[afro-nets] Pesticide use for Malaria Control in Africa

General afro-nets
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Pesticide use for Malaria Control in Africa
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All,

I would like to thank Bill for bringing up the issue of Pesti-
cide use for Malaria control in Africa. It has been a protracted
battle with malaria in Africa since the developed nations rid
most parts of their land of the mosquitoes that cause malaria.
It is however disheartening that 40 years down the line, Africa
is still plagued with the disease and the West continues to re-
sist our widespread use of pesticides.

The argument has been that pesticides find their way into our
farms and render our crops - for export - unfit for human con-
sumption and handling. An economic embargo is then hastily
placed on our produce leading to increased poverty due to lost
revenue. The catch 22 situation is this: use pesticides and say
goodbye to the dollars from agricultural exports, or maintain
the status quo at the risk of exposing your population to the
lethal Anopheline bite.

I am a strong advocate for the use of DDT and do believe that
controlled use for Indoor Residual Spraying is the way to go in
fighting malaria in Africa. Countries like South Africa which
have the capacity to produce the chemical have recorded some
success in its use. Eritrea has also been allowed to use DDT in
vector control. I have often questioned whether there is com-
plete lack of goodwill in international cycles to curb the
spread of malaria, especially now when climatic changes have ex-
pedited the spread of the disease. The truth be told - malaria
is a high income earner for the west and therefore there might
be more benefit to be derived from its spread than its eradica-
tion. We are not even close to achieving the MDGs as far as
fighting malaria is concerned and "the powers that be" have to
seriously rethink their commitment towards achieving these
goals.

Public Health professionals and scientists around the world need
to take a stance and advocate for what they represent - Health
for all! The world, at least on paper, recognises and acknowl-
edges that Health is a fundamental human right. Let us steer the
campaign to ensure that this is achieved for we owe our people a
professional duty of care.

Philip E. Otienoburu
Centers for Disease Control
mailto:Potienoburu@ke.cdc.gov

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Philip,

I would say, all Africa should first concentrate on protecting
itself from malaria rather than trying to earn pennies that too
swindled by the powerful!!

Instead become malaria free and self sufficient in food grains
and see the West coming on its knees to seek favours from the
mineral and oil rich Africa.

But for this to happen, you need to first eliminate corruption,
introduce total transparency and accountability all over African
continent.

The mute question is, would that be possible, given the level of
corruption and the present form of democracy which is actually
hypocrisy that is followed in most nations?!!

Kris Dev
mailto:krisdev@gmail.com

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Pesticide use for Malaria Control in Africa (3)
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Hello,

AFRO-NETS subscribers and Philip,

the issue of pesticide use in African can not easily be ex-
hausted.

However, I believe the spraying Bill has in mind is not indoor
residual spraying (IRS), Philip, but widespread bombardment of
the whole environment, which in my opinion is not viable, sus-
tainable, or even acceptable.

By the way Philip, Uganda too is on the way to IRS spraying with
DDT and I can assure you I believe it's the way to go or so I
believe.

And we are not "allowed" by anyone to spray but decide on our
own after due consideration of our problems.

Isaac Kigozi
mailto:kigoziisaac76@yahoo.co.uk

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Pesticide use for Malaria Control in Africa (4)
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Yes Isaac, what we are proposing is large area spraying. This is
being done in the US and has been, for the past 60-70 years with
the accompanying disappearance of malaria, yellow fever and
other mosquito borne disease. While outdoor spraying, both by
air and ground, is a major component in any modern mosquito con-
trol project, it is not the only one. Source reduction, lar-
vaciding, public education and, yes, even bednets, are important
components. The methods proposed have never shown any harmful
effects in the US. Why would they in Africa?

Sincerely,

Bill Nesler
mailto:sdbc@hur.midco.net

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Pesticide use for Malaria Control in Africa (5)
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Hello AFRO-NETTERS,

Dear Bill, you are leaving out a bit. When spraying was proposed
for New Orleans after the hurricane, there was a huge outcry
from those left in the city: they did NOT wish to be subjected
to aerial spraying.

The vast majority of US citizens find it totally unacceptable to
expose themselves or their families to aerial spraying! Every
time it has been tried, the public response was overwhelmingly
against it. The US public always votes against (when allowed) or
protests against any form of aerial spraying, even for Nile
River Valley Fever. For example, communities were very angry
when spraying against the Mediterranean Fruit Fly occurred in
California. People organized protests, filed law suits and gen-
erated a lot of political pressure: & they succeeded in stopping
the spraying.

Almost all aerial spraying in the USA occurs over economically
poor neighbourhoods, where people have little political voice.
They do not spray over Beverly Hills, but now they can aerial
spray in New Orleans, since the only people left are those too
poor to leave (and too poor to have political clout). By and
large, spraying in the USA is done TO people, FOR the benefit of
huge agro-business and other private-sector interests. Communi-
ties do not want aerial spraying: it is only against their will
that the poor find themselves subjected to aerial spraying.

Of course the "rich" in the USA do not use traditional bednets:
they have expensive alternatives. They LIVE inside a huge
"treated bednet", it is called a "custom-built" home. They live
in climate-controlled, sealed houses and can afford topical mos-
quito repellents when they go out. They spray around the outside
of their homes and treat their swimming pools. Such a combina-
tion of interventions is costly and wasteful.

Also, aerial spraying use hundreds of times more pesticides than
well-targeted Indoor Residual Spraying. Why would communities in
Africa welcome aerial spraying and the possible health / envi-
ronmental troubles any more than their North American counter-
parts? Especially when other methods are proven to work very,
very well.

The urgent need is to rapidly increase the use of proven inter-
ventions that work together well: Indoor Residual Spraying,
treated bednets, larvaciding, and FREE and immediate access to
effective anti-malarials for all. And it should be Africa First
for research spending on health, so that better interventions
are created and used very much more quickly. The US & Europe
must be forced to meet their pledges to fund programs now. Ac-
cess to preventative health care and interventions (including
IRS, bednets, etc.) is a human right, and lack of money should
never be a barrier to obtaining them.

Kindest regards,

Tom O'Connell
mailto:tsoconnell2@yahoo.com

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Hello Tom,

I think that you are not being completely honest either about
your agenda. If there was a huge outcry in New Orleans it is
news to me. If you mean the environmental wackos, I could proba-
bly buy your premise. So what environmental group was it, and is
that the group you belong to? I find it hard to believe that re-
lief workers would be raising hell about protecting their very
lives. I can assure you that dying from the assortment of dis-
eases that are left in the wake of a disaster like Katrina is
important to the people doing the work, not armchair quarter-
backs who sit on the sidelines.

When you speak of this "VAST MAJORITY" who are against aerial
spraying how many people know it even exists? How many people
even know what goes on on the streets after 10 PM when that
pickup truck cruises by fogging the neighborhoods of America.
That is how America lives outside to barbeque and spend quality
time with family and friends in their little fenced off piece of
America. You sir have a political agenda, you are one of those
environmentalists that are responsible for higher gas prices(no
new refineries) the levies breaking in New Orleans( when
strengthening was proposed law suits were filed and project
stopped due to environmental concerns).

Yeah you guys are real good for America and the rest of the
world. Have you actually been to Africa? I have, and I have seen
the impact that these diseases have on the "poor" people who
can't go to work because some bureaucrat thinks it is smart to
condemn the "poor" to that life style of sickness and poverty. I
can tell where your political aspirations lie by the way you
talk about the rich, like they are these evil people who must be
punished for being successful. Let me give you a news flash
there Tom, you and your kind are on the slippery slimy slope
down, and it's about time after listening to you since the 60s
it can't be soon enough for me.

One more thought Tom, Socialism has been proven to be a failure
everywhere; it has been tried in many places and failed misera-
bly. There is no utopia Tom. Most places you travel are probably
made more outdoor friendly with the use of pesticides, either
you have sickness without them or prosperity and a relatively
healthy population with them.

Craig Audiss
mailto:cybrcollectinc@yahoo.com

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Come on Craig,

save us the Capitalistic proselytizing! How can you call someone
an "environmental wacko" just because of the ideas he has about
how things should be done? He is entitled to be heard... I
thought that was the idea of America... "I don't agree with your
opinion but will defend to the death your right to hold it and
express it" ain't it?

Does the fact that the people don't know about what goes on in
their communities at night mean that they agree with it?... to
me it does not, it may imply a government that does not trust
its people to understand its agendas or one that just does what
it wishes with its people. One that considers people like ani-
mals on a farm not as humans with the ability to choose... is
this what America really is like? I do not know!

From what I have seen of what Blacks in America live like and
how they get treated and the statistics about school dropout
rates and even the jail population statistics I get a feeling
black people are 2nd class citizens still... and I do not be-
lieve a country that treats its citizens like that can desire
more for Africans living in Africa.

Environmentalists have nothing to do with the price of gas... at
least I don't believe so! Last time I checked the Demand on the
resources of the earth were far outstripping the supply... im-
plying that the prices were bound to go higher not lower! And
last time I checked it was Americans Driving large cars with
monstrous engine capacities like "Hummers" in the City and its
suburbs just for the "SEE ME" effect... do you seriously think
the worlds resources are inexhaustible? If so then you guys need
to revise your opinions.

It's also Americans causing instability in the oil market with
the war in Iraq... though I don't blame them Saddam was due what
he got... but its the competition for resources with China and
the rest of the world that is driving prices up... not environ-
mentalists.

You wanna know why the poor in Africa can not afford anything?
Because governments in the developed world have to keep voters
happy by protecting their markets from goods from Africa... by
taxing any finished product out of the market. They would prefer
we export Cocoa beans to having us export a bar of chocolate,
and export raw coffee beans so your industries can continue
functioning

You wanna know why we keep dying in large numbers of treatable
diseases? Because we can not get medicine since the PEPFAR funds
can only be used to buy branded drugs from American companies
and not generics...

You know why we have bureaucrats who cant make any sensible de-
cision? Because they are in the pockets of "big business" and
anyone who tries to be pro people is branded a socialist and
hounded out of power... Do I hear anyone saying Hugo Chavez...?,
Fidel Castro...?

I am not a socialist or any brand of political groupie... I just
agree with anyone who has an agenda that is for the people espe-
cially poorer people.

And by the way... why did socialism fail? Was it because it was
tried and tested or that America was spending money to ensure it
failed? Because 'big business' was running scared... and so en-
sured all African leaders who showed people mattered were
killed... anyone remember Lumumba, Sankara...? Come on people!

Our salvation does not lie in America or in Europe but in our
own efforts and in the utilisation of our meagre resources prop-
erly... proper stewardship is all that we need.

I guess I have preached tonight... but that's what I believe...
and I don't care about socialism, capitalism, communism, fascism
and all the other -isms as long as my people live a good life...
without poverty and disease.

P.S.: has anyone read the book... " about not getting by in
America" or something like that... by a Jewish former Journal-
ist? Will try getting the proper title but it shows how achiev-
able the American dream is.

Dr Isaac Michael Kigozi
National Drug Authority, Uganda
Plot 46-48 Lumumba Avenue
P.O.Box 23096
Kampala, Uganda
Tel. +256-41 255 665
Mobile +256-77-982 411
mailto:kigoziisaac76@yahoo.co.uk
mailto:pistollero76ug@yahoo.co.uk
mailto:kigoziisaac@hotmail.com

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To all you folks that do not agree with insecticide use for mos-
quito control,

can any of you show one location on Earth that has ever con-
trolled malaria without the broad use of insecticides (espe-
cially DDT)? If you cannot show this info, you have automati-
cally conceded the argument. I am not asking for a small reduc-
tion in incidence. I'm asking for proof of eradication as has
been done in places like Florida, Louisiana, California and Dar-
win, Australia. I beg You, my people, give me the proof.

Bill Nesler
mailto:sdbc@hur.midco.net

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Pesticide use for Malaria Control in Africa (10)
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Tom's words are music to my ears and seem to be totally objec-
tive. What we need to do is to develop a plan of expenditure and
how it would impact locals. Spraying can be resorted to uninhab-
ited places such as large marshy swamps infested with mosquitoes
and not in residential colonies, if that is dangerous. The pro-
posal of Tom, as follows, sounds good to me.

The urgent need is to rapidly increase the use of proven inter-
ventions that work together well: Indoor Residual Spraying,
treated bednets, larvaciding, and FREE and immediate access to
effective anti-malarials for all. And it should be Africa First
for research spending on health, so that better interventions
are created and used very much more quickly. The US & Europe
must be forced to meet their pledges to fund programs now. Ac-
cess to preventative health care and interventions (including
IRS, bednets, etc.) is a human right, and lack of money should
never be a barrier to obtaining them.

What do others think?

Kris Dev
mailto:krisdev@gmail.com

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Dear Isaac Kigozi,

I can see the contempt naturally flowing from you, against the
hegemony of West against East or North against South!!

You have made an impassioned plea for Self-Governance of Africa,
by Africa, for Africa. You are right - No outsider would truly
be interested in the welfare of some other deprived person or
state or continent!! We are all not Mother Teresa and the like!!

I am not trying to tom-tom, what I just posted yesterday to Open
Democracy, but for the fact that it is so apt to what Isaac has
said. So at the cost of being accused of self-promotion, I am
reproducing below, for the larger benefit of the African, Asian
and other deprived third world continents and countries.

Let us arise, awake and stop not till the goal is reached.

--
Transparency and Accountability in Governance
Posted: 21-Sep-2005 12:42

http://www.opendemocracy.net/forums/post!reply.jspa?forumID=186&threadID=44971&messageID=66693

Governments should be more transparent and accountable to the
citizens, who are its principal stakeholders.

But unfortunately, there is no single entity who could be held
responsible in Government. No one can be truly held responsible
in a democracy. The responsibility and accountability gets dis-
sipated. The political masters who are expected to be servants
invariably abuse their self assumed authority. There is no check
on them.

The bureaucracy plays second fiddle to the political masters,
for their own well being and survival. There is no clear cut au-
thority, responsibility and accountability. Similar is the case
with judiciary.

What is required in a democracy is clear line of authority, sin-
gle point responsibility, freedom to operate, total accountabil-
ity. All these would be possible, only if there is total trans-
parency in all actions.

This was not possible earlier due to the manual system of file
management in Governments and corporates. Luckily today, we have
the WWW to help in spreading the message of transparency and ac-
countability.

All that is required for any democracy in the world to truly
succeed is to ban currency circulation and make all transactions
of all individuals and organizations, transparent on the web for
the citizens to see, question and be held accountable to the
public.

This alone can eliminate corruption and make everyone behave
well in private and public. A paper-less communication and col-
laboration tool is essential to ensure this. Laws must be en-
acted for all citizens that any communications done outside the
electronic system shall not be recognized by law and individuals
held accountable for their actions.

Such an integrated system is possible and has actually been im-
plemented on a trial basis, to promote transparency and account-
ability in governments.

Kris Dev
Co-Founder, International Transparency and Accountability Network
http://Tr-Ac-Net.blogspot.com
mailto:krisdev@gmail.com

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Dear Bill,

You seem to insist much on the insecticide use for mosquito con-
trol. This can probably work well in some areas but should not
be guaranteed to be effective everywhere. There are several mos-
quito control tools, and each tool is efficacious. But the ef-
fectiveness of each tool remains a question of -

1) The nature of the area to be controlled. If it is adult con-
trol, probably aerial spray or IRS. But you can't do aerial
spray in residential areas as malaria mosquitoes breed not far
from human host. This is not only an issue of human health but
also of ecological concern (ecological imbalance. IRS is an is-
sue of economy.

2) Larvicing is also effective, but how about the areas with
complex mosquitoes breeding habitats, where the breeding habi-
tats are even not recognised, irrigation farming are practiced?

I think the best solution could be to have an integrated mos-
quito control campaign. In this all available and practically
possible control tools have to be implemented at the same time,
so that mosquitoes that will not be reached be one tool will be
reached by another.

This have to include both chemical control tools as well as bio-
logical control tools.

Kija Ng'habi
Research Scientist
Entomology Unit
Ifakara Health Research and Development Centre
Box 53, Ifakara, Morogoro, Tanzania
Tel: +255-23-2625164
Fax: +255-23-2625312
mailto:ndyai@yahoo.com
http://www.ihrdc.org

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Without getting personal, I would like to know the advantages
and disadvantages of spraying and not spraying pesticide, based
on proven statistics, if available, rather than by people who
argue for and against, just on personal theories.

Is there any independent neutral group which has done long term
study and brought out genuine reports for the benefit of human-
ity?

Kris Dev
mailto:krisdev@gmail.com

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Hi Kija,

I will attempt to answer your questions in the order they were
presented:

1) The nature of the area to be treated is absolutely critical.
This doesn't mean that aerial application or ground fogging is
precluded. I cite operations in Florida. The major metropolitan
areas in that state are regularly sprayed by air for mosquito
control with NO harmful side effects. Post hurricane Katrina
Louisiana is currently being sprayed by air, including metro ar-
eas.

2) Larvaciding, or, indeed, adulticiding is dependent on a mos-
quito monitoring component of any modern mosquito control pro-
gram. This work is normally carried out by an entomological
team. This normally includes light/CO2 traps, sentinel animals,
dipping for larva, laboratory work to exactly identify the kinds
of mosquito being caught.

3) Much has been said about the feeding habits of the anopheles.
While this may be an important factor, for aerial spraying or
ground fogging operations the flight habits are much more impor-
tant as this is when they are most easily controlled.

You are correct, an integrated program is necessary, including
spraying, larvaciding, IRS, and yes, even bed nets. You mention
biological controls. The larvaciding program would likely make
extensive use of Bacillus Thuringensis, an insect larva specific
bacteria.

I am still waiting for someone to give an example of somewhere
on Earth that malaria has been eradicated without the broad use
of insecticides.

Cheers,

Bill Nesler
mailto:sdbc@hur.midco.net

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Dr. Kigozi,

First of all let me point out that I have no objection to some-
one having an opinion. I do however object to someone getting on
a forum and claiming that there has been this huge ground swell
of dissent over aerial spraying when I know better. When you say
that just because the people don't know that spraying is going
on that they don't agree with it is nonsense. I can tell you
this, when the mosquitoes get bad so that people cannot enter-
tain outdoors in the evenings without getting eaten alive with
mosquito bites or worrying about contracting some mosquito dis-
ease like malaria the calls will pour into the county and state
offices until they spray and it goes away.

"If we cannot be comfortable in our own homes then why do we pay
taxes," would be the cry at the local government meetings. As
far as the mean and nasty government not wanting the citizenry
to know what they are up to, gosh if the citizens want to know
all they have to do is go on-line and look or go to the appro-
priate meetings that are announced in the papers. We run a
pretty transparent society here, I believe the government an-
nounces spraying procedures to the citizenry.

I really must take exception to your comment about the American
government treating it's people like farm animals. Do you even
have the faintest idea what a true Democratic Republic is?
Americans spend billions in impoverished nations like yours and
does the government take care of it's people? Usually not, the
money is gone and nothing gets accomplished. So don't throw
stones when you live in a glass house buddy. If you hate America
so much then don't take our money, OK.

Let's not forget also when malaria started being a problem with-
out aerial spraying and follow-up larvaciding, etc. Kids could-
n't go to school, parents couldn't go to work, small babies and
elderly start dying like they do in Africa, I can guarantee that
the American population would not put up with that.

The only alternative to spraying is bed nets and medicines and
they are woefully inadequate. First of all there are really no
medicines that are that successful that I am aware of that can
guarantee an adequate cure or prevention, second, if there were
who pays? I know that there are few American households with say
4 members that could afford this medicine to keep the family
healthy. I suppose the government and the so called "rich" would
have to step up to the plate and pay. Good thing that we don't
have people like you in charge or this would be a 3rd world
country in short order. Malaria medicine is very hard on the
body also, I have taken it and I prefer not to take it if possi-
ble. Aerial spraying works, medicines do not address the core
problem. That is why no malaria program will be successful with-
out aerial spraying, period.

I am not under the illusion that America is perfect but I can
assure you that your distorted view is not correct, Dr. What do
you care if someone buys a hummer and spends his entire paycheck
on gas, insurance and payments for the shallow "SEE ME" effect,
are you paying for it? This guy tells me that he is working and
contributing to society, if not he wouldn't be driving such a
conveyance. What does it tell you?

Wanna know why Africa doesn't export chocolate bars? Because
every time industry tries to invest in Africa he has to bribe so
many people that it is no longer viable. Even if they go ahead
and build, it is one thing after another to fleece the industry
out of it's money till they leave. Until Africa gets leadership
that truly cares about its people nothing will change. American
and European tax monies will be poured down a rat hole and the
poor will continue to die from diseases that have been put on
the insignificant list in places that have a responsible govern-
ment to its citizenry. If you want to send candy bars to America
you are going to have to show some real responsibility and con-
trolling basic diseases is your first step in that direction.
America is the dumping station to the world for products like
your chocolate bars. But I for one want to know that my choco-
late bar was not made by someone who was sick 1/2 the time.
Clean up the disease and industry will follow close behind.
Business people like a friendly environment where they can get a
quality and healthy workforce. Prosperity lurks around the cor-
ner of those that realize these simple points.

One last thing, Dr. I suggest that you read David Horowitz auto-
biography and you will care about socialism.

Craig Audiss
mailto:cybrcollectinc@yahoo.com

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Dearest Afro-Netters,

Bill, no one has ever promoted exclusive use of Insecticide-
Treated bednets (ITNs): what the evidence supports is the use of
IRS, ITNs and effective medications used in a combination that
is based on local evidence and local needs. ITNs are, by defini-
tion, treated with insecticides. Larvaciding and IRS both use
insecticides, but in small quantities and in very carefully tar-
geted ways. The evidence from many sources leads WHO’s Roll Back
Malaria (RBM) department and the RBM partnership to recommend a
multi-pronged approach. And WHO’s RBM department, composed of
many African and developing country scientists and scholars,
feel aerial spraying is not a good choice based on currently
available evidence.

I enclose a few peer-reviewed studies to show the impact of Bed-
Nets, just below. The first 5 with abstracts, the rest as refer-
ences widely available.

By the way, just so that people know my predispositions... I
have a degree in nursing (22 years experience), and an MBA --
not very socialist, I am afraid :slight_smile: -- and am completing an MSc
in Development Economics. I worked for WHO from 1999 to 2005,
with my last post as a member of the Roll Back Malaria Secre-
tariat. Most of my experience has been in working with Minis-
tries of Health and Finance in Africa to develop national health
plans (e.g. for malaria control), and get them funded and imple-
mented. My agenda is to reduce preventable death and illness as
rapidly as possible, using what works and is appropriate within
the context of developing countries, as defined by national ex-
perts and leaders.

Most kind regards,
Tom O’Connell
mailto:tsoconnell2@yahoo.com

--
REFERENCES on IMPACT OF BEDNETS

1. “Impact on malaria morbidity of a programme supplying insec-
ticide treated nets in children aged under 2 years in Tanzania:
community cross sectional study.” Salim Abdulla, Joanna Arm-
strong Schellenberg, Rose Nathan, Oscar Mukasa, Tanya Marchant,
Tom Smith, Marcel Tanner, and Christian Lengeler, BMJ 2001 322:
270-2;

ABSTRACT:
Ownership of nets increased rapidly (treated or not treated
nets: from 58% to 83%; treated nets: from 10% to 61%). The mean
haemoglobin level rose from 80 g/l to 89 g/l in the study chil-
dren in the successive surveys. Overall, the prevalence of anae-
mia in the study population decreased from 49% to 26% in the two
years studied. Treated nets had a protective efficacy of 62%
(95% confidence interval 38% to 77%) on the prevalence of para-
sitaemia and of 63% (27% to 82%) on anaemia. CONCLUSIONS: These
results show that nets treated with insecticide have a substan-
tial impact on morbidity when distributed in a public health
setting.

2. “Efficacy of permethrin-treated bed nets in the prevention of
mortality in young children in an area of high perennial malaria
transmission in western Kenya.” Phillips-Howard PA, Nahlen BL,
Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE,
Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH,
Sexton JD, Oloo AJ, Hawley WA. Division of Parasitic Diseases,
National Center for Infectious Diseases, Centers for Disease
Control and Prevention, Atlanta, Georgia 30341, USA.

ABSTRACT:
A group-randomized controlled trial of insecticide (permethrin)-
treated bed nets (ITNs) was conducted in an area of high peren-
nial malaria transmission in western Kenya to test the effect of
ITNs on all-cause mortality in children 1-59 months of age. ITNs
prevent approximately one in four infant deaths in areas of in-
tense perennial malaria transmission, but their efficacy is com-
promised if re-treatment is delayed beyond six months. (this
will be less a factor as Long-Lasting nets are used)

3. “Bed nets for the prevention of malaria and anaemia in preg-
nancy”. Dolan G, ter Kuile FO, Jacoutot V, White NJ, Luxemburger
C, Malankirii L, Chongsuphajaisiddhi T, Nosten F.; Shoklo Ma-
laria Research Unit, Mae Sod, Thailand.

ABSTRACT:
Women in 3 adjacent study sites were allocated at random to re-
ceive either a single size permethrin-impregnated bed net (PIB),
a non-impregnated bed net (NIB), or to a control group who used
either their own family size non-impregnated bed net (FNIB) or
no net. Although the overall effect of bed nets on patent para-
sitaemia was marginal, they were associated with a significant
reduction in maternal malaria-associated anaemia.(Shows that re-
duction in parasite load, even if not perfect, has big impact on
morbidity and mortality).

4. “Impact of permethrin-treated bed nets on the incidence of
sick child visits to peripheral health facilites". PENELOPE A.
PHILLIPS-HOWARD, BERNARD L. NAHLEN, KATHLEEN A. WANNEMUEHLER,
MARGARETTE S. KOLCZAK, FEIKO O. TER KUILE, JOHN E. GIMNIG, KRIS
OLSON, JANE A. ALAII, AMOS ODHACHA, JOHN M. VULULE, AND WILLIAM
A. HAWLEY;

ABSTRACT
During a randomized controlled trial of insecticide (perme-
thrin)-treated bed nets (ITNs) in an area with intense malaria
transmission in western Kenya, we monitored 20,915 sick child
visits (SCVs) by children less than five years of age visiting
seven peripheral health facilities. The SCVs were monitored over
a four-year period both before (1995­1996) and during the inter-
vention (1997­1998). Results are used to estimate the effect of
ITNs on the burden of malaria in this community and to evaluate
the potential role of these facilities in assessment of the im-
pact of large-scale public health interventions. Compared with
baseline, a 27% greater reduction in the incidence of SCVs was
seen in ITN villages than in control villages (37% versus 10%; P
= 0.049). A similar reduction was observed in SCVs diagnosed as
malaria (35% reduction in ITN villages versus 5% reduction in
controls; P = 0.04).

5. “Effect of permethrin-treated bed nets on the spatial distri-
bution of malaria vectors in western Kenya.” Gimnig JE, Kolczak
MS, Hightower AW, Vulule JM, Schoute E, Kamau L, Phillips-Howard
PA, ter Kuile FO, Nahlen BL, Hawley WA.; Am. J. Trop. Med. Hyg.,
68(4 suppl), 2003, pp. 115-120

ABSTRACT
The effect of insecticide (permethrin)-treated bed nets (ITNs)
on the spatial distribution of malaria vectors in neighboring
villages lacking ITNs was studied during a randomized controlled
trial of ITNs in western Kenya. Reduction in mosquito popula-
tions in villages lacking ITNs was most apparent in compounds
located within 600 meters of intervention villages. Sporozoite
infection rates decreased in control areas following the intro-
duction of ITNs (P < 0.001 for both species), but no spatial as-
sociation was detected between sporozoite rates and distance to
nearest intervention village. We conclude that high coverage of
ITNs is associated with a community-wide suppression of mosquito
populations that is detectable in neighboring villages lacking
ITNs, thereby affording individuals residing in these villages
some protection against malaria.

6. Nevill CG, Some ES, Mung’ala VO, Mutemi W, New L, Marsh K,
Lengeler C, Snow RW, 1996. Insecticide-treated bednets reduce
mortality and severe morbidity from malaria among children on
the Kenyan coast. Trop Med Int Health 1: 139­146.

7. Habluetzel A, Cuzin N, Diallo DA, Nebie I, Belem S, Cousens
SN, Esposito F, 1999. Insecticide-treated curtains reduce the
prevalence and intensity of malaria infection in Burkina Faso.
Trop Med Int Health 4: 557­564

8. Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vu-
lule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS,
Hightower AW, 2003. Community-wide effects of permethrin-treated
bed nets on child mortality and malaria morbidity in western
Kenya. Am J Trop Med Hyg 68(Suppl 4): 121­127.

9. ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA,
Mirel LB, Hawley WA, Friedman JF, Shi YP, Kolczak MS, Lal AA,
Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed
nets on malaria, anemia and growth in infants in an area of in-
tense perennial malaria transmission in western Kenya. Am J Trop
Med Hyg 68(Suppl 4): 68­77

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Pesticide use for Malaria Control in Africa (18)
------------------------------------------------

Craig,

Though I do not second many of your ideas or words, I must con-
gratulate you for your boldness to express what many know is the
truth and do not express:

"Because every time industry tries to invest in Africa he has to
bribe so many people that it is no longer viable. Even if they
go ahead and build, it is one thing after another to fleece the
industry out of its money till they leave. Until Africa gets
leadership that truly cares about its people nothing will
change. American and European tax monies will be poured down a
rat hole and the poor will continue to die from diseases that
have been put on the insignificant list in places that have a
responsible government to its citizenry."

"Clean up the disease and industry will follow close behind.
Business people like a friendly environment where they can get a
quality and healthy workforce. Prosperity lurks around the cor-
ner of those that realize these simple points."

I would suggest USA or Canada or Europe refrain from funding Af-
rica or Asia. Then they will come to terms with whatever they
have and prosperity will prevail in the end. In the process,
many millions may die; even otherwise they are dying, thanks to
their own leaders, bureaucrats and businessmen greed!!

But Craig, for sure USA or Europe has many hidden agenda to fund
Africa or Asia. I recollect, no sooner Bangladesh discovered
gas, the President of America, for the first time in history,
visited Bangladesh, breaking a visit to India. Is not for self-
ish ends?!!

I am with you if you say, get away from hypocrisy and let trans-
parency and accountability rule the world. Let there be fair
play and justice. Let not anyone act superior to anyone else, as
all are equal. It's just that some have been privileged to be
born in a society, which has got an edge over others, looting
and plundering the wealth of other nations. But it may not be
too long, before the fortunes are turned around.

If I have my way, I can show a prosperous Asia or Africa and a
poor USA or Europe!! You have already invited doom, by trying to
become the BIG POLICEMAN for the world. At what cost is what
your own countrymen are asking which your Governments are not
able to answer. Unfortunately the whole world is paying the
price. Pride goes before a fall. I saw it happen with my own
eyes for the late Enron, and now New Orleans!! This is the price
for all the atrocities and rape in Afghanistan or Iraq. Where
has all the humility, culture, ethics and leadership of USA or
Europe gone?

Kris Dev
mailto:krisdev@gmail.com

17

Pesticide use for Malaria Control in Africa (19)
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Tom,

First, insecticides used for mosquito control are applied by air
at rates that won't exceed 1 ounce per acre, in many cases as
little as 1/2 ounce per acre, of total spray. The most common
insecticides used are pyrethroids and naled. IRS will apply sig-
nificantly more inside houses (where people live). Thus the ex-
posure by bednets and IRS is at least as great as that from ae-
rial applications or ground fogging.

I have seen all these stats before.

I'm still waiting to hear about somewhere on Earth that has
eradicated malaria without the methods we are recommending.

Bill Nesler
mailto:sdbc@hur.midco.net

18

Pesticide use for Malaria Control in Africa (20)
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Craig,

Thanks for your free and frank opinions.

I don't hate America. I love America and Americans. What I hate
is hypocrisy and double standards. Why and how major contracts
to Halliburton only in Iraq? How come ton loads of currency are
distributed with no accountability? How come civilians and women
are raped and killed just for the pleasure of a few?

At whose cost is an aggression being raged? The tax payers of
the world!! Why is America and Europe adopting double standards?
See Haiti as an example!!

If you agree to total transparency and accountability, then I am
with you in the process of transformation. Let every nation
throw open its hidden agenda, so that there can be no secrecy!!

Africa has to repay a debt many times the loan it took, mainly
to buy American and European products and surely a major chunk
would have been stashed away by their leaders in US and Swiss
banks!!

Do we want to see a transformed society? Are you with me? If not
terrorism would spread like wildfire and no amount of interna-
tional and national security can keep the world safe!!

Kris Dev
Masilto:krisdev@gmail.com

19

Pesticide use for Malaria Control in Africa (21)
------------------------------------------------

Craig and Peter,

An article and excerpts, I thought may interest you both.

Kris Dev
mailto:krisdev@gmail.com

IMF Policies Thwart Poverty Goals - Report

By Jim Lobe

* WASHINGTON, Sep 19 (IPS) - If U.S. President George W. Bush is
serious about his enthusiastic embrace last week at the United
Nations of democracy and the Millennium Development Goals (MDGs)
to slash global poverty, he will press his treasury secretary
and other members of the governing board of the International
Monetary Fund (IMF) meeting here this week to stop imposing
strict spending limits on poor-country governments.

Meanwhile, the fact that the elected governments were effec-
tively boxed in by the IMF is doing nothing to promote confi-
dence in democratic institutions throughout the developing
world, according to the AAI.

"What this all comes down to is that the IMF acts like a school
bully, taking power away from publicly elected officials, par-
ticularly in the poorest and weakest countries," said David
Archer, the group's director for education. "This is not a rec-
ipe for working democracy; instead, it could spell democracy's
death knell." (END/2005).

http://www.ipsnews.net/news.asp?idnews=30338

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Pesticide use for Malaria Control in Africa (22)
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Craig,

Some more, but will be the last from me:

Indebted Countries Await Word on G8 Pledge
Shirin

* WASHINGTON, Sep 19 (IPS) - When the world's finance ministers
converge on Washington for the annual meetings of the World Bank
and the International Monetary Fund (IMF) this week, they will
determine the fate of an unprecedented proposal set forth by the
richest countries of the world regarding their relationship with
the poorest.

While the Bank and IMF prepare for their annual meetings, thou-
sands across the country and around the world are planning to
demonstrate their support of 100 percent debt cancellation in
Washington on Sep. 24. This will be one of the many messages on
display in the civil society march against the Iraq war and what
activists term the "economic war" against the poor of the world.

Ann-Louise Colgan of Africa Action, a Washington-based group,
says, "We know that even the limited G8 proposal on debt relief
faces challenges ahead of next week's meetings, but the eyes of
the world are on the World Bank and IMF, and campaigners
throughout the Global South and across this country will not al-
low the world's rich countries to backtrack on their commit-
ment." (END/2005)

http://www.ipsnews.net/news.asp?idnews=30334