Making a false case against Gardasil

May 2, 2009

Especially after working for so many years alongside the big drug companies working health legislation in the Senate, and after later policy work for private companies that made the point again that Big Pharma doesn’t always act scrupulously (remember Oraflex?), I’m no particular fan of the big companies.

But I am a big fan of getting the facts before making claims against them.  I also stand in awe of the accomplishments of medicine, including Big Pharma, in so many areas.  My oldest brother had polio as a kid, and it haunted him to his death.  Polio vaccine was a great advance.  I survived a bout of scarlet fever as an infant, but as a result I am particularly vulnerable to certain infections now; I stand in awe of a $10 prescription that literally saves my life.

Get the facts.  We’re talking saving lives here — be sure you’re accurate.

There is a nasty campaign against modern medicine claiming that vaccines and other injectable preventives do not work, or do much greater harm than is revealed.

One victim of this unholy smear campaign is the Merck Drug company, and its anti-cancer vaccine Gardasil.  This vaccine has been the topic of much controversy here in Texas.  I’ve written about it before.

So I was shocked once again browsing Neil Simpson’s blog (looking for a post that disappeared, it now seems), to discover this statement of concern from Mr. Simpson:

Gardasil Moms: If one of those 32 dead girls or women was your daughter. . . – I wouldn’t rush out and get the vaccine for your girls just yet.

32 dead girls from the vaccine?  Mr. Simpson fails to tell the whole story.  Here’s what CDC actually said:

As of December 31, 2008, there have been 32 U.S. reports of death among females who have received the vaccine. There was no common pattern to the deaths that would suggest that they were caused by the vaccine. [emphasis added]

This isn’t the first time opponents of Gardasil have failed to report accurately the deaths accounted for in the trials and use of the drug.  In previous outings, critics of the drug have done such bizarre things as counting deaths of people who never took the drug, as deaths perhaps caused by the drug.

For example, from the numbers available when I wrote about this in May 2007:

  • Of the 17 deaths reported in the clinical trials,  7 of them came from the placebo group.  That’s right:  Only 59% of the reported deaths were in the group that got Gardasil.  41% of the reported deaths came from people who had received no Gardasil vaccine.
  • 7 of the deaths were from auto accidents, 4 in the Gardasil group, 3 in the placebo group.
  • Most of the deaths were from causes generally thought to be unrelated to to Gardasil, including suicide and cancer.

Don’t you think that, in blaming deaths on a dosage of a vaccine, one should not count deaths to people who did not get the vaccine? So, can we trust numbers from a slander campaign that keeps repeating falsehoods for two years, though the data are freely available?

If you check the Gardasil site now, you’ll find more deaths have been added.  Merck follows up reports of problems, and they update the information when they can, as required by law.

There are now 24 deaths reported in Merck’s literature, 16 in the Gardasil group, and 9 in the control group; the Gardasil deaths have risen to 64% of total deaths; some new causes are added in.  But there is no glaring indictment of Gardasil, and it still seems to me to be rather unethical to claim, as Simpson’s source does, that deaths by auto accident can be attributable to Gardasil, especially when an almost equal number of auto accident deaths occurred in the control group.

Here is what the CDC says, unedited:

Reports to VAERS Following HPV Vaccination

As of December 31, 2008, more than 23 million doses of Gardasil were distributed in the United States.

As of December 31, 2008, there were 11,916 VAERS reports of adverse events following Gardasil vaccination in the United States. Of these reports, 94% were reports of events considered to be non-serious, and 6% were reports of events considered to be serious.

Based on all of the information we have today, CDC continues to recommend Gardasil vaccination for the prevention of 4 types of HPV. As with all approved vaccines, CDC and FDA will continue to closely monitor the safety of Gardasil.  Any problems detected with this vaccine will be reported to health officials, healthcare providers, and the public, and needed action will be taken to ensure the public’s health and safety.

23 million doses of the vaccine, high efficacy in preventing cancer and genital warts, only 6% serious events reported, no deaths that doctors can connect to the vaccine.

In the time Simpson writes about, several thousand women died of cervical cancer; he’s posing 32 deaths unrelated to the vaccine and saying it’s dangerous, when the facts show exactly the opposite.  Is that ethical?

It’s creationism syndrome:  Religionists decide on their conclusions, sometimes supported by scripture, but sometimes also supported by misreadings of scripture; then they set off in search of evidence to support their pre-conceived conclusion, and they step over real data and alter evidence to make sure their pre-conceived conclusions get the support.

In other words, they use doctored data.  Neil Simpson’s sources are using doctored data again.  Shame on them.  I’m sure he’ll correct it in his blog.

______________

Update, May 3: Simpson has not corrected his blog yet.  As an indicator of the issues at stake, you may want to look at CDC figures on cervical cancers, many of which are prevented completely by Gardasil.  Actually trends on the disease are encouraging:

Cervical cancer used to be the leading cause of cancer death for women in the United States. However, in the past 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly. This decline largely is the result of many women getting regular Pap tests, which can find cervical precancer before it turns into cancer.1

According to the U.S. Cancer Statistics: 2005 Incidence and Mortality Web site, 11,999 women in the U.S. were told that they had cervical cancer in 2005,* and 3,924 women died from the disease.2 It is estimated that more than $2 billion is spent on the treatment of cervical cancer per year in the U.S.3

Cervical cancer strikes disproportionately at minority women:

Even though these trends suggest that cervical cancer incidence and mortality continue to decrease significantly overall, and for women in some racial and ethnic populations, the rates are considerably higher among Hispanic and African-American women. Find more information about cervical cancer rates by race and ethnicity.

More information:


World Malaria Day brings out the DDT-poisoned claims – Beware the ill-informed cynics.

April 26, 2009

World Malaria Day is April 25, every year.  It’s not a big deal in the U.S. (but there were several activities this year).  One thing you can count on, however, is the unthinking, often irrational reaction of dozens of columnists and bloggers* who like to think all scientists and health care professionals are idiots, and that government policy makers never consider the lives of their constituents when environmental issues arise.

Here’s a good example:  At a blog named Penraker, in a post cynically titled “Beware the ‘compassionate’ people,” the author suggests that churches around the world are foolish for sending bednets to Africa to combat malaria, since, the blogger claims, DDT would be quicker, more effective, cheaper, and perfectly safe.

So  much error, so little time, and even less patience with people who don’t bother to get informed about an issue before popping off on it.

Penraker wrote:

Today the loopy “On Faith” pages of the Washington Post reminds us to be compassionate about malaria in Africa.

It urges the churches of the world to come together and join a campaign that would spread the use of mosquito nets in Africa so that the incidence of malaria can be gradually reduced.

Nets are a great idea.  They work to reduce malaria by 50% to 85%.  Nets are a simple solution, part of a series of actions that could help eliminate malaria as a major scourge of the world.  The Nothing But Nets Campaign has the endorsement of several major religious sects and the National Basketball Association.  It offers hope.

Churches uniting to save lives — what could be more spiritual?

Currently 750 children die EVERY DAY in Nigeria. So the great hearts on the left want to organize another conference. The conference will demonstrate their compassion for this needless death, and it will urge that mosquito nets be distributed more widely in Africa.

There is only one problem. Nowhere in the article do they mention DDT. DDT is far and away the most effective way to get rid of malaria.

Why should the article “mention” DDT?  DDT is a deadly poison, an environmental wildcard that once upon a time was thought to offer hope of severely reducing malaria, if it could be applied in enough places quickly enough, before mosquitoes developed resistance to it.  The campaign, coordinated by the World Health Organization, failed.  Agricultural and business interests also latched onto DDT, but they over-used it in sometimes trivial applications.  Mosquitoes quickly developed new genes that made them resistant and immune to DDT.

DDT can once again play a limited role in fighting malaria.  It can be used in extremely limited amounts, to spray the inside walls of homes, to kill mosquitoes that still land on the walls of a hut after feeding on a human.  But DDT is not appropriate for all such applications, and it is nearly useless in some applications, especially where the species involved is completely immune to DDT.

DDT was discovered to be deadly.  First European nations banned its use, and then the U.S. banned it.  Continued use after those bans increased the difficulties — manufacturing continued in the U.S. resulted in many nasty Superfund clean-up sites costing American taxpayers billions of dollars when manufacturers declared bankruptcy rather than clean up their plant sites.  The National Academy of Sciences studied DDT, and in 1980 pronounced it one of the most beneficial chemicals ever discovered — but also one of the most dangerous.  NAS said DDT had to be phased out, because the dangers more than offset its benefits.

The cessation of use of DDT, to protect wildlife and entire ecosystems, proved wise.  In 2007 the bald eagle was removed from the list of endangered species, a recovery made possible only with a ban on DDT.  DDT weakens chicks, especially of top predators, and damages eggs to make them unviable.  Decreasing amounts of DDT in the tissues of birds meant recovery of the eagle, the brown pelican, the peregrine falcon, and osprey.

Though it was not banned for ill effects on human health, research since 1972 strengthened the case that DDT is a human carcinogen (every cancer-fighting agency on Earth lists it as a “probable human carcinogen”).  DDT and its daughter products have since been discovered to act as endocrine disruptors, doing serious damage to the sexual organs of birds, fish, lizards and mammals.  Oddly, it’s also been discovered to be poisonous to some plants.

After DDT use against malarial mosquitoes was reduced, malaria stayed low for a while.  Unfortunately, the malaria parasites developed resistance to the pharmaceuticals used to treat humans.  Malaria came roaring back — DDT, an insecticide, was of no use to fight the blood parasite.  Newer, arteminisin-based pharmaceuticals offer hope of reducing the human toll

Still, with some improvements in delivery of pharmaceuticals, improvements in diagnosis, and improvements in education of affected populations about how they can reduce exposure and prevent mosquito breeding, world wide malaria deaths have been kept below 3 million annually.  Recent programs, helped by munificent organizing from the Bill and Melinda Gates Foundation, and from other charities, have reduced malaria considerably.  With no magic drug on the horizon, with no magic vector control, efforts have been redoubled to use the time-tested methods for beating the disease — reducing exposure to mosquitoes, improving health care, stopping mosquito breeding.  These methods, which ridded the U.S. of the disease very much prior to the discovery of DDT’s insecticidal properties, appear the best bets to beat malaria.

Once South Africa started using it, the death rate went way down.

South Africa used DDT constantly from 1946 through about 1996.  Other efforts to control mosquitoes worked until changing climate and political turmoil in nations adjoining South Africa produced malaria and mosquitoes that crossed borders.  South Africa turned to DDT as an emergency  measure; but the other, non-pesticide spraying methods, are credited with helping South Africa reduce malaria.

It turns out that DDT is much less harmful than we had been led to believe by scare reports early on. People at the Monsanto plant in California worked around the stuff for years with no discernible effects.

That’s not quite accurate.  Whether DDT seriously crippled workers is still in litigation, a quarter of a century after DDT stopped being manufactured in the U.S. Residual and permanent health damage keep showing up in studies done on workers in DDT production facilities, and on their children.  The Montrose plant in California is a Superfund site, as is the entire bay it contaminated.  In fact, three different bays in California are listed as cleanup sites (was there a Monsanto DDT plant in California?  Which one?).

To say there were “no discernible effects” simply is unsupportable from research or litigation on the matters.  Such a claim is completely misleading and inaccurate.

No matter. The compassionate ones don’t dare to mention it. They are ready to let 750 kids die every day, in Nigeria alone. That’s 273,000 a year.

273,000 kids a year are dying in Nigeria alone. Think about it.

Rachel Carson warned us that would happen if we didn’t control DDT use to keep it viable to fight malaria.  I’ve been thinking about it for more than 40 years.  The “compassionate” ones you try to ridicule have been fighting malaria in Africa for that entire time.  You just woke up — when are you going to do something to stop a kid from dying?  By the way, slamming environmentalists doesn’t save any kid.

The CDC says:

The World Health Organization estimates that each year 300-500 million cases of malaria occur and more than 1 million people die of malaria, especially in developing countries. Most deaths occur in young children. For example, in Africa, a child dies from malaria every 30 seconds. Because malaria causes so much illness and death, the disease is a great drain on many national economies. Since many countries with malaria are already among the poorer nations, the disease maintains a vicious cycle of disease and poverty.

Still the compassionate ones call for the use of bed netting to keep the kids from getting bit. There is only one obvious problem – kids aren’t in bed all day. Mosquitoes can bite them all day long, and the nets have no effect. So, they are proposing a massively stupid remedy.

First point on that section:  Did you bother to read the CDC document?  Nowhere do they call for DDT to be used.  Quite the contrary, they note that it doesn’t work anymore:

Wasn’t malaria eradicated years ago?

No, not in all parts of the world. Malaria has been eradicated from many developed countries with temperate climates. However, the disease remains a major health problem in many developing countries, in tropical and subtropical parts of the world.

An eradication campaign was started in the 1950s, but it failed globally because of problems including the resistance of mosquitoes to insecticides used to kill them, the resistance of malaria parasites to drugs used to treat them, and administrative issues. In addition, the eradication campaign never involved most of Africa, where malaria is the most common.

So, where do you get the gall to claim CDC support for your inaccurate diatribe?  CDC’s documents do not support your outrageous and inaccurate claims for DDT at all.

Second point, mosquitoes don’t bite all day long, and bednets have proven remarkably effective at stopping malaria.  Mosquitoes — at least the vectors that carry malaria — bite in the evening and night, mostly.  Protecting kids while they sleep is among the best ways to prevent malaria.

It appears to me that this blogger has not bothered to learn much about malaria before deciding he knows better than the experts, how to fight it.

Their outrageous and horribly unscientific “religious beliefs” are a firm block to their humanity. No, they just don’t care. No DDT can be used.

Every “ban” on DDT included a clause allowing use against malaria.  In the U.S. we allowed manufacture of DDT for export after the ban on use in the U.S. (and the ban on use in the U.S. had exceptions).  DDT was never banned for use in any African nation I can find.  DDT is manufactured, today, in India and China.  DDT can be used, even under the POPs treaty.  This blogger, Penraker,  just doesn’t have the facts.

You get the impression that their compassion is not about solving the problem. Their compassion seems to be about themselves – about proving they are good people by having compassion, rather than eradicating the problem. In fact, it looks like they have a desire to have the malaria epidemic continue, so they can organize little conferences and wring their hands, put together action plans, and call on somebody else to do something about the problem.

Actually, I get the idea that this blogger wants to whine and pose, and isn’t really concerned about kids with malaria.  He’s getting way too many facts dead wrong.

Nick Kristof of the New York Times, God bless him, is one of the few liberals to react reasonably to reality:

Mosquitoes kill 20 times more people each year than the tsunami did, and in the long war between humans and mosquitoes it looks as if mosquitoes are winning.

One reason is that the U.S. and other rich countries are siding with the mosquitoes against the world’s poor – by opposing the use of DDT.

“It’s a colossal tragedy,” says Donald Roberts, a professor of tropical public health at Uniformed Services University of the Health Sciences. “And it’s embroiled in environmental politics and incompetent bureaucracies.”

In the 1950’s, 60’s and early 70’s, DDT was used to reduce malaria around the world, even eliminating it in places like Taiwan. But then the growing recognition of the harm DDT can cause in the environment – threatening the extinction of the bald eagle, for example – led DDT to be banned in the West and stigmatized worldwide. Ever since, malaria has been on the rise.

…But most Western aid agencies will not pay for anti-malarial programs that use DDT, and that pretty much ensures that DDT won’t be used. Instead, the U.N. and Western donors encourage use of insecticide-treated bed nets and medicine to cure malaria

Yeah, go read that Kristof article.  He’s a bit off about DDT — but notice especially the date.  It’s the Bush administration he’s complaining about. I thought Penraker was complaining about environmentalists and silly “compassionate” types — but he’s complaining about Bush?  What else isn’t he telling us, or doesn’t he know?

But isn’t it dangerous?

But overall, one of the best ways to protect people is to spray the inside of a hut, about once a year, with DDT. This uses tiny amounts of DDT – 450,000 people can be protected with the same amount that was applied in the 1960’s to a single 1,000-acre American cotton farm.

Is it safe? DDT was sprayed in America in the 1950’s as children played in the spray, and up to 80,000 tons a year were sprayed on American crops. There is some research suggesting that it could lead to premature births, but humans are far better off exposed to DDT than exposed to malaria.

Indoor Residual Spraying (IRS) is endorsed even by Environmental Defense, the group that first sued to stop broadcast DDT spraying in the U.S.  It’s not environmentalists who oppose the practice, but businessmen, tobacco farmers and cotton farmers in Africa.  Who is Penraker to substitute his judgment for the judgment of Africans, the people on the ground, the people who suffer from malaria?

Alas, IRS, done right, is expensive.  A treatment with DDT is required twice a year, at about $12 an application when costs of the analysis of the mosquitoes and other circumstances are figured in.  That’s $24/year.  DDT spraying is more than 50% effective in preventing the disease.

Bednets cost $10, last five years at least, and are about 85% effective at preventing the disease.

Maybe Africans just want the cheaper, more effective methods used.  Doesn’t that make sense?

The piece in the Washington Post’s On Faith section is called “Religion from the Heart”

How ironic.

All the Washington Post and the New York Times would have to do is highlight that the use of DDT could save a million lives – most of them children, and they would be saved within a year.

That’s all they would have to do. Keep the spotlight on it, and save a million lives. Instead, they expunge the very idea from their pages, (witness this from the heart stuff)

I will never understand people who are willing to let millions of people die for the sake of their ideology.

And I will never understand people who get in a dudgeon, blaming people who are blameless, or worse, blaming people who are actually trying to fix a problem, all while being blissfully misinformed about the problem they complain about.

Yes, millions of lives could be saved — but not with DDT.  DDT won’t work as a magic potion, and it’s a nasty poison.  Why would anyone urge Africans to waste money, and lives, instead of actually fighting malaria?  Penraker fell victim to the hoaxers who want you to believe Rachel Carson was not accurate (her book was found accurate by specially-appointed panels of scientists), that DDT is a panacea against malaria (it’s not), that environmentalists are stupid  and mean (while they’ve been fighting against malaria for more than 40 years), and that everything you’ve heard from science is wrong.

Malaria gets a lot of deserved attention from people serious about beating the disease, for millions of good reasons.  Those who are serious about beating malaria don’t whine about DDT.

And then he brags about his intolerance for the facts.  Whom God destroys, He first makes mad.

_____________

Update: Blue Marble isn’t as offensive and obstreperous as others, but equally in error.  How can people be so easily misled from the facts of the matter?


Cuba treats Chernobyl victims

April 7, 2009

Here’s a very odd news item.  It’s odd because, first, the disaster at Chernobyl is widely dismissed, and certainly out of the news, so it’s unusual to see any news item that suggests it remains a big problem, or that hints at what a big problem it was (especially from a nominally communist view); and second, who would have predicted Cuba would play a role at all?

I found this at a blog dedicated to news from and about Cuba, Nacho’s Blog/El Blog de Nacho.  I’m guessing “acn” is a Cuban news agency:

(acn) – Havana – Over 20,000 children suffering from different diseases have been seen in Cuba as part of the Cuban Medical Program for Children of Chernobyl, marking last Wednesday the 19th anniversary of its creation. The plan began in 1990, when children and their relatives began to arrive en masse from Russia, the Ukraine, Byelorussia, Moldavia and Armenia to the former Pioneer Children’s Camp in Tarará, east of this city. Dr. Julio Medina, coordinator of the Program, explained that from 700 to 800 children arrive in Cuba annually to be treated by multidisciplinary teams of Cuban specialists. So far, patients with blood diseases have been treated, especially with different variants of leukemia; bone marrow and kidney transplants have been done, as well as cardiovascular surgery due to congenital malformations.

Ukrainian Dr. Nadiezhda Guerazimenko, coordinator of the Program in that country, highlighted the professionalism of Cuban doctors. She added that the best example of this statement lies in the high figure of patients who have returned to their respective countries cured of their ailments. The Program has a significant impact in the health and recovery of children and their families. In its almost two decades of existence, it has treated more than 16,000 Ukrainians, almost 3,000 Russians, and 671 Byelorussians. Some 40,000 people died immediately and millions were contaminated as a result of the nuclear disaster on April 26, 1986, which at first hit the Ukraine, and then extended to Russia, Belarus and different parts of Europe and Asia. The event caused several types of diseases, like leukemia, tumors, heart malformations, kidney problems, psoriasis, vitiligo and alopecia. Many of the children and youngsters seen today in Cuba weren’t even born when the disaster occurred. However, their parents were affected by the radiation.

______________

Yes, it turns out “acn” is the Cuban News Agency.


DDT ain’t pixie dust; we can’t poison Africa to health

February 7, 2009

Internet communications spreads information far and wide, but it also spreads disinformation and error far and wide — sometimes faster than good information.

Bill Gates gave a TED* Talk about the need to fight malaria, and where his billions-of-dollars campaign against the disease is going.  Within minutes, the nattering nabobs science ignorance were calling Gates an idiot, and calling for the poisoning of Africa.

Gates, you may remember, is either the richest man in the world or close to it due to his brilliant marketing of Microsoft products.  This would suggest to rational people that he is not an idiot, at a minimum, and perhaps should be listened to on topics which he has researched, such as malaria and mosquitoes.   Africa, you may remember, has a lot of people in it who don’t want to be poisoned, thank you very much. This may suggest that DDT would be controversial even were it a panacea, which it is not.

Rational voices exist.  Deltoid and Bug Girl both provided useful, and accurate information (though in this case, Tim Lambert at Deltoid refers to the DDT controversy on bed bugs, and to another Bug Girl post on research showing DDT won’t help against bed bugs).

Here’s the controversial two minutes of Gates’s talk (you can see it at Bug Girl, too):

Internet and other media now fall into a predictable rhythm:  Any news faintly related to DDT prompts stiff-necked conservatives and other do-nothings who don’t like environmentalists to write stuff calling for a “return” of DDT, making erroneous claims that DDT had made the world safe against malaria, and that only the delusional claims of Rachel Carson convinced everyone to stupidly stop spraying DDT.  And, of course, they then make the erroneous claim that all we need to do to fix everything is bring back DDT.

They don’t ever let the facts get in the way of a stupid, misplaced political hit.

In short, they treat DDT as pixie dust, a magic solution to every problem.  This is fantasy.  In reality, we cannot poison Africa to good health.

I’ve written about these issues before at length.  Hard research, good research, tells us what we have to do to fight malaria

  • Money must be spent to improve health care in Africa, especially to remote populations. Wiping out malaria requires that we get rid of the parasite in humans.  Mosquitoes get the parasite from infected humans, after all — if mosquitoes can’t get infected from humans, we don’t need to worry so much about killing the mosquitoes.  Preventing infections is good; curing those that exist is essential.  Malaria parasites’ ability to grow resistance to pharmaceuticals means we need health care delivery systems that will assure a complete cycle of medical treatment occurs in every victim, and before that, that a quick and accurate diagnosis will allow targeting of the right drug to the specific parasite.
  • Housing improvements will provide huge benefits. Malaria was wiped out in the U.S. and Europe partly by rising incomes.  Even poor people could afford screens on windows, which keeps mosquitoes out of the house, where most infections start.  Housing unsuitable to screening will put a larger burden on bednets.  But better housing is a key part of the fight.
  • Improving incomes help fight malaria. Families with more money can afford better housing, and better health care.  Malaria, and most disease, is very much an “Are Your Lights On” sort of problem.  Victims are the first to know they need to get medical care, and they are in the best position to prevent infections earlier.  If potential victims have the money to buy the tools to fight malaria, malaria has a tough time.
  • Good public works, from local governments, help fight malaria. Good roads work well to fight the disease.  Bad roads develop potholes.  In Africa, potholes fill with water and become breeding sites for mosquitoes.  Well-engineered, well-maintained roads and walkways make great contributions to eliminating malaria.
  • Education on how to avoid malaria pays huge dividends. People who know how to look for mosquito breeding places, and how to eliminate them, are crucial to the elimination of the disease.  Abandoned tires are classic mosquito breeding dumps, but so are rain gutters and even badly-drained flower pots.  When these things occur close to homes, mosquitoes breed there and bite victims close to home.  Since most people spend a signficant amount of time at or near their homes, eliminating these infection opportunities pays off well.  Further, certain breeds of mosquitoes are active at particular hours of the day or night.  Avoiding the places these breeds exist at the hours of their activity prevents malaria infection.  People must be educated to know these things, and to act on them.
  • Bednets work well, and bednets do not prevent the use of other methods. Pitting a fight against bednets and DDT is a favored tactic of pro-DDT groups.  Research shows bednets are very effective without DDT, but that DDT is not effective over the long term without bednets.  A mild solution of DDT applied to bednets in some areas improves the efficiency of the nets.  This is not an one-or-the-other issue.  Bednets always work, insecticides can be used appropriately.  To beat malaria, we will have to use every tool.  Bednets are a great tool, and they will be required regardless the availability or propriety of DDT.

The Bill and Melinda Gates Foundation stepped in to provide money and organization to the fight against malaria a few years ago.  In the last year alone his work and his money have helped prevent millions of cases of malaria, reducing the incidence of the disease by 50 percent in some areas, and 85 percent in others.  Whatever he says about malaria and mosquitoes deserves a good listen at least.

(Until I figure out how to embed TED into the new WordPress, here’s the link at TEDS:  http://www.ted.com/talks/view/id/451)

__________

*  TED is an acronym for Technology, Entertainment, Design


Beating malaria without DDT

November 3, 2008

I told you so.

Recent research and assessments of anti-malaria campaigns in Africa show dramatic results from the use of bed nets and other non-DDT spraying methods.

Rachel Carson was right.

I was compelled to jump into this issue when Utah’s U.S. Rep. Rob Bishop made a silly and incorrect statement against Rachel Carson, after his failed attempt to derail a bill to rename a post office in her honor on the 100th anniversary of her birth.  The slam-Rachel-Carson effort turned out to include Oklahama U.S. Sen. Tom Coburn (who has since recanted), and an array of anti-science types who rail against “environmentalists” and made astoundingly false claims against Carson’s work and Carson herself.

In those cases, Carson’s critics called for a return of massive spraying of DDT.  Eventually most of them backed off of calling for outdoor spraying.  Eventually Sen. Coburn lifted his hold on the post office renaming legislation (and it passed).

The calumny continued on the internet, however, with an active hoax campaign for DDT and against environmental protection and Rachel Carson.  Steven Milloy joined Lyndon Larouche in promoting the anti-Carson screeds of the late Dr. Gordon Edwards, a UC Davis entomologist who argued against science that DDT was harmless to humans and animals.

Enough about history.  Look at the real results on the ground, today:

First, note the study published in Lancet that documents a dramatic decrease in malaria in Gambia, using “low-cost” strategies that include bed netsAgence France Presse carried a summary of the study. [Another link to the same AFP article.]

Incidence of malaria in Gambia has plunged thanks to an array of low-cost strategies, offering the tempting vision of eliminating this disease in parts of Africa, a study published Friday by The Lancet said.

At four key monitoring sites in the small West African state, the number of malarial cases fell by between 50 percent and 82 percent between 2003 and 2007, its authors found.

The tally of deaths from malaria, recorded at two hospitals where there had been a total of 29 fatalities out of 232 admissions in 2003, fell by nine-tenths and 100 percent in 2007. A fall of 100 percent means that no deaths attributed to malaria occurred that year.

“A large proportion of the malaria burden has been alleviated in Africa,” the study concludes.

Also see:

Second, note that malaria rates also fell in Kenya, with a shift in infections away from young children, a very good sign. TropIKA.net carried a summary of that study.

Toronto’s Globe and Mail carried a longer story on Kenya’s experience, “Malaria a rare public-health success story in Africa.”

“We had to stay home and tend the sick – you can never leave them to go and work in the fields – and then there was no income and we were hungry. So truly, that 100 shillings was a great investment.”

The family heard about the importance of using a bed net to fend off malaria in a sermon at church, and then on the radio. Now, a year later, they would be able to get them for free, as Kenya ramps up its efforts to get every single citizen sleeping under a net.

Already, two-thirds of Kenyan children are sleeping beneath them and, as a result, child malaria deaths have fallen by 40 per cent in the past two years.

This remarkable success story has been repeated across much of Africa: Deaths of children under 5 declined 66 per cent in Rwanda from 2005 to 2007 and by 51 per cent in Ethiopia.

“This really is the one global public-health story that is simply and straightforwardly positive,” said Jon Lidén, spokesman for the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has been behind much of the push.

“It’s not a gradual change. It’s a fundamental change in the fight against malaria.”

Yet the decidedly unglamorous innovations responsible for the change – spraying houses, treating standing water to kill larvae, mass distribution of cheap polyester nets and better drugs, and simple public education on the need to treat suspected malaria quickly – receive almost no attention.

“We never make the headlines with this stuff,” said Shanaaz Sharif, head of disease control for Kenya’s Ministry of Health, which has thus far given out 11 million nets at a cost to the government of $6 each.

Sulay Momoh Jongo, 7, is seen inside a mosquito net in a mud hut is seen inside a mosquito net in a mud hut in Mallay village, southern Sierra Leone, on April 8, 2008. Although free treatment is sometimes available in Sierra Leone to fight the mosquito-borne disease -- whose deadliest strain is common in the countrys mangrove swamps and tropical forests -- many cannot get to health clinics in time. Worldwide, more than 500 million people become severely ill with malaria every year. One child dies of the disease every 30 seconds. Picture taken April 8, 2008. (Katrina Manson/Reuters)

From the Toronto Globe and Mail: “Sulay Momoh Jongo, 7, is seen inside a mosquito net in a mud hut is seen inside a mosquito net in a mud hut in Mallay village, southern Sierra Leone, on April 8, 2008. Although free treatment is sometimes available in Sierra Leone to fight the mosquito-borne disease — whose deadliest strain is common in the country’s mangrove swamps and tropical forests — many cannot get to health clinics in time. Worldwide, more than 500 million people become severely ill with malaria every year. One child dies of the disease every 30 seconds. Picture taken April 8, 2008. (Katrina Manson/Reuters)”

Despite pledges from the U.S. to signficantly increase funding to fight malaria, money has not flowed from the U.S., especially for bed nets.  Ironically, Canada is the chief donor of the nets.

Canada has had a key role in this success: The Canadian International Development Agency is the single largest donor of bed nets to Africa – nearly 6.4 million by the end of last year. In addition to government support, Canadian individuals and charities – notably the Red Cross – have embraced the issue by making donations and fundraising.

“Canadians … haven’t got the credit they deserve,” said Prudence Smith, head of advocacy for Roll Back Malaria, a partnership between key global-health agencies and donors such as the Bill and Melinda Gates Foundation.

Not all news is good. In Zimbabwe, dictator Robert Mugabe misused $7.3 million in malaria-fighting money from the Global Fund to Fight AIDS, Tuberculosis and Malaria. So far, he has not repaid the Global Fund. Politics continues to kill Africans, not an absence of DDT.

In India, where DDT use is untallied, manufacture massive, and use virtually uncontrolled, malaria is resurgent. According to The Telegraph in Calcutta, malaria is epidemic among people living in poorer sections of the city, often with fatal results.  ExpressIndia.com’s headline tells the story:  “Malaria puts city on the edge:  toll rises to 8.”

Public health officials in India will step up information and education campaigns, and urge residents “not to panic.”

See also:

In the Philippines, the government’s press agency promotes malaria prevention steps.

Science Daily reports progress in the long march for a malaria vaccine.

Public health officials warn the U.S. is completely unprepared for a malaria outbreak, according to The Orlando Sentinel, via the Houston Chronicle.

More:


Malaria/DDT Carnival addendum

October 11, 2008

It’s almost as interesting that these posts show up on the same day, as what they say.

Following on the heels of the impromptu Malaria/DDT carnival earlier in the week, take a look at these posts:


Why science matters in the campaign

September 7, 2008

Dr. Art Hunt at The RNA Underworld explains why Obama’s plan to double NIH research funding is a good idea.

Big bang for the buck:  Hunt’s analysis suggests doubling the research budgets might drive as much as a trillion dollar increase in our economy. Sure it’s optimistic — but read what he says.  And then consider:  Which platform offers the greatest hope of cures or treatments for cancers?  Which platform offers the best hope for a cure or treatments for Alzheimer’s disease?

The two industries I mention here – pharma and biotech – are intimately interwoven with the basic biomedical research enterprise, and a significant amount of the innovation that drives these industries originates (or originated) in the NIH-funded biomedical research laboratory. In this respect, the NIH budget is an investment, and a wildly-successful one. Even if we don’t take the face-value numbers I have pulled from Wiki here (that show an annual return of some 1000%, and more than 750,000 high-paying jobs the tax receipts from which would probably pay much of the NIH tab by themselves), and instead factor in that some of these receipts and jobs are not American, it is still easy to see that basic biomedical research returns considerably more than the investment made by the government. (And this doesn’t begin to weigh the intangibles, the ways that the research enterprise gives back to society as a whole.)

Science bloggers have been not so noisy as this issue might need:  The closest John McCain came to supporting science, the driver of our economy, was when he offered to assault education, and that’s the opposite of supporting science. Obama’s mentions are encouraging, but not frequent enough nor strident enough.

Think of just three of the issues that are affected by basic science research, that will be yelled about during the campaign:

The silence on science should make us very, very concerned.

Have you read Obama’s response to the 14 big questions on science policy?  McCain has not answered.

Other reading:


Creationist educational problem

August 10, 2008

Y’all with a smattering of understanding about evolution:  Go to this blog and help straighten out the creationists, will you?

“Creationist medical dilemma” at Unreasonable Faith

This is one of the hottest posts in the WordPress blogging continent at the moment.  Unreasonable Faith posted the old Doonesbury cartoon about the guy whose doctor diagnoses tuberculosis, and then asks the guy whether he’s a creationist before prescribing treatment (if you don’t know the cartoon, go see!).  I don’t think it was intended to attract so much traffic.

In the past three days creationists have moved into the comments section with all manner of creationist misinformation.  Few of the creationists are the hard-shelled, obnoxious type, but they could use some good information on genetics, mutations and evolution rates from someone familiar with the topics.


African nations back off of limited DDT use

August 7, 2008

Anti-DDT business interests appear triumphant, if only temporarily,  in their efforts to stop the use of DDT in the fight against malaria.

ProtectAfrica.com reports use of DDT has been stopped in northern UgandaNine corporations sued to stop the sprayingNew Visions reports a shift to a chemical named ICON for use in Indoor Residual Spraying, designed to protect people against mosquitoes in their homes.

I have links to stories saying Rwanda has abandoned DDT in the past few weeks, but none of the links work.

Meanwhile, from The East African in Nairobi, Kenya, comes the report that Tanzania became the first East African nation in recent years to use DDT for limited, indoor spraying. [But be wary of this source; the article also claims many nations outlawed DDT after 1972; not accurate in Africa, nor most other places.]

There is high irony in businesses opposing the use of DDT when environmental organizations in other nations do not oppose it.


Uganda and malaria, from the inside

July 30, 2008

This is probably as close to we can come to know what’s going on inside Uganda, especially with regard to malaria and efforts to fight it there.  Go see Mars and Aesculapius, “World Malaria Day.

As you can see, simply pumping DDT into the countryside is unlikely to solve the problems.


Rachel Carson: Nice lady scientist, no mass murderer

July 26, 2008

Aaron Swartz has the summary.  Start with the introduction here, and see the full text with links here.

He goes easy on the hoaxers, those who cast stones at Ms. Carson, but you still get the idea if you read the article.


Redefining “root canal”

June 28, 2008

It happens.  Last night I had a semi-emergency root canal. That’s not why I haven’t blogged, though — I feel fine.  I haven’t used any of the pain medication.  I’ve been able to work without the headache I thought was sinus, but now appears to have been an infected tooth.

But the story is Harry Sugg’s dental practice at Wheatland Dental.

There’s a lesson there for health care.  There’s a lesson there for professional services, like law offices.  There’s a lesson there for schools.

After a half-day wrangling with the dental insurance company — a phone system very unfriendly to clients asking questions, a fellow with bad information about which dentists in the area are on the plan — I got through in the late afternoon to Sugg’s office.  I’m a new patient, and I more than half expected them to offer an appointment late next week.

Instead, the receptionist said the entire staff, but for her, were out celebrating Dr. Sugg’s birthday.  But they’d be back in an hour, and I should be there when they arrived.

The waiting room has massaging chairs, two televisions running different, intrigueing DVDs, and a coffee pot.  Before I’d finished the paperwork I was offered a bottle of water.  Zip, zip, zip.  Oh, and no out-of-date magazines (a few interesting books, on history mostly, and astronomy).  The waiting room was not full at all — not a lot of waiting.  One group appeared to be there to support an aging family member.  They kept up a lively and often funny line of patter with the staff.  It was as if a co-ed barber shop had broken out in the waiting room.

The exam was quick, with digital x-rays, from a woman who noted most of the staff was in a training session in the lunchroom — the Guinness Book of World Records‘s champion speed reader was offering reading tips to the staff.  A quick diagnosis from Dr. Sugg — could I be back at 8:00 p.m. for the procedure?

That’s right:  8:00 p.m.  The office hours run until 9:00 p.m.  Other options were Saturday and Sunday.  It’s a ’round-the-clock, through-the-week operation.

I mortgaged our grandchildren, took the prescriptions to the pharmacy, got a quick dinner and headed back.  Dr. Linda Cha performed the procedure.  She deadened everything before I got a needle — didn’t feel any pain at any time.  Obviously highly skilled, she explained as much of the procedure as I needed, always solicitous to my comfort.

As I left the office at about 10:15 p.m., an attendant gave me a fresh red rose.  Today they called to check on my progress and spend a significant amount of time answering questions.

Could I get used to that kind of care?

So I thought back to the days I aided intake at Legal Services of North Texas — the cattle-call features, the crowded hallways, the lack of restrooms, the vending machines that often didn’t work, the impossible tasks of trying to match a sticky legal situation with an attorney to do the work for free.  Clients weren’t happy with much of anything there.  I did this often while I worked at Ernst & Young — free coffee, free soft drinks, free pastries, client-effusive hospitality.  Lots of training.   And at bigger lawfirms in town, with restroom attendants, shoeshine machines, on-site concierge for employees and clients if needed.

At one of our high schools in Dallas, men’s restrooms for faculty went without water to the sink for months.  The teachers’ “lounge” doubled as a site for a major computer node, so the ambient temperature was generally close to 90 degrees.  A coffee maker looked as though it hadn’t been used in months, nor that it could produce any coffee that wouldn’t resemble industrial sludge.  But teachers only get 30 minutes for lunch anyway.

Anyone who doubts there is a War on Education hasn’t been in most schools lately.

Harry Sugg runs a great business.  Professional offices and other businesses could learn a lot from how he operates his dental clinic.  Schools could learn a lot, too.  He could consult with school districts on how to treat employees and get good results.  I’ll wager the school districts wouldn’t listen.

Teacher meetings?  Frankly, I’d rather have a root canal.  And I’ll pay for the service.


Barnum’s Law and toxic feet

May 26, 2008

Much as we’d like to deny it, the evidence to verify Barnum’s Law just keeps piling up.

Here’s a blogger astounded by the black stuff on the pad on her feet, convinced that it’s toxic stuff magically drained out of her body, through her feet.

Who is going to tell her the facts?

Uh, you haven’t been suckered by that scam, have you?

Update: The blogger in question seems to have gotten the message:  The post has been yanked.  Smart people change things when their errors are pointed out.


Economics books: Casting light on the dismal science

December 21, 2007

An economics columnist for the New York Times, David Leonhardt, opened the discussions on the best economics books of the year in his column.

His nominee? A book about medical care: Overtreated: Why too much medicine is making us sicker and poorer, by Shannon Brownlee.

Here’s the hook to the story, retold from Brownlee by Leonhardt, and the reason I think economics is so interesting when done well:

In 1967, Jack Wennberg, a young medical researcher at Johns Hopkins, moved his family to a farmhouse in northern Vermont.

Dr. Wennberg had been chosen to run a new center based at the University of Vermont that would examine medical care in the state. With a colleague, he traveled around Vermont, visiting its 16 hospitals and collecting data on how often they did various procedures.

The results turned out to be quite odd. Vermont has one of the most homogenous populations in the country — overwhelmingly white (especially in 1967), with relatively similar levels of poverty and education statewide. Yet medical practice across the state varied enormously, for all kinds of care. In Middlebury, for instance, only 7 percent of children had their tonsils removed. In Morrisville, 70 percent did.

Dr. Wennberg and some colleagues then did a survey, interviewing 4,000 people around the state, to see whether different patterns of illness could explain the variations in medical care. They couldn’t. The children of Morrisville weren’t suffering from an epidemic of tonsillitis. Instead, they happened to live in a place where a small group of doctors — just five of them — had decided to be aggressive about removing tonsils.

But here was the stunner: Vermonters who lived in towns with more aggressive care weren’t healthier. They were just getting more health care.

A good economics book has a story at its heart, making the economics easier to illustrate and much more memorable for students of economics — this story should echo every time a person enters a physician’s office or stops by a hospital for any reason.

Health care is often a clash between good science and economic policies expounded by hard-core fanatics of one hypothesis or another who don’t understand the science; of course, neither do the scientists speak the economics language. And so our health care crises continue, deepen, drain our pockets, defy efforts to solve them and threaten to ruin the nation.

Put this book on the list of every policy maker you buy for, eh?

(No, I haven’t read the book.)

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More DDT poisoning

December 13, 2007

[Time passes and internet links die, expire, or otherwise fall into the black hole of irrelevancy. Alas. Rachel Carson is still right.]

Sometimes, when people make gross errors, they get caught. They apologize, or they mumble, and they move on.

A few times, when people make gross errors, they revel in it. Rather than admit the error, they make it again. They say it wasn’t an error. They repeat it, time and again, as if two wrongs make a right, or as if 126 wrongs make a right.

We caught Caosblog repeating some bad stuff about Rachel Carson, and false, good stuff about DDT, and false claims that eagles were not endangered by DDT. We called ’em on it. [But the blogger appears to have deleted the response. It was that good.]

Whoooee! This is the result.  Note the list of unquestioning links to other stuff on the web.  (Yeah. “Milton Fillmore.”  Probably not reading comprehension error so much as rant-blindness.)

If there is anything crazy and mean about Rachel Carson, it’s probably in that list. If there is any wild and insane claim about the safety of DDT, it’s in that list. If there were any accurate information, it would be a miracle. (Well, actually there’s some good information in the National Geographic story about malaria, but I doubt the blog writer bothered to read it.) The blog links to all the Lyndon Larouche crazies, all the tobacco lobbyist crazies, and acts as if such manure is golden.

Very little of it is accurate. Most of the material so far out to lunch, it’s not even wrong. The person who runs the blog sent me an e-mail saying my comments are no longer welcome there, because of the tone of my remarks. Too many links to too much refutation of blog’s points, I gather — too much real information!

DDT poisoning clearly is damaging, with effects far beyond anything Rachel Carson ever predicted.

This is the venal, vicious spirit that Sen. Tom Coburn defends with his hold in the U.S. Senate on honors for Mrs. Carson. This is the spirit with which the anti-Rachel Carson movement rails at environmentalists about malaria in Africa, while holding back funding for anti-malaria projects in Africa.

Woody Allen had a line in Annie Hall that may be appropriate: “There’s nothing wrong with you that couldn’t be cured with Prozac and a polo mallet.”

Reason and evidence won’t do it now. When someone starts out arguing that eagles were not threatened with extinction by the poison that a thousand studies verified was doing them in, you can’t reason them back to reality.

Below the fold: At the second outlet of that blog, conversation carried for a while, though not necessarily so for enlightenment. In 2015, I thought it a good idea to capture some of that.

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