into the school curriculum, provide a venue in schools for treatment or re-treatment of mosquito nets through school children (each pupil will bring their mosquito net for re-treatment) in coordination with local health officials. The DepEd shall issue and disseminate appropriate circulars for the purpose.

SECTION 4.            Responsibilities of the Department of National Defense (DND). — The DND, through its Secretary, shall issue and disseminate appropriate memorandum circulars to its regional and provincial units to conduct activities in raising the awareness on malaria prevention and control among their personnel and staff especially in endemic areas. The Armed Forces of the Philippines, through the Surgeon General, must ensure that military personnel assigned to endemic areas should undergo the pre- and post- malaria smear test. Provide assistance in terms of transportation and security support to local health personnel in the implementation of the campaign. Strengthen management of severe malaria to prevent deaths in its hospitals in partnership with DOH.

SECTION 5.            Responsibilities of the National Disaster Coordinating Council (NDCC). — The NDCC, through the Office of Civil Defense (OCD), shall coordinate the implementation of the malaria awareness month activities with the LGUs through the Barangay/Municipal/City Disaster Coordinating Councils, Regional Disaster Coordinating Councils, and Provincial Disaster Coordinating Councils.

SECTION 6.            Responsibilities of the Philippine Information Agency (PIA). — The PIA, through its Director-General, shall guide, integrate and supervise the public communication activities including advertisements of the malaria awareness communication campaign.

SECTION 7.            Responsibilities of the Local Government Units (LGUs). — The LGUs shall lead the local implementation of the malaria awareness campaign and allocate appropriate resources for the purpose. Ensure that basic quality health, services on the diagnosis, treatment, vector control (distribution of treated mosquito nets, re-treatment, indoor residual spraying) are sustained until 2015. Further, the LGUs shall coordinate with partner NGOs and/or private sectors in the conduct of the campaign and establish a network of all partners at the local level. The concerned LGUs shall issue appropriate local ordinances, resolutions, memorandum circulars and other relevant orders.

SECTION 8.            Responsibilities of the League of Provinces/Municipalities/Barangays. — Through their presidents, shall issue circulars, memoranda and other issuances to their members on the local implementation of malaria awareness activities.

SECTION 9.            Responsibilities of the National Commission on Indigenous Peoples (NCIP). — The NCIP, through their Chairperson, shall issue memorandum circulars to the field offices to participate actively in the conduct of malaria awareness campaign among tribal minorities/indigenous communities in coordination with local health officials. The NCIP shall likewise support and help in coordinating field activities and help in the translation of IEC materials.

SECTION 10.         Responsibilities of the Department of Tourism (DOT). — The DOT, through its Secretary, shall issue and disseminate appropriate memorandum circulars to its regional field offices to conduct activities, in coordination with the Provincial Health Offices, in raising the awareness of tourists on malaria prevention especially in endemic areas.

SECTION 11.         Participation of the Civil Societies. — All non-government organizations, members of the civil societies, professional groups, business sectors and other concerned groups are encouraged to contribute to the success of the malaria awareness campaign through information dissemination, social mobilization, providing donations and other appropriate means.

SECTION 12.         Bilateral and multilateral agencies. — All donor partners will be encouraged to support malaria control program in line with the goals of Millennium Development Goal No. 6: Combat HIV/AIDS, malaria and other diseases at all levels. Integrated programs shall be encouraged.

IN WITNESS WHEREOF, I have hereunto set my hand and caused the seal of the Republic of the Philippines to be affixed.

DONE in the City of Manila, this 10th day of November, in the year of Our Lord, Two Thousand and Six.

(Sgd.) GLORIA MACAPAGAL-ARROYO

1 Comment | Malaria, WHO - World Health Organization | Tagged: Gloria Macapagal-Arroyo, Malaria, Philippines, World Health Organization | Permalink
Posted by Ed Darrell

Yes, malaria is still a plague; it’s not Rachel Carson’s fault, and your saying so probably kills kids

May 30, 2014

May 27’s Google Doodle honoring Rachel Carson brought out a lot of those people who have been duped by the anti-Rachel Carson hoaxers, people who are just sure their own biased views of science and the politics of medical care in the third world are right, and Carson, and the people who study those issues, are not.

So comes “The Federalist,” what appears to me to be a reactionary site, which yesterday got great readership for a story from Bethany Mandel. Mandel tells a story of a child in Cambodia suffering from malaria. The suffering is horrible and the child most likely died. It’s a tragic story of poverty and lack of medical care in the third world.

Erroneously, Mandel up front blames the suffering all on Rachel Carson, in a carp about the Google Doodle.

Here was my quick response between bouts in the dentist’s chair yesterday [links added here]:

[Bethany Mandel wrote:] Using faulty science, Carson’s book argued that DDT could be deadly for birds and, thus, should be banned. Incredibly and tragically, her recommendations were taken at face value and soon the cheap and effective chemical was discontinued, not only in the United States but also abroad. Environmentalists were able to pressure USAID, foreign governments, and companies into using less effective means for their anti-malaria efforts. And so the world saw a rise in malaria deaths.

Don’t be evil?

Start by not telling false tales.

1. Carson presented a plethora of evidence that DDT kills birds. This science was solid, and still is.

2. Carson did not argue DDT should be banned. She said it was necessary to fight disease, and consequently uses in the wild, requiring broadcast spraying, should be halted immediately.

3. Scientific evidence against DDT mounted up quickly; under US law, two federal courts determined DDT was illegal under the Federal Insecticide, Fungicide, and Rodenticide Act; they stayed orders to ban the chemical pending hearings under a new procedure at the new Environmental Protection Agency.

EPA held hearings, adversary proceedings, for nine months. More than 30 DDT manufacturers were party to the hearings, presenting evidence totaling nearly 10,000 pages. EPA’s administrative law judge ruled that, though DDT was deadly to insects, arachnids, fish, amphibians, reptiles, birds and mammals, the labeled uses proposed in a new label (substituted at the last moment) were legal under FIFRA — indoor use only, and only where public health was concerned. This labeling would allow DDT to remain on sale, over the counter, with few penalties for anyone who did not follow the label. EPA took the label requirements, and issued them as a regulation, which would prevent sales for any off-label uses. Understanding that this would be a severe blow to U.S. DDT makers, EPA ordered U.S. manufacture could continue, for the export markets — fighting mosquitoes and malaria being the largest export use.

This ruling was appealed to federal courts twice; in both cases the courts ruled EPA had ample scientific evidence for its rule. Under U.S. law, federal agencies may not set rules without supporting evidence.

4. DDT was banned ONLY for agriculture use in the U.S. It was banned in a few European nations. [Addition, December 30, 2014: In fact, the U.S. action against DDT by EPA specifically called for DDT use in any fight against a vector borne disease, like malaria.]

5. DDT has never been banned in Africa or Asia.

6. USAID’s policy encouraged other nations to use U.S.-made DDT, consistent with federal policy to allow manufacture for export, for the benefit of U.S. business.

7. U.S. exports flooded markets with DDT, generally decreasing the price.

Fred Soper, super malaria fighter, whose ambitious campaign to erase malaria from the Earth had to be halted in 1965, before completion, when DDT abuse bred mosquitoes resistant and immune to DDT.

8. Although WHO had been forced to end its malaria eradication operation in 1965, because DDT abuse had bred mosquitoes resistant to and immune to DDT, and though national and international campaigns against malaria largely languished without adequate government funding, malaria incidence and malaria deaths declined. Especially after 1972, malaria continued a year-over-year decline with few exceptions.

Note that the WHO campaign ended in 1965 (officially abandoned by WHO officials in 1969), years before the U.S. ban on DDT.

Every statement about DDT in that paragraph of [Mandel’s] article, is wrong.

Most important, to the purpose of this essay, malaria did not increase. Malaria infections decreased, and malaria deaths decreased.

I’m sure there are other parts of the story that are not false in every particular. But this article tries to make a case against science, against environmental care — and the premise of the case is exactly wrong. A good conclusion is unlikely to follow.

Mandel was hammered by the full force of the anti-Rachel Carson hoaxers. I wonder how many children will die because people thought, “Hey, all we have to do is kill Rachel Carson to fix malaria,” and so went off searching for a gun and a bullet?

You are not among them, are you?

Update: This guy, a worshipper of the Breitbart, seems to be among those who’d rather rail against a good scientist than lift a finger to save a kid from malaria. If you go there, Dear Reader, be alert that he uses the Joe Stalin method of comment moderation: Whatever you say, he won’t allow it to be posted. Feel free to leave comments here, where we practice First Amendment-style ethics on discussion.

8 Comments | DDT, History, Malaria, Rachel Carson, Science, WHO - World Health Organization | Tagged: Bethany Mandel, DDT, History, hoax, Malaria, medicine, Rachel Carson, Science, WHO | Permalink
Posted by Ed Darrell

Nothing But Nets invites you to join in the fight against malaria, for World Malaria Day

April 3, 2014

I get e-mail from Nothing But Nets, in preparation for World Malaria Day, April 25, 2014:

Dear Ed,

As you know, World Malaria Day is April 25, and supporters will be taking action throughout April to help us send 25,000 bed nets to families in Africa.

Are you in?

Our champions are holding basketball tournaments, soccer games, and running in 5K races to get their friends, families, and communities involved in the fight against malaria.

Megan Walter, our supporter from Richmond, Virginia, organized a unique event in her hometown. She partnered with her local trampoline park to jump for nets – and they raised $10 for every jumper who participated. The event was a huge success, raising more than $2,000 to send 200 bed nets to families in Africa. What made it even better is that Megan had fun doing it!

There are lots of ways to raise money and send nets while doing what you love. Every $10 you raise helps us purchase and distribute life-saving bed nets with our UN partners.

What sports challenge will you do this April?

Join us in sending nets and saving lives for World Malaria Day! Together, we can defeat malaria.

Sincerely,

Liz Wing
Senior Grassroots Officer, Nothing But Nets

P.S. Whether you run, swim, or play basketball, you can help raise critical funds and save lives. Take a challenge.

Compete to Beat Malaria Footer

Donate Now | Unsubscribe | View in browser

You noted, of course: No call for more DDT. No slamming of science, scientists, medicine, medical workers, or Rachel Carson and environmental organizations.

This comes from people who fight malaria for a (meager) living, on non-profit basis, without political bias. In short, these people need help, and consequently have no use for the pro-DDT, anti-Rachel Carson, anti-WHO, anti-science hoaxes.

Please give. Every $10 can save a life.

Leave a Comment » | DDT, History, Malaria, Nothing But Nets, Rachel Carson, WHO - World Health Organization, World Health Organization (WHO), World Malaria Day | Tagged: DDT, Malaria, Nothing But Nets, Rachel Carson, WHO, World Malaria Day | Permalink
Posted by Ed Darrell

World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing (but not DDT)

March 21, 2014

News release from the World Health Organization:

World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing

News release

Cover of World Malaria Report 2013

11 December 2013 | Geneva/Washington DC – Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally and by 49% in Africa, according to the “World malaria report 2013” published by WHO.

An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa.

The large majority of the 3.3 million lives saved between 2000 and 2012 were in the 10 countries with the highest malaria burden, and among children aged less than 5 years – the group most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54%.

But more needs to be done.

“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” says Dr Margaret Chan, WHO Director-General. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century.”

In 2012, there were an estimated 207 million cases of malaria (uncertainty interval: 135 – 287 million), which caused approximately 627 000 malaria deaths (uncertainty interval 473 000 – 789 000). An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80% of malaria cases occur in Africa.

Long way from universal access to prevention and treatment

Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.

In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50% in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.

There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.

Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.

Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies – recommended for infants, children under 5 and pregnant women – has also been slow in recent years.

“To win the fight against malaria we must get the means to prevent and treat the disease to every family who needs it,” says Raymond G Chambers, the United Nations Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria. “Our collective efforts are not only ending the needless suffering of millions, but are helping families thrive and adding billions of dollars to economies that nations can use in other ways.”

Global funding gap

International funding for malaria control increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012. Domestic funding stood at around US$ 0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to US$ 2.5 billion in 2012 – less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.

Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in four countries in south-east Asia, and insecticide resistance has been found in at least 64 countries.

“The remarkable gains against malaria are still fragile,” says Dr Robert Newman, Director of the WHO Global Malaria Programme. “In the next 10-15 years, the world will need innovative tools and technologies, as well as new strategic approaches to sustain and accelerate progress.”

WHO is currently developing a global technical strategy for malaria control and elimination for the 2016-2025 period, as well as a global plan to control and eliminate Plasmodium vivax malaria. Prevalent primarily in Asia and South America, P. vivax malaria is less likely than P. falciparum to result in severe malaria or death, but it generally responds more slowly to control efforts. Globally, about 9% of the estimated malaria cases are due to P. vivax, although the proportion outside the African continent is 50%.

“The vote of confidence shown by donors last week at the replenishment conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria is testimony to the success of global partnership. But we must fill the annual gap of US$ 2.6 billion to achieve universal coverage and prevent malaria deaths,” said Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “This is our historic opportunity to defeat malaria.”

Notes for editors:

The “World malaria report 2013” summarizes information received from 102 countries that had on-going malaria transmission during the 2000-2012 period, and other sources, and updates the analyses presented in 2012.

The report contains revised estimates of the number of malaria cases and deaths, which integrate new and updated under-5 mortality estimates produced by the United Nations Inter-agency Group for Child Mortality Estimation, as well as new data from the Child Health Epidemiology Reference Group.

Leave a Comment » | Africa, DDT, Foreign Aid, Health care, Malaria, WHO - World Health Organization | Tagged: Africa, DDT, Foreign Aid, Health care, Malaria, WHO, World Health Organization | Permalink
Posted by Ed Darrell

Legacy of DDT abuse: Cleaning up old pesticide dumps

February 15, 2014

Contrary to science denialist claims, DDT is not harmless. Users and abusers of DDT, abandoned stocks of DDT and other pesticides around the world, after the stuff had become essentially useless against insect or other pests originally targeted.

In the U.S., EPA moves in to clean up DDT dumps, under the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA), or Superfund. In much of the world, various UN agencies find the old pesticides, and clean them up as funding allows.

The Food and Agricultural Organization (FAO) documents its cleanup efforts with photos of sessions training technicians to find and catalog dump sites, repackaging of old drums when necessary, extraction, packing and shipping to a disposal site.

Photos tell a story words on paper cannot.

Caption from FAO: TN (Tanzania) before: 40 tonnes of 50 year old DDT were found in Menzel Bourguiba Hospital, TN – : M. Davis

Sometimes the toxic wastes did not stay neatly stacked.

FAO caption: TN before: 40 tonnes of 50 year old DDT were found in Menzel Bourguiba Hospital, TN View real size

DDT use against insect vectors of disease essentially halted in the mid-1960s. The Rockefeller Foundation’s and UN’s ace mosquito fighter, Fred Soper, ran into mosquitoes in central Africa that were resistant and immune to DDT. Farmers and businesses had seized on DDT as the pesticide of choice against all crop pests, or pests in buildings. By the time the UN’s malaria-fighting mosquito killers got there, the bugs had evolved to the point DDT didn’t work the malaria eradication campaign.

Also, there were a few DDT accidents that soured many Africans on the stuff. Around lakes where local populations caught the fish that comprised the key protein in their diet, farmers used DDT, and the runoff killed the fish.

Use of DDT ended rather abruptly in several nations. Stocks of DDT that had been shipped were abandoned where they were stored.

For decades.

FAO caption: Obsolete DDT in Luanda, Angola – July 2008 – : K. Cassam

Prevention and disposal of obsolete chemicals remains as a thorny problem throughout much of the world. Since 2001, under the Persistent Organic Pollutants Treaty, (POPs), the UN’s World Health Organization (WHO) has coordinated work by WHO and a variety of non-governmental organizations (NGOs), as well as governments, to make safe the abandoned pesticides, and detoxify or destroy them to prevent more damage. FAOs efforts, with photos and explanation, is a history we should work to preserve.

DDT provided powerful insect killing tools for a relatively short period of time, from about 1945 to 1965. In that short period, DDT proved to be a deadly killer of ecosystems to which it was introduced, taking out a variety of insects and other small animals, on up the food chain, with astonishing power. One of DDT’s characteristics is a long half-life — it keeps on killing, for months or years. Once that was thought to be an advantage.

Now it’s a worldwide problem.

5 Comments | DDT, Environmental protection, EPA, History, Public health, Superfund, WHO - World Health Organization | Tagged: CERCLA, DDT, Environmental protection, FAO, History, pollution, Public health, Superfund, Toxic wastes, WHO | Permalink
Posted by Ed Darrell

Rachel Carson/DDT hoaxing from the Ayn Rand Institute

April 21, 2013

Welcome, refugees and truth-seekers from WUWT: If this site seems a little unusual to you, you should know that at Millard Fillmore’s Bathtub we try to stick to science, and we don’t censor opposing opinions. Genuinely interested in the DDT/Malaria issue? See this collection.

______________

A couple of physicists get together in a podcast from the Ayn Rand Institute, ~~Poke in Your~~ Eye to Eye, and demonstrate that they don’t know biology well, they know less about history, but they don’t hesitate to tell whoppers about Rachel Carson and the value of DDT: “Silent Spring 50 Years Later [a special Earth Day podcast].”

A better indication of the legacy of Rachel Carson: Schools across America named after the woman, to inspire children to explore science, and to read and write. Here, the main entrance of Rachel Carson Middle School in Herndon, Virginia. (Photo: Wikipedia)

Earth Day must be coming up. The usual suspects trot out their usual disinformation and hoax campaigns — and it will continue through Earth Day on April 22, International Malaria Day on April 25, through Rachel Carson’s birthday, and probably all summer.

Mencken warned us that hoaxes, once out of the bottle, can’t be put back. Twain (and others) remind us that whopping falsehoods travel around the world “while truth is getting its boots on.” Amanda Maxham, who is listed as an astrophysicist at the Rand site, interviewed physicist Keith Lockitch — and they repeat almost all the hoary old false fables invented by Gordon Edwards and Steven Milloy about malaria, DDT, and Rachel Carson.

A few of the errors committed by the polemicists at the Ayn Rand Institute:

‘DDT doesn’t breed mosquitoes more resistant to the stuff, but instead weakens the population through reducing diversity.’ Absolutely wrong. Turns out the new alleles mosquitoes pick up that makes them resistant and immune to DDT, are ALSO the alleles that make mosquitoes resistant to the whole class of chemicals, and thereby foul up efforts to develop new pesticides.
Cleaning up DDT in Africa: 40 tons of 50 year old DDT were found in Menzel Bourguiba Hospital, Tanzania – FAO photo
‘Rachel Carson didn’t account for the value of DDT in eradicating malaria.’ They start out claiming DDT ended malaria in the U.S. (it didn’t; CDC had won the fight will just mop up operations left, by 1939; DDT wasn’t even available for another seven years), and run through the false claim that DDT alone had almost eradicated malaria from Sri Lanka, but listening to Rachel Carson, the nation stopped spraying and malaria roared back (the nation stopped ALL of its malaria fighting efforts due to costs and civil war; when the fight was taken up again, DDT was not useful; largely without DDT, Sri Lanka has once again nearly wiped out malaria).
‘Because of a lack of DDT use, malaria continues to ravage the world killing a million people a year.’ Actually, malaria is at the lowest level in human history, killing less than a million a year, with great progress being made against the disease using the methods Rachel Carson urged in 1962. Had we listened to Carson earlier, we could have saved a few million more lives, and perhaps have eradicated malaria already. Also, it’s important to remember that DDT was never banned in Africa nor Asia; the ban on use of DDT on cotton crops in the U.S. did not cause any increase in malaria anywhere; since the ban on DDT use in the U.S. malaria has constantly declined in incidence and deaths.
‘DDT is very effective because it’s ALSO repellent to mosquitoes, after it ceases to kill them.’ So in the end, they urge the use of a poisonous-to-wildlife, mildly carcinogenic substance, because it repels mosquitoes? Bednets are more effective, cheaper, not-poisonous to wildlife, and they aren’t even suspected of causing cancer.

Rachel Carson’s life is a model for budding scientists, aspiring journalists, and teachers of ethics. That so many people spend so much time making up false claims against her, in favor of a deadly toxin, and against science, tells us much more about the subrosa intentions of the claim fakers than about Rachel Carson.

Want the facts about Rachel Carson? Try William Souder’s marvelous biography from last year, On a Farther Shore. Want facts on DDT? Try EPA’s official DDT history online (or look at some of the posts here at Millard Fillmore’s Bathtub). Want the facts about malaria? Check with the world’s longest running, most ambitious malaria fighting campaign operated by the good people at the World Health Organization, Roll Back Malaria, or see Sonia Shah’s underappreciated history, The Fever: How malaria has ruled mankind for 500,000 years.

More:

Ode to (Silent) Spring (theamericanscholar.org)
Prenatal exposure to pesticide DDT linked to adult high blood pressure (sciencedaily.com)
First day of the conference celebrating Rachel Carson’s and Ruth Harrison’s books – 50 years on (cabiblog.typepad.com)
The Silent History of Rachel Carson (misbehavedwoman.wordpress.com)
Pertpetuating Crichton’s version of the DDT hoax (timpanogos.wordpress.com)
Global Environment Facility: “Countries move toward more sustainable ways to roll back malaria”

Roll Back Malaria, World Malaria Day logo for 2013

Wall of Shame (hoax spreaders to watch out for this week):

Michael Mann now a DDT expert; Defends indefensible Rachel Carson – Rachel lied, millions died (and are still dying) (junkscience.com)
Green Luddites (possil.wordpress.com)
20 Years Ago: 4-18-93 – Feds designate Rachel Carson home as national landmark (junkscience.com)

8 Comments | DDT, Environmental protection, History, Hoaxes, Rachel Carson, Science, WHO - World Health Organization, World Malaria Day | Tagged: Ayn Rand Institute, DDT, Earth Day, Environmental protection, History, Hoaxes, Malaria, Rachel Carson, Science, Silent Spring, World Health Organization, World Malaria Day | Permalink
Posted by Ed Darrell

Laissez Faire Today, lazy and unfair as yesterday on issues of DDT

September 25, 2012

In June [2012] I drew encouragement that Henry I. Miller, the musty old anti-science physician at the Hoover Institution, had not renewed his annual plea to bring back DDT. Miller is just one of the most predictable trolls of science and history; most years he waits until there are a number of West Nile virus victims, and then he claims we could have prevented it had we just jailed Rachel Carson and poisoned the hell out of America, Africa, Asia and the Moon with DDT. For years I’ve reminded him in various fora that DDT is particularly inappropriate for West Nile . . .

Rachel Carson Homestead Springdale, Pennsylvania (Photo credit: Wikipedia)

Since June, Miller popped up and popped off in Forbes, but using the event of the 50th anniversary of Rachel Carson’s brilliant book Silent Spring. Brilliance and science and history aside, Miller still believes that protecting wildlife and humans from DDT’s manifold harms is a threat to free enterprise — how can anyone be expected to make a profit if they can’t poison their customers?

Miller is not the only throwback to the time before the Age of Reason, though. It’s time to put the rebuttals on the record, again.

Comes this morning Jeffrey Tucker of Laissez Faire Today, complaining that the resurgence of bedbugs in America is an assault on democracy, apple pie, free enterprise, and Rachel Carson should be exhumed and tortured for her personal banning of DDT worldwide. You can read his screed. He’s full of unrighteous and unholy indignation at imagined faults of Carson and imagined benignity of pesticides.

I responded (links added here):

I’m shocked by your mischaracterizations of Rachel Carson, her great book Silent Spring (which it appears to me you didn’t read and don’t know at all), and pesticide regulation. Consequently, you err in history and science, and conclusion. Let me detail the hub of your errors.

You wrote:

Carson decried the idea that man should rule nature. “Only within the moment of time represented by the present century has one species — man — acquired significant power to alter the nature of the world.” This anthropocentrism she decried.

Carson was concerned that we were changing things that would have greater effects later, and that those effects would hurt humans. Her concern was entirely anthropocentric: What makes life worth living? Should we use chemicals that kill our children, cripple us, and create havoc in the things we enjoy in the outdoors, especially if we don’t know the ultimate effects?

Exactly contrary to your claim, her book was directed at the quality and quantity of human lives. She wanted long, good lives, for more people. How could you miss that, if you read any of her writings?

She suggested that killing a bedbug is no different from killing your neighbor: “Until we have the courage to recognize cruelty for what it is — whether its victim is human or animal — we cannot expect things to be much better in this world… We cannot have peace among men whose hearts delight in killing any living creature.”

Carson never wrote that there should be difficulty in killing bedbugs. The passage you quote, but conspiratorially do not cite, comes not from Silent Spring, but from a commentary on a compilation of hunting stories.* She’s referring to killing for the sake of killing, in that passage. I think it’s rather dishonest to claim she equates fighting biting bedbugs with killing animals unsportingly. I worry that you find it necessary to so grossly and dishonestly overstate your case. Is your case so weak?

In fact, she spoke of animals in patently untrue ways: “These creatures are innocent of any harm to man. Indeed, by their very existence they and their fellows make his life more pleasant.”

She did not write that about bedbugs. That’s a false claim.**

I guess she never heard of the Black Death.

I guess you never heard of accuracy. On page 266 of Silent Spring Carson directly addressed plague in a list of insect- and arthropod-borne diseases; Carson wrote:

“The list of diseases and their insect carriers, or vectors, includes typhus and body lice, plague and rat fleas, African sleeping sickness and tsetse flies, various fevers and ticks, and innumerable others.

“These are important problems and must be met. No responsible person contends that insect-borne disease should be ignored. The question that has now urgently presented itself is whether it is either wise or responsible to attack the problem by methods that are making it worse.” (Silent Spring, page 266)

Carson describes abuse of pesticides — such as DDT on bedbugs — that actually makes the insects stronger and tougher to get rid of. That appears to be your stand, now, to do whatever Carson said not to do, in order to poke a thumb in her eye, even if it means making bedbugs worse.

[Tucker continued:] In short, she [Rachel Carson] seemed to suggest that bedbugs — among all the millions of other killer insects in the world — enjoy some kind of right to life. It was a theory that could be embraced only in a world without malaria and bedbugs. But embraced it was.

That’s total fiction. What you write is completely divorced from fact.

By 1972, DDT was banned. And not only DDT. The whole enterprise of coming up with better and better ways to further human life and protect its flourishing was hobbled.

By 1960, DDT had ceased to work against bedbugs — this was one of the things that worried Carson*** and would worry any responsible person [see Bug Girl’s blog]. In her book, Carson warned that indiscriminate use and abuse of DDT would render it useless to fight disease and other insects and pests. By 1965, super mosquito-fighter Fred Soper and the World Health Organization had to stop their campaign to eradicate malaria when they discovered that abuse of DDT in agriculture and other uses had bred malaria-carrying mosquitoes in central and Subsaharan Africa that were resistant and immune to DDT. Keep in mind that the U.S. ban on DDT applied only in the U.S., and only one other nation in the world had a similar ban. DDT has never been banned in Africa, nor Asia.

Carson sounded the warning in 1962. By 1972, when the U.S. banned use of DDT on agricultural crops (and only on crops), it was too late to preserve DDT as a key tool to wipe out malaria.

Was the pesticide industry “hobbled?” Not at all. EPA’s order on DDT explicitly left manufacturing in the U.S. available for export — keeping profits with the pesticide companies, and multiplying the stocks of DDT available to fight disease anywhere in the world that anyone wanted to use it.

The fact is that DDT was a fortunate find, a bit of a miracle substance, and we overused it, thereby cutting short by decades its career as a human life-saver. That was exactly what Carson feared, that human lives would be lost and made miserable, unnecessarily and prematurely, by unthinking use of chemical substances. Pesticide manufacturers have been unable to come up with a second DDT, but not because regulation prevents it. Carson understood that.

There is no shortage of science-ignorant, and science-abusive websites that claim Rachel Carson erred. But 50 years out, the judgment of the President’s Science Advisory Council on her book remains valid: It’s accurate, and correct, and we need to pay attention to what she wrote. Not a jot nor tittle of what Carson wrote in 1962 has proven to be in error. Quite the contrary, as Discover Magazine noted in 2007, thousands of peer-reviewed studies reinforce the science she cited then.

Malaria deaths today are at the lowest level in human history, largely without DDT, and much due to malaria fighters having adopted the methods of fighting the disease that Carson advocated in 1962. Unfortunately, those methods were not adopted for nearly 40 years. Still, the reductions in malaria are remarkable. At peak DDT use in 1959 and 1960, a half-billion people in the world got malaria every year, one-sixth of the world’s people. 4 million died from the disease. In 2009, about 250 million people got malaria — a reduction of 50% in infections — and fewer than 800,000 people died — a dramatic reduction of more than 75% in death toll. This is all the more remarkable when we realize that world population more than doubled in the interim, and at least a billion more people now live in malaria-endemic areas. Much or most of that progress has been without DDT, of necessity — every mosquito on Earth today now carries the alleles of resistance and immunity to DDT.

You impugn a great scientist and wonderful writer on false grounds, and to damaging effect. I hope you’re not so careless in other research.

Rachel Carson was right. The re-emergence of bedbugs, 50 years after she wrote, is not due to anything Carson said, but is instead due to people who petulantly refused to listen to her careful and hard citations to science, and exhortations to stick to what we know to be true to protect human health and the quality of life.

_____________

* Rachel Carson: Legacy and Challenge, by Lisa H. Sideris, Kathleen Dean Moore, citing another of Carson’s writings, a critique of a collection of Aldo Leopold’s essays on hunting, Round River.

** Here is the full quote, from pages 99-100 of Silent Spring, highlights added here:

Incidents like the eastern Illinois spraying raise a question that is not only scientific but moral. The question is whether any civilization can wage relentless war on life without destroying itself, and without losing the right to be called civilized. These insecticides are not selective poisons; they do not single out the one species of which we desire to be rid. Each of them is used for the simple reason that it is a deadly poison. It therefore poisons all life with which it comes in contact: the cat beloved of some family, the farmer’s cattle, the rabbit in the field, and the horned lark out of the sky. These creatures are innocent of any harm to man. Indeed, by their very existence they and their fellows make his life more pleasant. Yet he rewards them with a death that is not only sudden but horrible. Scientific observers at Sheldon described the symptoms of a meadowlark found near death: ‘Although it lacked muscular coordination and could not fly or stand, it continued to beat its wings and clutch with its toes while lying on its side. Its beak was held open and breathing was labored.’ Even more pitiful was the mute testimony of the dead ground squirrels, which ‘exhibited a characteristic attitude in death. The back was bowed, and the forelegs with the toes of the feet tightly clenched were drawn close to the thorax…The head and neck were outstretched and the mouth often contained dirt, suggesting that the dying animal had been biting at the ground.’

*** See page 273 of Silent Spring.

More:

At Millard Fillmore’s Bathtub, a commentary on the good deeds wrought from Silent Spring.
How Silent Spring Became the First Shot in the War Over the Environment (science.time.com)
How Important Was Rachel Carson’s Silent Spring in the Recovery of Bald Eagles and Other Bird Species? (scientificamerican.com)
Sense of Wonder Contest – Cast your vote on the intergenerational entries! (aarp.org)
JFK Fought DDT in Rachel Carson’s Environmental Crusade – Bloomberg (bloomberg.com)
NYT: How Silent Spring Ignited the Environmental Movement (bespacific.com)
Force of nature: The book that started the green revolution (nzherald.co.nz)

2 Comments | DDT, denialism, Disease, Environmental protection, History, Malaria, Rachel Carson, Science, WHO - World Health Organization | Tagged: Bug Girl, DDT, Disease, Environmental protection, Henry I. Miller, Jeffrey Tucker, Laissez Faire Today, Malaria, Rachel Carson, Science, Silent Spring, WHO, World Health Organization | Permalink
Posted by Ed Darrell

April 25 is World Malaria Day

April 25, 2012

From the World Health Organization, for World Malaria Day 2012:

World Malaria Day

25 April 2012

In 2010, about 3.3 billion people – almost half of the world’s population – were at risk of malaria. Every year, this leads to about 216 million malaria cases and an estimated 655 000 deaths. People living in the poorest countries are the most vulnerable.

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

World Malaria Day – which was instituted by the World Health Assembly at its 60th session in May 2007 – is a day for recognizing the global effort to provide effective control of malaria. It is an opportunity:

for countries in the affected regions to learn from each other’s experiences and support each other’s efforts;

for new donors to join a global partnership against malaria;

for research and academic institutions to flag their scientific advances to both experts and general public; and

for international partners, companies and foundations to showcase their efforts and reflect on how to scale up what has worked.

Related links

More about World Malaria Day

Roll Back Malaria Partnership

WHO Global Malaria Programme

More about malaria

Fewer than 700,000 deaths? That’s significantly fewer than most reports of more than a million per year — significant progress has been made it fighting malaria. Keep up those efforts, whatever they are.

Watch your news outlets. Will the pro-DDT, anti-Rachel Carson hoaxsters hold sway, or will the facts on fighting malaria, from the malaria fighters, get top billing?

malaria world day (madekreations.wordpress.com)
Elimination of Widespread and Deadly Disease Will Help American Troops, Tourists (claycountymsgop.com)
World Malaria Day – you can make a difference (endlesslyrestless.wordpress.com)
6 Days to World Malaria Day!!! (todaysnaira.wordpress.com)
New frontiers in the battle against malaria – Financial Times (drugstoresource.wordpress.com)
Roll Back Malaria (firstaidtosavealife.com)
Plan to rid country of malaria (thehimalayantimes.com)
What We’re Reading: Fighting malaria is a full-time job (one.org)
Mosquito Squad of Grand Rapids Joins Malaria No More (grandrapidsmosquitosquad.wordpress.com)

6 Comments | DDT, Malaria, Rachel Carson, WHO - World Health Organization | Tagged: DDT, Malaria, World Health Organization, World Malaria Day | Permalink
Posted by Ed Darrell

Anecdotal evidence: Malaria spreads to Tanzania highlands, warming climate blamed

April 16, 2011

Here’s one story that critics of science and scientists who study global warming will try to avoid mentioning: Malaria’s spread in Tanzania appears to be due to deforestation plus a warming climate that altered historic rainfall patterns.

It’s anecdotal evidence, partly. The case reinforces the point Al Gore made in An Inconvenient Truth, that climate change can smooth the path for the spread of diseases like malaria.

Via AllAfrica.com, from The Citizen in Dar es Salaam (Sunday Citizen News):

Malaria Threatens Nation’s Highlands

Felix Mwakyembe, 6 March 2011

Opinion

Mbeya — Tanzania’s southern highlanders have long worried about pneumonia and other respiratory illnesses brought on by the cool, wet weather. But as climate change contributes to warmer temperatures in the region, residents are facing a new health threat: malaria.

In Rungwe, a highland district in the south-western Mbeya region bordering Malawi and Zambia, malaria is fast replacing coughs, fever and pneumonia as the most serious local health problem. The change has taken by surprise the region’s residents, who live over 1,000 metres (3,200 feet) above sea level and outside Tanzania’s traditional malarial zones.

Ms Asha Nsasu, 32, of Isebe village, had no idea she had contracted malaria when she was sent to Makandana District Hospital in late December. “I felt weak. I thought it was pneumonia,” Nsasu said. “Then they told me it was malaria.”

In 2009, health centres in Rungwe district reported 100,966 malaria cases, a jump of 25 per cent from 2006, hospital records show.

Malaria is now the biggest public health threat facing Rungwe district, which lies about 940 kilometres (590 miles) southwest of Dar es Salaam, according to the Tukuyu Medical Research Centre, part of the National Institute for Medical Research. One third of outpatients visiting the hospital were diagnosed with the mosquito-borne illness in 2007, according to records from that year, making it the most common disease for outpatients.

Most highland areas in Tanzania are experiencing a growing burden of malaria cases, officials at the Tukuyu Centre said. Climatic changes brought on in part by local environmental degradation are contributing to the growing prevalence of malaria in the district, said Mr Gideon Ndawala, Rungwe district’s malaria coordinator.

“People have cleared the forests, rain has decreased, temperatures have risen,” Mr Ndawala said in an interview. “(When) I first reported on the district in 1983, it was very cold and it rained throughout the year except from mid-September to early November. The weather was not favourable for mosquito breeding,” he said.

Now, however, temperatures are higher and rain more erratic, he said, and mosquito populations – which thrive on warmer temperatures and breed in pools of stagnant water – are on the rise. Worst hit by the surge in malaria are Tukuyu district town, Ikuti, Rungwe Mission and Ilolo, according to district health officials.

Half a century ago, these traditionally cool areas saw no mosquitoes and did not register any malaria cases, but now the weather is warmer, said Mr Ambakisye Mwakatobe, a 76-year-old man from Bulyaga village in Rungwe.

“In the past, we never saw mosquito nets here. I saw a net for the first time at the age of 20, when I joined Butimba Teachers College in 1957,” he said, in an interview at his village home.

Mzee Mwakatobe said cases of malaria began to appear several decades ago but residents did not relate them to warming temperatures, believing the mosquitoes instead were arriving on buses from lower regions.

“It was in the 1970s when we started getting malaria here. I thought it was the buses from Kyela and Usangu that brought mosquitoes,” he admitted. But “the weather also started to change in those years,” he said.

A half-century ago, “it was very cold here and it rained throughout the year. Three things were compulsory: a sweater, pullover or heavy jacket; an umbrella or raincoat; and gumboots,” he added. “There was frost all day long and cars had to put their lights on.

“But today things have changed,” he said. “Look, now we even put on light shirts. There is no need for sweaters, gumboots or umbrellas.”

Scientists agree that the changing weather is feeding into Rungwe’s worsening malaria problem.

“Up until 1960, districts like Rungwe, Mbeya, Mufindi, Njombe, Makete and Iringa in the southern highland regions were malaria free. Today is quite different – malaria prevalence is high,” said Mr Akili Kalinga, a research scientist at Tukuyu Medical Research Centre.

Malaria accounts for 30 per cent of the burden of disease in Tanzania and is a huge drain on productivity, according to a report produced by research scientists for the Sixth Africa Malaria Day in 2006. In response to the rising malaria caseload, the government is taking steps to stem the disease’s expansion.

Measures include public health education in newly vulnerable districts on home cleanliness and water storage, how to eliminate the places of still water where mosquitoes live and breed, and the use of mosquito nets and fumigation, said Dr Sungwa Ndagabwene, Rungwe’s medical officer.

“The government is taking serious measures to fight malaria. We started with a ‘mosquito nets for all’ campaign – saying every person should sleep under bed nets,” Mr Ndagabwene said.

The government also has begun spraying the inside of homes with insecticide, first in the Kagera Region and now throughout the Lake zone, near Lake Victoria, he said. It plans to expand the spraying programme, which has helped cut malaria transmission in Zanzibar, to the rest of the Tanzania’s malaria-affected regions.

Such spraying programmes aim to kill mosquitoes that land on the inside walls of homes. Spraying can protect homes for between four to ten months depending on the insecticide, according to the World Health Organisation (WHO).

WHO has approved 12 insecticides it considers safe for such spraying programmes, including DDT – a controversial endocrine disruptor that has proved one of the most effective ways to control mosquito populations but that has also been linked to environmental damage and health problems including cancer.

Mr Ndagabwene said spraying the chemical only indoors limited its environmental impact. WHO officials have said they believe the benefits of using the pesticide outweigh its risks. The Stockholm Convention bans the use of DDT but exempts countries that choose to use the chemical to control malaria.

Tanzania is one of the world’s worst malaria-affected countries, recording 14 to 18 million clinical cases annually and 60,000 deaths, 80 per cent of them in children under five years old, according to a 2010 malaria reduction plan put together by USAID.

Children under five and pregnant women are most affected by the disease, official health figures show. (AlertNet)

The author is a freelance writer based in Dar es Salaam

More:

Also see this story, in which Tanzania’s health minister urges a continued focus on malaria, despite the decline in the disease in the country.

Leave a Comment » | Africa, Climate change, climate_change, DDT, Geography - Physical, Global warming, Health care, History, medicine, Science, WHO - World Health Organization | Tagged: Africa, Climate change, DDT, Global warming, Health care, History, Malaria, Science, Tanzania, WHO | Permalink
Posted by Ed Darrell

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Key facts

Symptoms

Who is at risk?

Disease burden

Transmission

Prevention

Insecticide-treated mosquito nets

Antimalarial drugs

Insecticide resistance

Diagnosis and treatment

Antimalarial drug resistance

Surveillance

Elimination

Vaccines against malaria

WHO response

WHO Global technical strategy for malaria 2016-2030

The Global Malaria Programme

“High burden high impact approach”

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WHO calls for reinvigorated action to fight malaria

Global malaria gains threatened by access gaps, COVID-19 and funding shortfalls

A plateau in progress

COVID-19 an added challenge

WHO response

Meeting global malaria targets

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

Scale-up in malaria control

An unfinished agenda

Global targets

An urgent need for more funding

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RTS,S/AS01 malaria vaccine

WHO multi-country evaluation on LLINs

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Scale-up in effective malaria control dramatically reduces deaths

Moving towards elimination

Fragile gains

Gains at risk in Ebola-affected countries

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MALACAÑANPALACE

MANILA

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World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing

Long way from universal access to prevention and treatment

Global funding gap

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World Malaria Day

Related links

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Malaria Threatens Nation’s Highlands

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George Santayana (1863-1952)

Who needs a soak in Millard Fillmore’s Bathtub?

Pi Day!