Mosquito/Malaria Control (41)
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Dear colleagues,
This article pretty much says it all.
Bill Nesler
mailto:sdbc@hur.midco.net
--
Americas response to Hurricane Katrina was slow, disorganized
and inadequate. Thankfully, our response to potential outbreaks
of West Nile virus and other diseases has been much better. In
fact, aircraft are already spraying vast quantities of insecti-
cides all along the Gulf Coast.
How is it, then, that bureaucrats in agencies funded by US tax-
payers are still telling Africans they cannot use insecticides
and must be content with politically correct strategies like bed
nets and anti-malarial drugs (both of which are in horribly
short supply)? It is an absurd, hypocritical and unconscionable
situation. And millions are dying as a result. This timely and
provocative article addresses this important issue.
Permission is granted to translate the article, edit it for
length or tone or to give it a local perspective (to emphasize
problems in your own country, e.g.), post it to your website,
email it to colleagues, or submit it for posting or publication
by newspapers, newsletters and other organizations that might
have an interest in this important issue if you provide proper
credit for the article.
Paul Driessen
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Get out your bed nets
We must let Africans fight mosquitoes and disease the same way
we do: with pesticides
Paul Driessen
Gulf Coast residents are slowly recovering from Katrinas winds,
floods, anarchy, and tardy local, state and federal disaster re-
sponses. Now they face yet another peril.
Millions of acres of brackish, polluted water could become fer-
tile breeding grounds for billions of mosquitoes. Some fear the
hordes could infect survivors with West Nile virus and encepha-
litis or even malaria and yellow fever. They point out that
the United States had 2,500 serious cases and 100 deaths from
WNV in 2004; that yellow fever killed 9,000 people in New Or-
leans and Memphis in the summer of 1878; and that malaria killed
thousands of Americans every year until the 1940s.
However, a comparable disaster in Katrinas wake is unlikely,
say experts. US health officials have already launched C-130
aircraft capable of spraying 60,000 acres per day with Dibrom,
which is safe for humans and the environment but extremely ef-
fective for mosquito control.
In 1999 three C-130 Hercules sprayed for 22 days in the wake of
Hurricane Floyd. They killed 99% of all mosquitoes across 1.7
million acres in Virginia and North Carolina. This years pro-
gram will be even more extensive.
Inexplicably, this rapid response to health threats here in the
United States stands in marked contrast to the approaches US-
funded aid programs take in developing countries wracked by dis-
eases of truly epidemic proportions. Indeed, hurricane survivors
can be thankful that US health officials are not controlled by
the U.S. Agency for International Development (AID), World
Health Organization (WHO) or World Bank (WB). Those agencies
would likely tell survivors, Get out your bed nets.
All three organizations decry the horrendous disease and death
toll that malaria inflicts on African and other developing coun-
tries. In fact, nearly 450 MILLION Africans get malaria every
year, and up to 2 million die. Half the victims are children.
In Kenya, malaria claims 34,000 children a year; in Uganda, up
to 50,000; Ethiopia: 75,000. In the Democratic Republic of
Congo, it kills 225,000 children annually!
The USAID, WHO and WB all give lip service to insecticides. But
they almost never support, promote or fund the use of DDT or
other insecticides. Instead, they emphasize insecticide-treated
nets (ITNs) and new anti-malaria drugs. This supposedly under-
scores their renewed assault on malaria and a strategy that
has moved from words to action.
Sadly, its more rhetoric than reality.
For years, USAID spent millions on malaria consultants and con-
ferences. This year, its expanded budget also emphasizes produc-
ing 55 million pediatric doses of new Artemisia-based (ACT)
drugs by 2006. But with 500 million people getting malaria every
year worldwide, this is woefully inadequate, especially with the
disastrously poor transportation and medical infrastructure
across much of Africa.
AID is also fostering net distribution, via partnerships with
the private sector, and the Bank recently gave Congo $30 million
to get at least two ITNs in each household. This, it says,
could slash child deaths by as much as one-fifth.
Two nets per household is hardly enough, especially when the en-
tire family could be protected by programs that spray walls with
tiny amounts of DDT just once or twice a year, to keep 90% of
mosquitoes from even entering the home, killing any that land,
and irritating the rest so they dont bite. And a 20% reduction
is unconscionably low, when DDT programs get four times that.
South Africa used household DDT spraying, followed by ACT drugs,
to slash malaria rates by 93% in three years. Its success in-
spired Mozambique, Zambia and other countries to institute simi-
lar programs. But the EU has threatened Uganda with sanctions on
its agricultural goods, if it follows suit.
WHO Director Lee Jong-Wook calls nets and drugs proven strate-
gies. But seven years after the vaunted Roll Back Malaria cam-
paign was launched, even his own organization admits its still
too soon to tell if malaria rates have gone down at all. More-
over, with ACT drugs in short supply, many of its anti-malaria
kits still contain drugs that are no longer effective against
this killer disease.
USAID claims spraying wont work because there arent enough
trained sprayers, inadequate infrastructures prevent them from
getting to villages, and a high percentage of homes must be
treated if spraying is to be effective. This is simply false.
Spraying isnt rocket science. Training people and getting the
job done once or twice a year is easier than getting bed nets
and drugs to every parent and child. And spraying protects every
person in every house thats treated.
Bed nets protect only those who use them, work only if theyre
not torn, and are of little use when people are still working or
doing homework. Further, many people simply dont use them.
Sleeping under a bed net is nearly impossible during torrid Af-
rican nights, says Omololu Falobi, a journalist in Nigeria. Use
the net anyway, and you get heat rashes all over your face and
body. Most villages have no electricity to power fans or air
conditioners, and many of the same environmentalists who oppose
pesticides also oppose electricity generation on any scale that
would power these cooling systems.
Even in cities like Lagos power outages are frequent, rendering
fans and AC useless. Even if you have a generator, says Fa-
lobi, you dont want to put it on throughout the night, for
fear of carbon monoxide poisoning.
Kenyan Pauline Mwinzis father nevertheless insisted that his
family use bed nets. But she still came down with cerebral ma-
laria and nearly died, and her father succumbed to the disease
when she was six. Today, she says, as mother of several kids
myself, I refuse to use bed nets. Theres got to be a better way
of dealing with mosquitoes.
There is. But anti-pesticide activists and bureaucrats safe in
their malaria-free offices refuse to consider them. Instead,
they worry about trivial risks from pesticides and ignore the
devastation and death caused by diseases that pesticides could
prevent.
These are life-or-death decisions for malaria-endemic countries.
Their health ministers must have the right to make decisions
based on science and effective use of scarce human, medical and
financial resources without fear of reprisals if their deci-
sions include DDT and other pesticides, along with nets, drugs
and other measures.
America would never tell hurricane survivors they must rely on
bed nets and anti-malaria drugs that are in critically short
supply, or simply dont work. Telling Africans to do so violates
their most basic human rights to health, prosperity and life
itself.