29 November 2017 | Geneva – After unprecedented global success in malaria control, progress has stalled, according to the World malaria report 2017. There were an estimated 5 million more malaria cases in 2016 than in 2015. Malaria deaths stood at around 445 000, a similar number to the previous year.
“In recent years, we have made major gains in the fight against malaria,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “We are now at a turning point. Without urgent action, we risk going backwards, and missing the global malaria targets for 2020 and beyond.”
The WHO Global Technical Strategy for Malaria calls for reductions of at least 40% in malaria case incidence and mortality rates by the year 2020. According to WHO’s latest malaria report, the world is not on track to reach these critical milestones.
A major problem is insufficient funding at both domestic and international levels, resulting in major gaps in coverage of insecticide-treated nets, medicines, and other life-saving tools.
Funding shortage
An estimated US$ 2.7 billion was invested in malaria control and elimination efforts globally in 2016. That is well below the US $6.5 billion annual investment required by 2020 to meet the 2030 targets of the WHO global malaria strategy.
In 2016, governments of endemic countries provided US$ 800 million, representing 31% of total funding. The United States of America was the largest international funder of malaria control programmes in 2016, providing US$1 billion (38% of all malaria funding), followed by other major donors, including the United Kingdom of Great Britain and Northern Ireland, France, Germany and Japan.
The global figures
The report shows that, in 2016, there were an estimated 216 million cases of malaria in 91 countries, up from 211 million cases in 2015. The estimated global tally of malaria deaths reached 445 000 in 2016 compared to 446 000 the previous year.
While the rate of new cases of malaria had fallen overall, since 2014 the trend has levelled off and even reversed in some regions. Malaria mortality rates followed a similar pattern.
The African Region continues to bear an estimated 90% of all malaria cases and deaths worldwide. Fifteen countries – all but one in sub-Saharan Africa – carry 80% of the global malaria burden.
“Clearly, if we are to get the global malaria response back on track, supporting the most heavily affected countries in the African Region must be the primary focus,” said Dr Tedros.
Controlling malaria
In most malaria-affected countries, sleeping under an insecticide-treated bednet (ITN) is the most common and most effective way to prevent infection. In 2016, an estimated 54% of people at risk of malaria in sub-Saharan Africa slept under an ITN compared to 30% in 2010. However, the rate of increase in ITN coverage has slowed since 2014, the report finds.
Spraying the inside walls of homes with insecticides is another effective way to prevent malaria. The report reveals a steep drop in the number of people protected from malaria by this method – from an estimated 180 million in 2010 to 100 million in 2016 – with the largest reductions seen in the African Region.
The African Region has seen a major increase in diagnostic testing in the public health sector: from 36% of suspected cases in 2010 to 87% in 2016. A majority of patients (70%) who sought treatment for malaria in the public health sector received artemisinin-based combination therapies (ACTs) – the most effective antimalarial medicines.
However, in many areas, access to the public health system remains low. National-level surveys in the African Region show that only about one third (34%) of children with a fever are taken to a medical provider in the public health sector.
Tackling malaria in complex settings
The report also outlines additional challenges in the global malaria response, including the risks posed by conflict and crises in malaria endemic zones. WHO is currently supporting malaria responses in Nigeria, South Sudan, Venezuela (Bolivarian Republic of) and Yemen, where ongoing humanitarian crises pose serious health risks. In Nigeria’s Borno State, for example, WHO supported the launch of a mass antimalarial drug administration campaign this year that reached an estimated 1.2 million children aged under 5 years in targeted areas. Early results point to a reduction in malaria cases and deaths in this state.
A wake-up call
“We are at a crossroads in the response to malaria,” said Dr Pedro Alonso, Director of the Global Malaria Programme, commenting on the findings of this year’s report. “We hope this report serves as a wake-up call for the global health community. Meeting the global malaria targets will only be possible through greater investment and expanded coverage of core tools that prevent, diagnose and treat malaria. Robust financing for the research and development of new tools is equally critical.”
Details of DDT use in the past year usually show up in the bowels of the report.
Spread the word; friends don't allow friends to repeat history.
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.
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.
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.
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.
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.
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.
Spread the word; friends don't allow friends to repeat history.
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.
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.
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.
Spread the word; friends don't allow friends to repeat history.
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.
Spread the word; friends don't allow friends to repeat history.
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.
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.
Spread the word; friends don't allow friends to repeat history.
Another question of mine that will probably never see the light of day. This group has no answer, so why would they allow the question?
I stumbled across a blog-looking page from the American Council on Science and Health, an industry apologist propaganda site, on World Malaria Day, which was April 25. You may recognize the name of the group as one of the industry-funded sites that constantly attacks Rachel Carson, and often the World Health Organization, with the unscientific and false claims that environmentalists bannned DDT and thereby condemned millions of Africans to die from malaria — which, ASCH claims, could have easily been eradicated with more DDT poisoning of Africa.
On World Malaria Day, ASCH took note, flirted with the facts (that DDT doesn’t work as it once was thought to work), but then backed away from the facts — that the ban on DDT in the U.S. came years AFTER WHO suspended the malaria eradication campaign in Africa when it was discovered DDT couldn’t kill DDT-adapted mosquitoes, already subject to years of abuse of DDT by agriculture and other industries. ASCH said:
DDT kills mosquitoes, although not as well as it did 60 years ago. But it also irritates them and repels them, so the small amount sprayed inside homes effectively reduces the transmission of the malarial microbe substantially. The banning of DDT, based upon political anti-chemical bureaucrats and “environmentalists” inspired by Carson’s “Silent Spring” who ran our EPA in 1972, helped to impede the malaria control program led by the UN’s WHO.
Impede? Impossible for a 1972 ban to have been responsible for the earlier suspension of the WHO campaign, not to mention EPA’s ban ended at the U.S. borders. So I asked:
Screen capture of query to ACSH on how EPA’s ban “impeded” WHO’s campaign against malaria, ended years earlier.
I would be very interested in just how the 1972 ban on DDT in the U.S. “impeded” the UN’s antimalaria campaign, which stopped using DDT heavily seven years earlier, and was suspended in 1969.
After the ban on U.S. use of DDT, all of U.S. manufacture was dedicated to export to Africa and Asia, which greatly increased DDT supplies available there.
How did this impede?
Want to wager a guess as to whether they’ll ever allow the comment to see the light of day at their site, let alone answer it?
“DDT is good for me advertisement” from circa 1955. Photo image from the Crossett Library Bennington College. This ad today is thought to be emblematic of the propaganda overkill that led to environmental disasters in much of the U.S. and the world. DDT cleanups through the Superfund continue to cost American taxpayers millions of dollars annually.
Spread the word; friends don't allow friends to repeat history.
Significant gains against malaria could be lost because funding for insecticide-treated bednets has dropped, and malaria parasites appear to be developing resistance to the pharmaceuticals used to clear the disease from humans, while insects that transmit the parasites develop resistance to insecticides used to hold their populations down.
African bedroom equipped with LLINs (insecticidal bednets) Photo: YoHandy/Flickr
Insecticidal bednets have proven to be a major, effective tool in reducing malaria infections. Careful studies of several different projects produced a consensus that distributing the nets for free works best; people in malaria-infected areas simply cannot afford to pay even for life-saving devices, but they use the devices wisely when they get them. Nets often get abbreviated in official documents to “LLINs,” an acronym for “long-lasting insecticidal nets.”
Generally, the report is good news.
Dramatic facts emerge from the report: The “million-a-year” death toll from malaria has been whacked to fewer than 700,000, the lowest level in recorded human history. More people may die, and soon, if aid does not come to replace worn bednets, distribute new ones, and if the drugs that cure the disease in humans, lose effectiveness. Many nations where the disease is endemic cannot afford to wage the fight on their own.
Links in the Fact Sheet were added here, and do not come from the original report — except for the link to the WHO site itself.
Malaria is a preventable and treatable mosquito-borne disease, whose main victims are children under five years of age in Africa.
The World Malaria Report 2012 summarizes data received from 104 malaria-endemic countries and territories for 2011. Ninety-nine of these countries had on-going malaria transmission.
According to the latest WHO estimates, there were about 219 million cases of malaria in 2010 and an estimated 660,000 deaths. Africa is the most affected continent: about 90% of all malaria deaths occur there.
Between 2000 and 2010, malaria mortality rates fell by 26% around the world. In the WHO African Region the decrease was 33%. During this period, an estimated 1.1 million malaria deaths were averted globally, primarily as a result of a scale-up of interventions.
Funding situation
International disbursements for malaria control rose steeply during the past eight years and were estimated to be US$ 1.66 billion in 2011 and US$ 1.84 billion in 2012. National government funding for malaria programmes has also been increasing in recent years, and stood at an estimated US$ 625 million in 2011.
However, the currently available funding for malaria prevention and control is far below the resources required to reach global malaria targets. An estimated US$ 5.1 billion is needed every year between 2011 and 2020 to achieve universal access to malaria interventions. In 2011, only US$ 2.3 billion was available, less than half of what is needed.
Disease burden
Malaria remains inextricably linked with poverty. The highest malaria mortality rates are being seen in countries that have the highest rates of extreme poverty (proportion of population living on less than US$1.25 per day).
International targets for reducing malaria cases and deaths will not be attained unless considerable progress can be made in the 17 most affected countries, which account for an estimated 80% of malaria cases.
The six highest burden countries in the WHO African region (in order of estimated number of cases) are: Nigeria, Democratic Republic of the Congo, United Republic of Tanzania, Uganda, Mozambique and Cote d’Ivoire. These six countries account for an estimated 103 million (or 47%) of malaria cases.
In South East Asia, the second most affected region in the world, India has the highest malaria burden (with an estimated 24 million cases per year), followed by Indonesia and Myanmar. 50 countries are on track to reduce their malaria case incidence rates by 75%, in line with World Health Assembly and Roll Back Malaria targets for 2015. These 50 countries only account for 3% (7 million) of the total estimated malaria cases.
At present, malaria surveillance systems detect only around 10% of the estimated global number of cases. In 41 countries around the world, it is not possible to make a reliable assessment of malaria trends due to incompleteness or inconsistency of reporting over time.
This year, the World Malaria Report 2012 publishes country-based malaria case and mortality estimates (see Annex 6A). The next update on global and regional burden estimates will be issued in December 2013.
Malaria interventions
To achieve universal access to long-lasting insecticidal nets (LLINs), 780 million people at risk would need to have access to LLINs in sub-Saharan Africa, and approximately 150 million bed nets would need to be delivered each year.
The number of LLINs delivered to endemic countries in sub-Saharan Africa dropped from a peak of 145 million in 2010 to an estimated 66 million in 2012. This will not be enough to fully replace the LLINs delivered 3 years earlier, indicating that total bed net coverage will decrease unless there is a massive scale-up in 2013. A decrease in LLIN coverage is likely to lead to major resurgences in the disease.
In 2011, 153 million people were protected by indoor residual spraying (IRS) around the world, or 5% of the total global population at risk. In the WHO African Region, 77 million people, or 11% of the population at risk were protected through IRS in 2011.
The number of rapid diagnostic tests delivered to endemic countries increased dramatically from 88 million in 2010 to 155 million in 2011. This was complemented by a significant improvement in the quality of tests over time.
In 2011, 278 million courses of artemisinin-based combination therapies (ACTs) were procured by the public and private sectors in endemic countries – up from 182 million in 2010, and just 11 million in 2005. ACTs are recommended as the first-line treatment for malaria caused by Plasmodium falciparum, the most deadly Plasmodium species that infects humans. This increase was largely driven by the scale-up of subsidized ACTs in the private sector through the AMFm initiative, managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Drug and insecticide resistance
Antimalarial drug resistance is a major concern for the global effort to control malaria. P. falciparum resistance to artemisinins has been detected in four countries in South East Asia: in Cambodia, Myanmar, Thailand and Viet Nam. There is an urgent need to expand containment efforts in affected countries. For now, ACTs remain highly effective in almost all settings, so long as the partner drug in the combination is locally effective.
Mosquito resistance to at least one insecticide used for malaria control has been identified in 64 countries around the world. In May 2012, WHO and the Roll Back Malaria Partnership released the Global Plan for Insecticide Resistance Management in malaria vectors, a five-pillar strategy for managing the threat of insecticide resistance.
You were perceptive. You noted there is no call from malaria fighters for more DDT, nor for any change in DDT policy. This is a report from medical personnel, from public health experts, the real malaria fighters. It’s not a political screed.
India to see decrease in malaria cases: WHO (thehindu.com) – India remains the world’s largest manufacturer and user of DDT; were DDT the panacea cynical critics and hoaxsters claim it is, India would not have 24 million malaria infections each year; India has the highest rate and highest total of malaria cases in Asia
Real news on a topic like DDT takes a while to filter into the public sphere, especially with interest groups, lobbyists and Astro-Turf groups working hard to fuzz up the messages.
News from the DDT Expert Group of the Conference of the Parties to the Stockholm Convention was posted recently at the Stockholm Convention website — the meeting was held in early December in Geneva, Switzerland.
Logo of the Stockholm Convention on Persistent Organic Pollutants (POPs Treaty) Wikipedia image
In the stuffy talk of international relations, the Stockholm Convention in this case refers to a treaty put into effect in 2001, sometimes known as the Persistent Organic Pollutants Treaty (POPs). Now with more than 152 signatory nations and 178 entities offering some sort of ratification (not the U.S., sadly), the treaty urges control of chemicals that do not quickly break down once released into the environment, and which often end up as pollutants. In setting up the agreement, there was a list of a dozen particularly nasty chemicals branded the “Dirty Dozen” particularly targeted for control due to their perniciousness — DDT was one of that group.
DDT can still play a role in fighting some insect-carried diseases, like malaria. Since the treaty was worked out through the UN’s health arm, the World Health Organization (WHO), it holds a special reservation for DDT, keeping DDT available for use to fight disease. Six years ago WHO developed a group to monitor DDT specifically, looking at whether it is still needed or whether its special provisions should be dropped. The DDT Expert Group meets every two years.
Stockholm Convention continues to allow DDT use for disease vector control
Fourth meeting of the DDT Expert Group assesses continued need for DDT, 3–5 December 2012, Geneva
Mosqutio larvae, WHO image
The Conference of the Parties to the Stockholm Convention, under the guidance of the World Health Organization (WHO), allows the use of the insecticide DDT in disease vector control to protect public health.
Mosquito larvae
The Stockholm Convention lists dichlorodiphenyltrichloroethane, better known at DDT, in its Annex B to restrict its production and use except for Parties that have notified the Secretariat of their intention to produce and /or use it for disease vector control. With the goal of reducing and ultimately eliminating the use of DDT, the Convention requires that the Conference of the Parties shall encourage each Party using DDT to develop and implement an action plan as part of the implementation plan of its obligation of the Convention.
At its fifth meeting held in April 2011, the Conference of the Parties to the Convention concluded that “countries that are relying on DDT for disease vector control may need to continue such use until locally appropriate and cost-effective alternatives are available for a sustainable transition away from DDT.” It also decided to evaluate the continued need for DDT for disease vector control at the sixth meeting of the Conference of the Parties “with the objective of accelerating the identification and development of locally appropriate cost-effective and safe alternatives.”
The DDT Expert Group was established in 2006 by the Conference of the Parties. The Group is mandated to assess, every two years, in consultation with the World Health Organization, the available scientific, technical, environmental and economic information related to production and use of DDT for consideration by the Conference of the Parties to the Stockholm Convention in its evaluation of continued need for DDT for disease vector control.
The fourth meeting of the DDT Expert Group reviewed as part of this ongoing assessment:
Insecticide resistance (DDT and alternatives)
New alternative products, including the work of the Persistent Organic Pollutants Review Committee
Transition from DDT in disease vector control
Decision support tool for vector control.
The DDT expert group recognized that there is a continued need for DDT in specific settings for disease vector control where effective or safer alternatives are still lacking. It recommended that the use of DDT in Indoor Residual Spray should be limited only to the most appropriate situations based on operational feasibility, epidemiological impact of disease transmission, entomological data and insecticide resistance management. It also recommended that countries should undertake further research and implementation of non-chemical methods and strategies for disease vector control to supplement reduced reliance on DDT.
The findings of the DDT Expert Group’s will be presented at the sixth meeting of the Conference of the Parties, being held back-to-back with the meetings of the conferences of the parties to the Rotterdam and Basel conventions, from 28 April to 11 May 2013, in Geneva.
Nothing too exciting. Environmentalists should note DDT is still available for use, where need is great. Use should be carefully controlled. Pro-DDT propagandists should note, but won’t, that there is no ban on DDT yet, and that DDT is still available to fight malaria, wherever health workers make a determination it can work. If anyone is really paying attention, this is one more complete and total refutation of the DDT Ban Hoax.
Rachel Carson’s ghost expresses concern that there is not yet a safe substitute for DDT to fight malaria, but is gratified that disease fighters and serious scientists now follow the concepts of safe chemical use she urged in 1962.
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 . . .
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’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 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.
** 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.’
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.
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
Rollback Malaria (RBM) was established in 1998 in part to reinvigorate the worldwide fight against malaria, and in part to facilitate the negotiations for what became the Stockholm Convention, the Persistent Organic Pesticides Treaty of 2001.
That’s about the time the ungodly assault on WHO and Rachel Carson started, by hysterical DDT advocates. We now know that Roger Bate, Richard Tren, Donald Roberts and their comrades in pens are stuck in that 1998 fight.
Here’s a short account, from RBM, about just what happened:
The DDT Controversy
In 1999 the RBM Secretariat was called upon to help resolve a controversy emerging from intergovernmental negotiations to establish an international environmental treaty. At the centre of this controversy was DDT, former hero of the malaria eradication campaign and current totemic villain of the environmental movement. The treaty being negotiated was intended to eliminate the production and use of twelve persistent organic pollutants. DDT, still used for malaria control in over 20 countries, was included among ‘the dirty dozen’ chemicals slated for elimination, eliciting a strong reaction from public health activists and malaria specialists who claimed that its elimination would result in unacceptable increases in malaria morbidity and mortality. Environmental specialists and others claimed that environmentally friendly alternatives to DDT, although more expensive, could easily be deployed to guard against such a negative impact.
The controversy over the role of DDT in malaria vector control and the dangers posed to the environment escalated and attracted considerable media attention. The controversy was perpetuated in part because of a relatively weak evidence base on the human toxicity of DDT, the cost-effectiveness of proposed alternatives, and the probable impact of public health use of DDT (compared to agricultural use) on the environment. Resolution was also hampered by the relative lack of public health expertise among the Intergovernmental Negotiating Committee delegates, who were primarily active in the fields of foreign and environmental policy.
The challenges presented to the RBM Secretariat in responding to the controversy were many and varied. They included: evaluation of the evidence base and the drafting of policy guidance (a WHO normative role); a major communications effort; and the establishment of new cross-sectoral partnerships and working relationships. In the process, RBM formed new and highly effective ‘partnerships’ or ‘working relations’ with the United Nations Environment Programme (UNEP), the US Environmental Protection Agency, the environmental policy apparatus of core RBM partners, as well as a variety of health and environmental NGOs. RBM conducted country and informal expert consultations and convened and chaired a special working group on DDT which was able to establish a position on the use of the insecticide in public health and the process for evaluating and moving to alternatives. The weight of WHO’s technical authority contributed greatly toward establishing the credibility of the working group. Information about the treaty negotiations and the WHO position on DDT was disseminated to health specialists via the WHO regional networks and to treaty focal points via UNEP.
The RBM Secretariat led the WHO delegation to all meetings of the Intergovernmental Negotiating Committee and prepared information and media events for each, supporting the participation of health/malaria specialists from a number of countries. The RBM Secretariat also served as the media focal point on malaria and DDT and provided interviews and information to all major media, as well as presentations to professional meetings and interest groups.
RBM’s objectives throughout this process were:
to establish consensus on the present and future role of DDT and alternatives in malaria control;
to encourage greater involvement of public health specialists in country-level discussions about the treaty and in country delegations to the negotiating sessions;
to provide information to negotiators and others that would reduce controversy and result in a win-win situation for public health and the environment (in which the longer term goal of DDT elimination is achieved through strengthened, more robust malaria control);
to benefit from the media attention to inform the public about malaria; and
to mobilize resources to support malaria control from outside the health sector.
All of these objectives have been met and the final treaty, known as the ‘Stockholm Convention on Persistent Organic Pollutants’ provides for the continued public health use of DDT and international assistance for the development and implementation of alternatives.
Resources to support the initial work of the RBM Secretariat were provided by environmental agencies/offices. In addition, the Pan American Health Organization (PAHO) and the WHO Regional Office for the Americas (AMRO) and most recently the WHO Regional Office for Africa (AFRO) have been awarded project development grants from the Global Environment Facility (GEF) to promote regional efforts to strengthen malaria control and reduce reliance on DDT.
Tuesday morning, March 8, the Republican-controlled House of Representatives Committee on Energy and Commerce opened hearings on global warming, staging an assault on science with a series of witnesses, some of whom recently have made a career out of mau-mauing scientists.
Dr. Donald Roberts’ testimony to the House Committee on Energy and Power, on March 8, 2011, presented a grand collection of Bogus History, coupled with Bogus Science. Roberts has an unfortunate history of presenting doctored data and false claims to Congress.
One witness took after the EPA directly and Rachel Carson by implication, with a specious claim that DDT is harmless. Donald Roberts is a former member of the uniformed public health service. Since retiring, and perhaps for a while before, he started running with a bad crowd. Of late he’s been working with the Merry Hoaxsters of the unrooted Astroturf organization Africa Fighting Malaria (AFM), a group dedicated to publishing editorials tearing down the reputation of Rachel Carson, the World Health Organization (WHO) and the Environmental Protection Agency (EPA).
(That would all be purple prose, were it not accurate in its description of people, organizations and their actions.)
Why was Roberts testifying at a hearing on global warming? He’s carrying water for the anti-science, “please-do-nothing” corporate crowd. It’s a tactic from the old tobacco lobbyist book: Roberts claims that scientists got everything wrong about DDT, and that the ban on DDT done in error has wreaked havoc in the third world. Therefore, he says, we should never trust scientists. If scientists say “duck!” don’t bother, in other words.
Roberts is in error. Scientists, especially Rachel Carson, were dead right about DDT. Because corporate interests refused to listen to them, the overuse and abuse of DDT rendered it ineffective in the fight against malaria, and DDT use as part of a very ambitious campaign to eradicate malaria had to be abandoned in 1965. The entire campaign had to be abandoned as a result, and more than 30 million kids have died since.
So don’t grant credence to Roberts now. He’s covering up one of the greatest industrial screw-ups in history, a screw up that, by Roberts’ own count, has killed 30 million kids. What in the world would motivate Roberts to get the story so wrong, to the detriment of so many kids?
Roberts said:
Putting issues of EPA budget aside, I want to introduce my technical comments with a quote from a recent Associated Press article with a lead statement “none of EPA’s actions is as controversial as its rules on global warming.” In my opinion, this is wrong.
Dr. Donald Roberts testifying to the House Energy Committee, March 8, 2011. Screen capture from Committee video.
Roberts is correct here in his opinion. It is simply wrong that EPA’s rules on global warming and controls of the pollutants that cause it should be controversial. Among air pollution scientists the rules are not controversial. Among climate scientists the rules are not controversial. Roberts and his colleagues at the so-called Competitive Enterprise Institute, Africa Fighting Malaria (AFM), and American Enterprise Institute (AEI) work hard to manufacture controversy where the science does not support their case.
It is wrong. Roberts should be ashamed.
Roberts said:
Almost forty years ago EPA banned DDT in the United States. Its action against DDT was extraordinarily controversial, and still is. As activists advanced fearful claims against DDT, the EPA was warned, over and over again, a ban would destroy critically important disease control programs and millions upon millions of poor people in developing countries would die as consequence. Leaders of the World Health and Pan American Health Organizations, and even the U.S. Surgeon General warned against the ban. The EPA banned DDT anyway, and the doomsday predictions of those public health leaders proved prescient.
EPA’s ban on DDT in the U.S. was limited to the United States. Roberts doesn’t say it flat out, but he implies that the U.S. ban on spraying DDT on cotton fields in Texas and Arkansas — and cotton was about the only crop where DDT was still used — somehow caused a ban on DDT in Africa, or Asia, or South America, or other places where malaria still occurs.
I’m also not sure that health officials “pleaded” to stop the U.S. ban on any grounds, but certainly they did not plead with Ruckelshaus to keep spraying DDT on cotton. Roberts is making stuff up in effect, if not in intent.
Probably more to the point, health officials had stopped significant use of DDT in Africa in 1965, seven years before EPA acted in the U.S., because overuse of DDT on crops in Africa had bred mosquitoes that were resistant and immune to the stuff. Since 1955, in close cooperation with the malaria-fighting experts from the Rockefeller Foundation including the great Fred Soper, WHO carried on a methodical, militant campaign to wipe out malaria. The program required that public health care be beefed up to provide accurate malaria diagnoses, and complete treatment of human victims of the parasitic disease. Then an army of house sprayers would move in, dosing the walls of houses and huts with insecticide. Most malaria-carrying mosquitoes at the time would land on the walls of a home or hut after biting a human and getting a blood meal, pausing to squeeze out heavy, excess water to make flight easier. If the wall were coated with an insecticide, the mosquito would die before being able to bite many more people, maybe before becoming capable of spreading malaria.
DDT was Soper’s insecticide of choice because it was long-lasting — six months or more — and astonishingly deadly to all small creatures it contacted.
But, as Malcolm Gladwell related in his 2001 paean to Soper in The New Yorker, Soper and his colleagues well understood they were racing against the day that mosquitoes became resistant enough to DDT that their program would not work. They had hoped the day would not arrive until the late 1970s or so — but DDT is such an effective killer that it greatly speeds evolutionary processes. In the mid-1960s, before an anti-malaria campaign could even be mounted in most of Subsaharan Africa, resistant and immune mosquitoes began to stultify the campaign. By 1965, Soper’s crews worked hard to find a substitute, but had to switch from DDT. By 1972 when the U.S. banned DDT use on cotton in the U.S., it was too late to stop the resistance genes from killing WHO’s anti-malaria program. In 1969 WHO formally abandoned the goal of malaria eradication. The fight against malaria switched to control.
Roberts claims, implicitly, that people like those who worked with Soper told EPA in 1971 that DDT was absolutely essential to their malaria-fighting efforts. That could not be accurate. In 1969 the committee that oversaw the work of the UN voted formally to end the malaria eradication project. In effect, then, Roberts claims UN and other health officials lied to EPA in 1971. It is notable that Soper is credited with eradicating malaria from Brazil by 1942, completely without DDT, since DDT was not then available. Soper’s methods depended on discipline in medical care and pest control, and careful thought as to how to beat the disease — DDT was a help, but not necessary.
Interestingly, the only citation Roberts offers is to his own, nearly-self-published book, in which he indicts almost all serious malaria fighters as liars about DDT.
Can Roberts’ testimony be trusted on this point? I don’t think we should trust him.
In fact, DDT and the eradication campaign had many good effects. In 1959 and 1960, when DDT use was at its peak in the world, malaria deaths numbered about 4 million annually. The eradication campaign ultimately was ended, but it and other malaria-fighting efforts, and general improvements in housing and sanitation, helped cut the annual death toll to 2 million a year by 1972.
After the U.S. stopped spraying DDT on cotton, mosquitoes did not migrate from Texas and Arkansas to Africa. As noted earlier, the EPA order stopping agricultural use, left manufacturing untouched, to increase U.S. exports. So the ban on DDT in the U.S. increased the amount of DDT available to fight malaria.
Malaria fighting, under Soper’s standards, required great discipline among the malaria fighters — the sort of discipline that governments in Subsaharan Africa could not provide. Had WHO not slowed its use of DDT because of mosquito resistance to the stuff, WHO still would not have been able to mount eradication campaigns in nations where 80% of residences could not be sprayed regularly.
Advances in medical care, and better understanding of malaria and the vectors that spread it, helped continue the downward trend of malaria deaths. There was a modest uptick in the 1980s when the parasites themselves developed resistance to the drugs commonly used to treat the disease. With the advent of pharmaceuticals based on Chinese wormwood, or artemisinin-based drugs, therapy for humans has become more effective. Today, the annual death toll to malaria has been cut to under a million, to about 900,000 per year — a 75% drop from DDT’s peak use, a 50% drop from the U.S. ban on farm use of DDT.
With the assistance of WHO, most nations who still suffer from malaria have adopted a strategy known as Integrated Vector Management, or IVM (known as integrated pest management or IPM in the U.S.). Pesticides are used sparingly, and insect pests are monitored regularly and carefully to be sure they are not developing genetic-based resistance or immunity to the pesticides. This is the method that Rachel Carson urged in 1962, in her book, Silent Spring. Unfortunately, much of the malaria-suffering world didn’t come to these methods until after the turn of the century.
Progress against malaria has been good since 2001, using Rachel Carson’s methods.
Don Roberts’ blaming of science, EPA, WHO, and all other malaria fighters is not only misplaced, wrong in its history and wrong in its science, but it is also just nasty. Is there any way Roberts could not know and understand the facts?
These are the facts Roberts works to hide from Congress:
“Science” and scientists were right about DDT. DDT is a dangerous substance, uncontrollable in the wild according to federal court findings and 40 years of subsequent research. If we were to judge the accuracy of scientists about DDT, we would have to conclude that they were deadly accurate in their judgment that use of DDT should be stopped.
If the ban on DDT was controversial in 1972, it should not be now. All research indicates that the judgment of EPA and its director, William Ruckelshaus, was right.
EPA was not warned that a ban on agricultural use of DDT would harm public health programs, in the U.S., nor anywhere else in the world. In any case, EPA’s jurisdiction ends at U.S. borders — why would WHO say anything at all?
DDT use to fight malaria had been curtailed in 1965, years before the U.S. ban on farm use, because overuse of DDT on crops had bred DDT-resistant and DDT-immune mosquitoes. Consequently, there was not a huge nor vociferous lobby who warned that health would be put at risk if DDT were banned. Claims that these warnings were made are either false or grossly misleading.
Malaria death rates declined to less than 50% of what they were when DDT was banned from farm use in the U.S. — there was no “doomsday” because the U.S. stopped spraying DDT on cotton, and there never has been a serious shortage of DDT for use against malaria, anywhere in the world.
How much of the rest of the testimony against doing something about global warming, was complete hoax?
[Editor’s note: My apologies. I put this together on three different machines while conducting other activities. On proofing, I find several paragraphs simply disappeared, and edits to make up for the time of composing and fix tenses, got lost. It should be mostly okay, now, and I’ll add in the links that disappeared shortly . . . oh, the sorry work of the part-time blogger.]
Update, 2015: Video of the hearing, from YouTube:
Spread the word; friends don't allow friends to repeat history.
In the last two weeks we’ve seen a virtual-world assault by Richard Tren, Roger Bate and Don Roberts, alternately telling fantastic tales about how Rachel Carson from beyond the grave organized a mass murder that rivals Joseph Stalin, or saying that environmentalists conspire to keep life-saving chemicals from getting to Africa and Asia.
Fraud? That’s all on Bate. Here are things Bate will not tell you:
No malaria fighting organization claims it needs more DDT.
DDT has never been banned in Africa, nor Asia.
If any nation wishes to use DDT to fight malaria, that nation need only write a letter to the World Health Organization informing WHO of that fact.
If anyone violates the Persistent Organic Pollutants Treaty (POPs) and uses DDT without telling WHO first, there is no penalty.
Malaria death rates are, now, at the lowest level in human history. While there is a threat of a resurgence of malaria, the threat comes because the malaria parasites themselves develop resistant to the pharmaceuticals used to treat the disease in humans — no connection to DDT.
DDT use cannot stop malaria. Consider: India is one of two or three nations today who still manufacture DDT, and India uses more DDT than all the rest of the world’s nations put together. Malaria is still a problem for India.
Beating malaria requires more than poisoning the hell out of Africa.
Roger Bate: Walking science, history, law and policy fraud. His claims are hoaxes.
Or, until that account is unsuspended by the forces supporting Donald Trump: Follow @FillmoreWhite, the account of the Millard Fillmore White House Library
Error: Please make sure the Twitter account is public.
Dead Link?
We've been soaking in the Bathtub for several months, long enough that some of the links we've used have gone to the Great Internet in the Sky.
If you find a dead link, please leave a comment to that post, and tell us what link has expired.
Thanks!
Retired teacher of law, economics, history, AP government, psychology and science. Former speechwriter, press guy and legislative aide in U.S. Senate. Former Department of Education. Former airline real estate, telecom towers, Big 6 (that old!) consultant. Lab and field research in air pollution control.
My blog, Millard Fillmore's Bathtub, is a continuing experiment to test how to use blogs to improve and speed up learning processes for students, perhaps by making some of the courses actually interesting. It is a blog for teachers, to see if we can use blogs. It is for people interested in social studies and social studies education, to see if we can learn to get it right. It's a blog for science fans, to promote good science and good science policy. It's a blog for people interested in good government and how to achieve it.
BS in Mass Communication, University of Utah
Graduate study in Rhetoric and Speech Communication, University of Arizona
JD from the National Law Center, George Washington University
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