[afro-nets] The World Bank Becomes Interested in Malaria Control (3)

The World Bank Becomes Interested in Malaria Control (3)
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Bill,

You don't have to be cynical about the bednet. No one has said
that it is a miracle! At least at the personal level, it is a
last line of defense and there is undisputable evidence that it
reduces the burden of malaria. Can you tell us what our options
are? Certainly not the "Zanzibar" type mass spraying about which
we were all well educated last week! Please, let us offer op-
tions that are evidence-based and cost-effective!

Dr. J. Williams
mailto:JWILLIAMS@navrongo.mimcom.net

The World Bank Becomes Interested in Malaria Control (4)
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Dr. Williams,

The options are well known in the mosquito/malaria control busi-
ness. Take a look at the eradication of malaria in Florida,
California, Darwin, Australia, etc. Not one of these places used
bednets. All of them used, and still use, what you call mass
spraying. Probably the reason the Zanzibar project failed was
the lack of follow-up and a sustained program. This type work
can be done for about the same cost, or less, than supplying
everyone with a bednet. Most of this type work can be done for
less than $1.00 per acre per application. In a densely populated
city that is far less than the cost of bednets, and far more ef-
fective.

At one time (60-65 years ago) over 1/2 of all school children in
the northern central valley of California tested positive for
malaria. Today it is virtually unheard of. If we want consis-
tency in our policies why are bednets not recommended when there
is an outbreak of malaria in these locations? It seems to me
that freedom from a preventable disease falls under the heading
of human rights. As such, this issue should be addressed by the
most efficient means at our disposal, not the band-aid approach
of bednets.

Bill Nesler
mailto:sdbc@hur.midco.net

The World Bank Becomes Interested in Malaria Control (7)
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Dear Bill,

While I tend to agree with you, I would like to know, if there
can be a better local alternative for eradication of malaria
such as local herbs, local pesticides, etc., which would be
harmless to humans and yet eradicate mosquitoes?

Kris Dev
mailto:krisdev@gmail.com

The World Bank Becomes Interested in Malaria Control (8)
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Dear Kris Dev,

Indeed, I agree and believe that better local alternatives may
help in eradication of Malaria.

Here we need a collective effort if we will succeed in this Ma-
laria eradication. I want to call on environment people to re-
search on the local residential areas where people live and ei-
ther knowingly or unknowingly provide very conducive breeding
situations for the mosquitoes.

Example, in many residential areas where only a few lucky people
have water supplies, the majority who don't have "need water".
Water is a basic need for everybody; we will do anything to get
water in order to carry on with life. For friends who have no
water supply will cut water pipes everywhere where there is a
supply so as to have water for their domestic use! After this
the pipes are left to pour on streets and make many pools of wa-
ter where mosquitoes can breed and build up their own strong
army that "fast fast" go around spreading malaria to us. In the-
se same pools other people wash themselves and also animals
drink from same water which is quite unsafe for human consump-
tion! At the end of the day, we get not only malarial infection
but many other infections equally harmful to our health.

I want to suggest as follows:
- Could those concerned for safe environment survey into such
situations and find solutions? It is not easy for just anybody
to report on environmental situations where health is endangered
- one thinks about the troubles she/he will get by trying to re-
port certain situations where you need to go and prove before
courts etc.

To cut the long story short:
Will the environmental bodies, water supply, politic figures,
law makers, and others try collectively to explore possible
means of limiting breeding of mosquitoes etc.? In every residen-
tial area there should be a public water supply where everybody
can get supplied. Here we will control or stop many water pools
where water collects and allow for mosquito breeding! Health
education alone cannot promote good health; we need also the ba-
sic knowledge and means to survive wherever we live.

The funds donated by banks etc. could be used more construc-
tively to stop Malaria. To me it sounds quite unsatisfying when
we are helped to buy treated mosquito nets, sprays, but create
many places for mosquitoes to breed! We need to critically look
into many aspects in order to effectively eradicate malaria or
limit it.

Friends, please let us all do something concrete and permanent
if possible. It should be the responsibility of everybody to
fight against malaria disease but this needs well planned coor-
dination (net-working if I may put it this way).

Please come up with some more useful suggestions.

Lukesia Rugeiyamu
mailto:lukesiar@yahoo.com

The World Bank Becomes Interested in Malaria Control (9)
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Dear Kris,

It's interesting that you have mentioned the use of local
herbs/pesticides to stop malaria.

I do know that ICIPE (International Centre of Insect Physiology
and Ecology) based in Nairobi (Kenya) (http://www.icipe.org) has
been carrying out research on the NEEM tree which is reputed to
be quite effective against a variety of illnesses and vectors. I
do know that they are now in the process of researching and de-
veloping biopesticides derived from the NEEM tree for agricul-
tural use.

Of interest is their agreement with the Chinese Ministry of Sci-
ence and Technology to donate equipment to develop biopesticides
that specifically target malarial vectors.

Please visit:
http://www.icipe.org/news_and_events/pr004.html
http://www.taa.org.uk/EastAfricanBranch/BioProspecting.html

Patrick Mbindyo
mailto:pmbindyo@magricon.com

The World Bank Becomes Interested in Malaria Control (10)
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Hi All,

I followed avidly this debate on the malaria control in Africa
question. I have no doubt in my mind that to achieve malaria
control in the continent we need a combination of vector control
and personal protection. The personal protection part is where
ITNs come in. However, we know that mosquitoes bite mostly at
dusk in most parts of Africa. The million dollar question is,
where do you find the vulnerable population - under-fives and
pregnant women at dusk. The clear answer for those of us who
live right here, is outside there homes usually until 8-9 pm
unless it is raining or too cold. If we have limited resources
allocated to malaria control, then it has to be applied to the
control measure that will give maximum benefit and without been
too simplistic it would be to strike at the mosquito.

Paula Tavrow contributed the article on DDT resistance which was
very informative. But can people please tell me why there are
different standards for malaria control by continent? Why can't
measures that worked in the US, Australia, etc. be applied here?

In daily medical/paediatric practice we encounter drug resis-
tance with bacteria, malaria and have several superbugs and we
know that as long as organisms continue to be exposed to antim-
icrobials there will always be a few resistant bugs evolving.
The solution to possible wide-scale DDT resistance in Africa
should be taken care of like microbial resistance is handled
elsewhere. -- Use carefully, in a targeted fashion and avoid
abuse or unnecessary usage, use appropriate dosing or spraying
schedules.

Possible DDT resistance should not stop us from doing what is
right. Possible microbial resistance does not stop us from
treating people with infection. We just make sure we do it prop-
erly and avoid abuse.

I apologise for my very long winded and simplistic view.

Ifedayo Adetifa
mailto:ifedayo_tiffy@yahoo.com

The World Bank Becomes Interested in Malaria Control (13)
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Hi Ifedayo,

I think you were right on, no need to apologise. There is need
to combine methods at best. Indeed, what some of us were most
concerned about during the earlier debate (Mosquito/Malaria Con-
trol) was, why not promote use of DDT, or other spray/control
methods that were/are used successfully in the US, Italy, Aus-
tralia, etc. in the past or currently, also in Africa? We need
not invest wholly in bednets only. More research is also re-
quired alongside those efforts. In short, let us not apply dif-
ferent standards.

Thank you,

John Arube-Wani
mailto:arube@chdc-muk.com

The World Bank Becomes Interested in Malaria Control (11)
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Dear Patrick,

I understand Neem products are being patented by USA, whereas
they have no Neem trees!! So much for transparency and account-
ability!!!

Kris Dev
mailto:krisdev@gmail.com

The World Bank Becomes Interested in Malaria Control (12)
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I do know that ICIPE (International Centre of Insect Physiology
and Ecology) based in Nairobi (Kenya) (http://www.icipe.org) has
been carrying out research on the NEEM tree which is reputed to
be quite effective against a variety of illnesses and vectors.

I do understand that this was stopped a while back as some Afri-
can nations and India raised a storm over this. I wonder if the
same person is trying to do it again... Maybe we should re-read
John le Carre's Constant Gardener and wake up!

This also raises the nasty question of IPR in malaria (and other
diseases). African and Asian traditional medicine practitioners
do have a number of treatments for some of these diseases which
have been proven to be quite effective.

If they are not protected, why should they reveal their secrets?
Again, why aren't African nations militant on IPR the way west-
ern nations are?

Patrick Mbindyo
mailto:pmbindyo@magricon.com

The World Bank Becomes Interested in Malaria Control (13)
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Dear Patrick,

I see a few reasons:

1. The third world (Africa and Asia) are seen as inferior to the
first and second world!!

2. These third world depend on the dole of the first and second
world. They go with a begging bowl.

3. Most leaders of third world are corrupt and their loyalty can
be purchased for low sums by the first and second world, as they
have to continue in their posts, through elections or rigging,
etc., aided by the first and second world.

Unless the developing nations become independent like China and
learn to stand on its own feet without any doles, there cannot
be any equality of opportunity for the third world. They would
not be respected by other nations.

What do you think?

Kris Dev
mailto:krisdev@gmail.com

The World Bank Becomes Interested in Malaria Control (15)
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I agree with you, but see the need to go further to examine the
following issues:

(a) Africa was underdeveloped by the west (colonialism) and is
yet to come to terms with this. I do not see merit in asking the
west to recompense Africa for what was done during that time.
The division of Africa into French, British, German, Belgian
etc. zones still affects us - we do not see each other as sail-
ors in the same ship, needing to work together to grow. We are
independent, sovereign... and broke; subject to coups, corrup-
tion, dumping of illegal goods, traffic of persons, authoritar-
ian rule, genocide, TB, malaria, HIV/AIDS, and others.

(b) Africa has agreed to be colonialised even after independence
(neo-colonialism). This is where elites, sometimes in associat-
ing with the west, in the newly independent countries took up
the former "white" jobs, residences, hospitals, schools, etc.
and created divisions based on "class" (see Colin Leys, Underde-
velopment in Kenya, the Political Economy of Neo-Colonialism,
1964-1971, Heinemann Educational Books, London, 1975). Their po-
litical economy dictates that access to good schools, hospitals,
etc. be based on one's closeness to the ruling elite or politi-
cal currency (in terms of votes), and not the ability to con-
tribute to national GDP.

Additionally, the help received in terms of foreign aid is tied
to conditions that have generally done more harm than good in
terms of locking the recipient country to the donor. Sometimes,
the aid given requires the recipient country to buy services or
goods from the donor which may be more expensive than if sourced
from other countries. This has created a donor dependency / pro-
ject syndrome that is yet to be done away with by most African
nations.

(c) In relation to (a) above, initiatives to break the cycles
that lock Africa into the same meaningless cycles do not seem to
have currency. See for example the OAU, break up of the EAC, and
other regional imbalances.

We now have NEPAD and the African Union. We also have the New
Sudan. Somalia is getting back on track. These efforts need to
be strengthened.

(d) The west also suffers from a perspective of Africa that may
not be right, for example focussing on Africa only when disas-
ters happen. In spite of having diseases, poor infrastructure
etc., Africa still boasts some of the world's best tourist des-
tinations, heritage sites, and economic potential. For example:
if proper commercial farming was to be done, Mozambique need not
suffer famine. If her hydroelectric potential was to be fully
developed, East and Central Africa would have power for decades
to come. Take the case of Southern Sudan - her oil can meet the
needs of some of East and Central Africa's oil needs.

It is my contention that we are in a situation that we did not
create. Additionally, there are cases where we are the cause of
our problems. We have not solved these problems and continue to
perpetuate them.

It is my contention that Africa can do what China or any other
Asian Tigers have done. We have the technological expertise and
resources do this. We also have an enormous market for the goods
and services we shall produce.

It is my contention that we need not suffer from diseases that
we are able to control.

The question to me and my fellow Africans is what do we do from
here?

Patrick Mbindyo
mailto:pmbindyo@magricon.com

The World Bank Becomes Interested in Malaria Control (16)
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I agree with you. Africa is still a slave, a slave to the
DOLLAR...

Africa needs to put its heads together and deal with this Ma-
laria problem.

Linda Masm
mailto:masm@malawi.net

The World Bank Becomes Interested in Malaria Control (17)
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Dear Linda,

One sure way to do is to ban currency circulation, to minimise /
eliminate corruption. All transactions must be made transparent
through genuine bank accounts of individuals and organizations.
Thus any payment can be traced to its origin.

You will be surprised, when you realise, there is money for
every thing and a surplus too!! That speaks the level of present
corruption!!

Do you all agree?

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