Got questions about ObamaCare? Check out this site

June 24, 2013

I get e-mail; this one may prove useful to more than a few people, especially anyone who owns a small business and has questions about how ObamaCare — the Affordable Care Act — will affect your taxes, your hiring, your expenses, etc.:

The White House, Washington

Hi, all –

In fewer than 100 days, the new health care reform law takes an important step forward. On October 1, 2013, Health Insurance Marketplaces will open in every state, and millions of Americans will be eligible to apply for coverage. Between now and then, we’re sure that lots of people will be looking for information about the upcoming changes.

That’s why we revamped HealthCare.gov.

On the updated site, you’ll be able to get a personalized list of coverage options, tailored to your situation, and a checklist to help prepare for October 1. You’ll find a rich set of answers to frequently asked questions, powerful search features to help you find the specific information you need, and two great ways to talk to customer service representatives, 24/7: a new 1-800 number (1-800-318-2596) and online chat.

When open enrollment starts on October 1, 2013, you’ll be able to use the site to compare various health care plans side by side to find a plan that fits your life and your budget. You’ll even be able to use HealthCare.gov to apply for coverage or be directed to your own state’s application portal.

We hope you’ll use the site to get answers to your questions about the health care law — and forward this email to your friends so they can do the same.

Thanks!

Tara

Tara McGuinness
Senior Communications Advisor
The White House

P.S. — Have questions about what else you can expect from health care reform? Click here for a timeline of the key features of the Affordable Care Act.

Visit WhiteHouse.gov

[My e-mail address cut out ]

The White House • 1600 Pennsylvania Ave NW • Washington, DC 20500 • 202-456-1111

Several people I’ve run into have questions about the program — some of the questions are serious, and difficult for me to answer, and some are silly (“Why do I have to give up my insurance now?” Answer:  You don’t.)  There’s a great need for answers.  Distortions of the plan from the nasty political fights involved, have taken hold in the mind of many as representations of what the plan weill do.

Go try the site.  Does it answer your questions?  What questions do you have that are not answered by this site?

More:

Screenshot of HealthCare.gov. Click to visit the site.

Screenshot of HealthCare.gov. Click to visit the site.


Resources for World Malaria Day 2013

April 25, 2013

Not a word about condemning Rachel Carson.  No plea to use DDT to try to poison Africa or Asia to health.  That’s a great start.

More:

Mother and son under a protective bednet, the most efficient method to prevent malaria.  Columbia University MVSim image

Mother and son under a protective bednet, the most efficient method to prevent malaria. Columbia University MVSim image


April 25 is World Malaria Day — right, Bill?

April 24, 2013

He’s absolutely right.

English: World Malaria Day Button (english)

English: World Malaria Day Button (english) (Photo credit: Wikipedia)

What are you doing to fight malaria today?

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National Infant Immunization Week, April 20-27, 2013

April 23, 2013

National Infant Immunization Week:  Find out about the power to protect with immunizations on http://www.vaccines.gov/

This week is National Infant Immunization Week designated by the U.S. Centers for Disease Control (CDC).  Vaccinations worked miracles in extending human lifespans, and in making childhood much safer from disease, for those children who get vaccinated.

Information following comes directly from the CDC:

Protect Your Baby with Immunization

Photo: A mother and childImmunization is one of the best ways parents can protect their infants from 14 serious childhood diseases before age two. Check to see if your baby is up to date on immunizations.

It is important for children to be fully immunized. Diseases that can be prevented with vaccines can be very serious – even deadly – especially for infants and young children. For example, children younger than 2 years old are at the highest risk for serious pneumococcal disease like pneumonia, blood infection (sepsis), and meningitis. Before the pneumococcal vaccine was used routinely, an estimated 17,000 cases of severe types of pneumococcal infection, like meningitis, occurred each year.

Immunization. Power to Protect.

Immunizations have helped to greatly improve the health of children in the United States. Most parents today have never seen first-hand the devastating consequences that vaccine-preventable diseases have on a family or community. While most of these diseases are not common in the United States, they persist around the world. It is important that we continue to protect our children with vaccines because outbreaks of vaccine-preventable diseases can and do occasionally occur in this country.

For example, in 2010, there were 27,550 people reported to have “whooping cough” (pertussis) in the United States. Twenty-seven deaths were reported – 25 of these were in children younger than 1 year old. In 2011, 222 people were reported to have measles in the United States – that’s more than any year since 1996. Measles is brought into the United States by unvaccinated U.S. residents and foreign visitors who get infected when they are in other countries. Measles is still common in many parts of the world, including Europe, Asia, the Pacific, and Africa. In fact, in France alone, more than 15,000 people were reported to have measles in 2011. Measles spreads easily, and it can be serious, causing hospitalization and even death. Young children are at highest risk for serious complications from measles.

Vaccinating your baby according to the recommended immunization schedule gives him or her the best protection against 14 serious childhood illnesses – like measles and whooping cough – before he is two years old. The recommended schedule is designed to protect infants and children early in life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases.

Vaccine Information for ParentsVisit CDC’s vaccine website for parents.

The Diseases Vaccines Prevent

The recommended immunization schedule for babies includes vaccination protection against all of the following diseases:

Vaccinate On Time, Every Time

Even though the United States experiences outbreaks of some vaccine-preventable diseases, the spread of disease usually slows or stops because of immunization. If we stopped vaccinating, even the few cases we have in this country could very quickly become tens or hundreds of thousands of cases. Fortunately, most parents choose to vaccinate their children and immunization rates in this country are at or near record high levels. In fact, less than 1% of children do not receive any vaccines. However, some children have not received all of their vaccines and therefore are not fully immunized. It’s important that children receive all doses of the vaccines according to the recommended immunization schedule. Not receiving all doses of a vaccine leaves a child vulnerable to catching serious diseases.

That’s why it’s important to make sure that your child is up to date on his or her immunizations. Call your pediatrician to find out if your child is due for any vaccinations. Or, you can use this online tool to enter your child’s current record and quickly see if any doses have been skipped or missed. It is important to your child’s health to be up to date on immunizations.

Paying for Immunization

Photo: A babyMost health insurance plans cover the cost of vaccinations, but you should check with your insurance provider before going to the doctor. If you don’t have health insurance, or if your insurance does not cover vaccinations, the Vaccines for Children (VFC) program may be able to help with the cost.

The VFC program helps families of eligible children who might not otherwise have access to immunization. The program provides vaccinations at no cost. Children younger than 19 years of age are eligible for VFC vaccines if they are:

  • Medicaid-eligible
  • Uninsured
  • American Indian or Alaska Native,
  • Underinsured and vaccinated in Federally Qualified Health Centers or Rural Health Clinics.

Parents of uninsured or underinsured children who receive vaccines at no cost through the VFC Program should check with their health care providers about possible administration fees that might apply. These fees help providers cover the costs of giving the vaccines, including storing the vaccines and paying staff members to give vaccines to patients. However, VFC vaccines cannot be denied to an eligible child if a family can’t afford the fee.

Have Questions about Immunization?

  • Talk with your child’s health care professional, contact your local or state health department, or call the CDC at 800-CDC-INFO (800-232-4636).
  • Visit CDC’s vaccine website for parents

More Information

CDC works 24/7 saving lives and protecting people from health threats to have a more secure nation. A US federal agency, CDC helps make the healthy choice the easy choice by putting science and prevention into action. CDC works to help people live longer, healthier and more productive lives.

Last syndicated: April 19, 2013
This content is brought to you by: Centers for Disease Control and Prevention (CDC)

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Obamacare: Still the better way, still saving money, still a good deal

January 20, 2013

A guy named William Duncan at a blog called Sensible Thoughts posted something I found inherently unsensible a while back.  He listed six reasons why he thought the Affordable Care Act should be repealed. (“A while?” “Yeah, July 2012 is ‘a while.’”)

His sixth point was the old canard about Congress and the President being exempt.  Of course they are not exempt, and so I told him.

Your sixth reason is in error. There is no provision to exempt either the president or Congress from the act. There is no language in the bill such as you describe. Language from page 114 can be found here:

http://timpanogos.wordpress.com/2012/04/17/obamacare-making-stuff-up-to-complain-about/

At some length, Mr. Duncan removed that point, but said he still thinks the law should be repealed on the other five points I hadn’t dealt with.

Ed:
Thank you for the correction on point #6. I have gone back and looked at this, and you are absolutely right. Although the Wall Street Journal and folks like Sean Hannity reported that the President and members of Congress are exempt from participation in the Affordable Care Act, in the end that did NOT make it into the language of the legislation. I have deleted point #6 from the post as a result. Thank you for the correction. Now, if you copuld only prove me wrong on the rest of the points listed…. Unfortunately, this remains a bill the the American public did not want, and was purchased by shenanigans that the Administration should be ashamed of.

A quick and dirty response; we may need to put more meat on these response bones in the next couple of months, because the opposition to ObamaCare relies on severely distorted claims about the law and what it actually does.  Much if not most of the good stuff in the law is completely ignored by these critics, and we should point that out, too.

I responded (images added here):

Disproof?

What makes you think Americans didn’t want it? There was a whale of an anti-health care campaign after the act passed, but when it passed, it enjoyed a majority of support. And, when we take each provision of the bill and ask people about that provision, they approve overwhelmingly.

English: Depiction of the House vote on H.R. 3...

Depiction of the House vote on H.R. 3590 (the Patient Protection and Affordable Care Act) on March 21, 2010, by congressional district. Democratic yea, dark blue; Democratic nay, light blue; Republican nay, red; No representative seated, white. Image from Wikipedia

For example, not even you are opposed to continuing the Reagan-era program that encourages medical schools to train more general practitioners. No one seriously objects to the provisions that pay physicians to practice in under-served areas, like West Texas, Iowa, and West Virginia. No one objects to the provisions that train more nurses. Only the most rabid racists complain about continuing and expanding the health care clinics on Indian reservations.

The law has dozens of provisions like those, and no one in their right mind objects to them.

Your other five points?

  1. The Supreme Court killed that one for you. They said that, even if you call it a fine, it’s a tax. And at that, it’s a helluva bargain. For those who do not purchase health insurance because they can’t afford to, they must pay $695 additional tax, per year. That’s about what I’d pay monthly on the open market.In any case, there are no fines, according to the Supreme Court.
    English: Depiction of the Senate vote on H.R. ...

    Depiction of the Senate vote on H.R. 3590 (the Patient Protection and Affordable Care Act) on December 24, 2009, by state. Color code is difficult to decipher; let it suffice that if there are two Democratic yea votes, the state is colored deep blue; if two Republican nay votes, very red. Image from Wikipedia

    But I can’t imagine why you oppose bargains in health care, especially when they lower the costs of health care to the insured, who will no longer pay the 15% to 25% premium to cover indigent care.

  2. With all the “new taxes,” CBO, the non-partisan group that scores these issues for Congress, projects the bill will decrease federal spending and cut the deficits annually, when fully enacted in 2014 and all out years.Do you oppose deficits or not?All the other taxes are fair, strike only the tippy-top income tiers, and are cheap at that.These taxes make the system more fair. It’s stacked against anyone making less than $150,000 a year, now. That’s most of us. I don’t like it when government helps the rich, at the expense of the poor — that’s contrary to moral standards my church holds, for example, and it tends to damage the economy.So I think more fair taxes, and lower costs, will be quite popular, once we see them.So, new taxes aren’t a good justification to oppose the law.
  3. Speaking of fallacious accounting — CBO, the group you cite, says the bill will reduce the deficits. You assume the Law won’t work, while small portions of it have already slashed inflation in health care costs, from 20% in 2009 to 4% in 2011 and 2012.But, what about repeal? CBO looked at that, too — repeal of the law will increase deficits, not decrease them. It’s only $109 billion increase in deficits, but these number directly refute all claims that repeal would be cheaper. See the analysis gateway here: http://www.cbo.gov/publication/43471
  4. This Medicare issue was hashed out, accurately and well I thought, in the campaign. Medicare costs will be reduced by holding costs down — benefits will not be reduced. Eric Cantor and Paul Ryan ran into some difficulty with this, because their budget plans assumed the savings from the Affordable Care Act, while eliminating the law that produced the savings.I’m sure there will be some adjustments required. Medicare seems a little ham-fisted when it comes to dealing with local and regional cost differences, but nationwide, over the past 40 years, enormous savings have been realized by reducing some reimbursements for procedures that once were uncommon and expensive, to a less expensive rate, now that they are more common. On the whole, over 40 years, over thousands of procedures, physicians have changed their expectations, and things have worked fine. Oh, there have been grumblings, I know. But the cuts in costs, without cuts in benefits, have stuck.Under the Affordable Care Act, we hope a lot more people will move to company plans from Medicare, or at least to the exchange plans offered in each state.One of the changes already introduced is working [link added here]. Rather than pay providers for each procedure, Medicare now reimburses hospitals for effective hospitalization — that is, when a patient is discharged and then re-enters a hospital for the same complaint, the hospital will lose money. Hospitals are keeping patients a few days longer on many procedures, to insure that one hospitalization is all that is required. Savings are already being made in costs, while improvements have resulted in the health care – better health in the patients!In all, CBO says costs will come down with the Affordable Care Act, as advertised, and costs will rise and deficits will rise if the Act is repealed.
  5. Your abortion argument is too metaphysical, and not enough real-world. Do you want to reduce the number of abortions? Then provide health care, make sure contraception is freely available (not for free, but freely), and stand back. Those two things reduce abortions, as they did during the Clinton administration.Restrictions on abortion, on the other hand, make it more likely a woman will choose to terminate a pregnancy under a number of circumstances: She doesn’t have health care coverage, her coverage does not cover pre-natal care, her coverage won’t cover a new infant, the pregnancy is unplanned due to lack of good information on family planning or lack of access to affordable contraception.You can choose: Restrict abortions and increase the number of abortions, or provide health care, and reduce the number of abortions.It may be a bit counter-intuitive, but you’d better study the issue. The Affordable Care Act’s provisions, Obamacare, have over the years reduced abortions where applied; cutting off that care has increased the number of abortions.My advice would be, don’t kill the babies to make a political point.

I am concerned that you don’t appear much familiar with what the bill actually does. Here are a few reasons to keep the law.

  1. We need more physicians, and the bill provides them.
  2. We need more physicians in underserved areas, and the bill provides them.
  3. We need more nurses, and the bill provides them.
  4. We need more community clinics in underserved urban areas [link added here], where illnesses and injuries frequently go untreated until extreme trauma results, and the victim must get extremely expensive care in an emergency room. This will be one of the biggest cost savers — and the law provides those clinics.
  5. The law will cut the private bureaucracy, and completely dismantle the private death panels set up by insurance companies, saving at least 10% of every health care dollar, applying that money to care instead of bureaucracy. This is already occurring.
  6. Preventive care under the Act is greatly encouraged — if we can boost flu vaccines by another 10%, it will save thousands of lives annually, and millions of dollars in hospitalization costs. Flu shots came with no co-pay this year — did you notice? — so that anyone with any insurance at all could drop by any pharmacy offering flu shots and get one with no out-of-pocket expenses.
    This is huge. Everyone agrees the cheapest health care is for healthy people. The Affordable Care Act changes the way health care is delivered, to emphasize prevention of disease and injury, instead of triage. Prevention usually costs about 10% what the triage would cost.
  7. Removing the lifetime cap on insurance payments, per patient, will save a few thousands of lives, annually. It should kill the phenomenon where many families, hit with a costly disease or accident, had to declare bankruptcy as a result. A significant portion of all bankruptcies have been “not adequately-insured” cases. Those should almost disappear.
  8. Allowing children to stay insured, on a parent’s plan, for those critical years after high school and college and into the second job, with benefits has already benefited millions of Americans, saving millions of dollars and probably a few lives.

I cannot imagine why anyone would want to go back to 20% annual health care cost inflation, the highest per capita health care costs in the world by a factor of two, while leaving one out of every seven people uninsured even though we were paying amounts more than the insurance would have cost.

Obamacare reduces the deficits, and puts our health system on the path to catch up to the rest of the industrialized world, with better care for less cost.

I’ll keep it, thank you.

(See this, too: “More good news about Obamacare: CBO says it will save money”

More:


V for Vaccine: A slightly rude film with a powerful point

January 10, 2013

A couple of kids in the Dallas area have died already from influenza — neither had been vaccinated against it.  Deaths have occurred across the nation, frequently in young, otherwise healthy people.

Nasty flu bugs going around this year, and the every-year epidemic has hit about two months early.  One part of the good news is that the vaccines this year are especially well-suited to target the viruses that cause the trouble.  The vaccines work well every year, but especially well in 2012 and 2013.

The bad news is that millions of people haven’t bothered to get vaccinated. That’s not good.

  1. Under Obamacare, there’s no copay for insurance for a flu shot.  It’s “free” if you have any kind of insurance. In addition, county health offices offer the vaccines for free to any comers.  A couple of weeks ago at the pharmacy I stood behind a woman who confessed she’d not gotten a flu shot (pharmacies are pushing vaccinations these days, to promote their mini-clinics).  “I’ve got that crappy teachers’ insurance,” she told the technician.  “It never pays for anything like that.”  The tech looked it up, and told her that her copay was zero, and her insurance paid for it — essentially a free shot, to her.  On the way into the clinic she said, “I’ve never gotten a flu shot before.”  Oy.
  2. Think Herd Immunity:  Are you usually healthy?  Great.  But if you’re pregnant, or you work around people who are or may be pregnant, or if you’re over 60, or if you have any chronic condition like diabetes, high blood pressure, chronic sinusitis, or a raft of other things, you’re at risk, and you put others in those risk categories at risk.  My grandfather worked at a hospital while my mother and my oldest brother were living with him; after a week of my grandfather’s working in the polio ward, my brother came down with the disease.  Of course we don’t know for sure, but my grandfather kicked himself for 40 years, until his death, because he thought he’d brought home the disease my brother caught.  With vaccines, those incidents become much more rare.

Risking this blog’s G rating, I’m going to post this film, “V for Vaccine.”  Found it at New Anthropocene.  Turn up your offense filter, or ignore the language — but pay attention to what this guy says, PowerM1985:

Is it worth getting your children vaccinated if it risked them becoming autistic? In this video I give a short demonstration of why I personally believe that even if there was a risk of my child becoming autistic (AND THERE IS NOT!) I would still get them vaccinated.

You should probably know that the work of the Centers for Disease Control to correctly predict which strains of the viruses will be most prevalent, and get vaccines that will fight those viruses, has been very, very good this year.

  • Influenza A (H3N2), 2009 influenza A (H1N1), and influenza B viruses have all been identified in the U.S. this season. During the week of December 23-29, 2,346 of the 2,961 influenza positive tests reported to CDC were influenza A and 615 were influenza B viruses. Of the 1,234 influenza A viruses that were subtyped, 98% were H3 viruses and 2% were 2009 H1N1 viruses.
  • Since October 1, 2012, CDC has antigenically characterized 413 influenza viruses, including 17 2009 influenza A (H1N1) viruses, 281 influenza A (H3N2) viruses and 115 influenza B viruses.
    • All 17 of the 2009 influenza A (H1N1) viruses were characterized as A/California/7/2009-like. This is the influenza A (H1N1) component of the Northern Hemisphere vaccine for the 2012-2013 season.
    • Of the 281 influenza A (H3N2) viruses, 279 (99%) were characterized as A/Victoria/361/2011-like. This is the influenza A (H3N2) component of the Northern Hemisphere influenza vaccine for the 2012-2013 season.
    • Approximately 69% of the 115 influenza B viruses belonged to the B/Yamagata lineage of viruses, and were characterized as B/Wisconsin/1/2010-like, the influenza B component for the 2012-2013 Northern Hemisphere influenza vaccine. The remaining 31% of the tested influenza B viruses belonged to the B/Victoria lineage of viruses.

What are you waiting for?  Go get a flu shot!

More:

English: This is CDC Clinic Chief Nurse Lee An...

This is CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. (Photo credit: Wikipedia)

Graphic on influenza, 2013 - Flu.gov

Information from Flu.gov; click image to get to active Flu Vaccine Finder


World Malaria Report 2012: Malaria still declining, but more resources needed fast

January 4, 2013

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.

Malaria room

African bedroom equipped with LLINs (insecticidal bednets) Photo: YoHandy/Flickr

UN’s World Health Organization (WHO) published its annual report on the fight against malaria last month, December 2012.  Accompanying the many page World Malaria Report 2012  were a press release and a FAQ; the fact-sheet appears unedited below.

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.

Logo for World Health Organization

17 December 2012

World Malaria Report 2012

FACT SHEET

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.

www.who.int/malaria

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.

More, and related articles:


More good news about Obamacare: No pre-existing conditions clause

May 31, 2012

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Is the anti-vaccine movement dangerous?

April 24, 2012

I get e-mail from Bob Park, the physicist curmudgeon/philosopher at the University of Maryland (I’ve added links):

Robert L. Park

Robert L. Park (Photo credit: Wikipedia)

“DEADLY CHOICES”: PAUL OFFIT EXPOSES THE ANTI-VACCINE MOVEMENT.

There was never a time before people knew that falling trees and large animals with teeth can kill.  Microbes are another matter. They had been killing us for perhaps 200,000 years before Antonie van Leeuwenhoek showed them to us. Paul Offit and two colleagues worked for 25 years to develop a vaccine for the rotavirus, a cause of gastroenteritis that kills as many as 600,000 children a year worldwide, mostly in underdeveloped countries.  The vaccine is credited with saving hundreds of lives a day.  Offit wrote “Autism’s False Prophets” in 2008 exposing British physician Andrew Wakefield for falsely claiming the MMR vaccineis linked to autism.

H. Fred Clark and Paul Offit, the inventors of...

H. Fred Clark and Paul Offit, the inventors of RotaTeq. (Photo credit: Wikipedia)

Vaccination prevents more suffering than any other branch of medicine, but is still opposed by the scientifically ignorant who accept the upside-down logic of the alternative medicine movement.  Because vaccination of schoolchildren against virulent childhood infections is ubiquitous, crackpots, scoundrels and gullible reporters get away with linking it to unrelated health problems as they did in the 1980s with the ubiquitous power lines.  We still hear echoes of the power-line scare in the cell phone/cancer panic. Paul Offit has just written “Deadly Choices: How The Anti-Vaccine Movement Threatens Us All.”  We need to do everything we can to stop it.

You don’t subscribe to Bob Park’s “What’s New?”  You should.

THE UNIVERSITY OF MARYLAND.
Opinions are the author’s and not necessarily shared by the
University of Maryland, but they should be.

Archives of What’s New can be found at http://www.bobpark.org
What’s New is moving to a different listserver and our subscription process has changed. To change your subscription status please visit this link:
http://listserv.umd.edu/cgi-bin/wa?SUBED1=bobparks-whatsnew&A=1

You’ll be smarter for reading his little missiles missives missiles.

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Measles cases reported in the United States be...


Good news about health care in the U.S.: The case for Obama’s health care reforms

March 7, 2012

Here’s a preview of another piece of television that many Republicans hope you will not bother to see, a piece that explains exactly how and why the health care reforms championed by President Obama will help you and millions of others:

Program: U.S. Health Care: The Good News

Episode: The Good News in American Medicine

Journalist T.R. Reid examines communities in America where top-notch medical care is available at reasonable costs and, in some instances, can be accessed by almost all residents. Included: Mesa County, Colo.; Seattle; Everest, Wash.; Hanover, N.H. In Mesa County, for instance, doctors, hospitals and insurers place an emphasis on prevention; and a program that offers pre-natal care to poor women has proved popular.

T. R. Reid’s report started airing on PBS stations in mid-February.  If you haven’t seen it, go to this site to view the entire production.

More, resources (suggested by PBS, mostly):


Fighting malaria with indoor use of insecticides, with USAID money

September 18, 2011

Short video demonstrating the Indoor Residual Spraying program in Mali, financed by funding from the U.S. Agency for International Development (USAID).  Note there is no ban on DDT, note that fighting malaria, even with poisons for mosquitoes, requires more than just spraying poison.

The video is in French.

539 views, September 18, 2011

DDT “costly for Uganda”

July 22, 2011

To aid researchers looking for news from Africa on malaria and DDT, I’ll reproduce the entire news story from Uganda’s New Vision here.  Stories from this outlet frequently trouble me, in the unquestioning way writers take quotes from people where a more probing reporter might be more skeptical.  I am not sure of the status of New Vision among Uganda’s media, but it’s one of the few available to us here on a regular basis.

So, here’s the story, on DDT usage to fight malaria.  A couple of points we need to remember:  First, it’s clear that DDT is not banned in Uganda, and that DDT usage goes on, despite the crocodile tears of Richard Tren, Roger Bate, and the Africa Fighting Malaria, Astroturf™ group; second, this story relates difficulties in using DDT, including cost.  It’s not that the stuff itself is expensive.  DDT doesn’t work on all mosquitoes anymore, and it’s dangerous to much other wildlife.  Malaria fighters must do serious work in advance to be sure the populations of mosquitoes targeted will be reduced by DDT — that is, that the bugs are not immune to DDT — and care must be taken to control the applications, to be sure it’s applied in great enough concentrations, and only indoors, where it won’t contaminate the wild.

Here’s the story from New Visions:

DDT spraying costly for Uganda

Tuesday, 5th July, 2011

By Raymond Baguma and Gerald Kawemba

INDOOR residual spraying as a strategy to control malaria in Uganda is too costly and has affected the programme countrywide.

According to Dr. Seraphine Adibaku, the head of the Malaria Control Programme, this is why other malaria control strategies such as use of insecticide-treated nets and Artemisinin-based combination therapy are considered to be ahead of indoor residual spraying.

The Government is implementing the indoor residual spraying using pyrethrum-based and carbon-based insecticides in 10 malaria-endemic districts in the northern and eastern regions.

They include Amolatar, Apac, Kitgum, Kumi and Bukedea.

“About three million people in the 10 districts have been covered. We have reached over 90% of the population,” Adibaku said.

She added that under the Presidential Malaria Initiative, the budget for indoor residual spraying is sh4.5b per district each year.

Adibaku said it would be much cheaper if the ministry distributed insecticide-treated mosquito nets.

She, however, said indoor spraying has an advantage of delivering immediate impact compared to treated nets.

Adibaku disclosed that the health ministry is re-evaluating the effectiveness of using DDT for malaria control.

Dr. Joaquim Saweka, the World Health Organisation (WHO) resident representative in Uganda, said indoor residual spraying is highly effective and has been successful in Zanzibar and Rwanda.

He, however, added that it is capital intensive and needs a lot of money for each application done twice a year.

Saweka cited his previous posting in Ghana during which a town of 300,000 inhabitants required $3m for spraying each year.

He said with the high cost of spraying and low financial resources available, Uganda needs to prioritise usage of insecticide-treated mosquito nets.

Saweka added that Uganda is on the right path to eradicating malaria with efforts in prevention, diagnosis and treatment as well as universal coverage of insecticide-treated nets.

Health minister Dr. Richard Nduhura yesterday kicked off a nationwide programme to distribute 11,000 bicycles to health volunteers who will diagnose and treat malaria in homes. The programme is supported by the Global Fund.

It is part of the Government’s home-based management of malaria, which is part of a larger national strategy to deliver treatment to children within 24 hours after diagnosis.

 


Hochul won Congressional seat in upstate New York

May 24, 2011

I get e-mail from Nancy Pelosi from time to time, like tonight:

Ed –

It is my great pleasure to report that tonight, thanks to you, Democrat Kathy Hochul has won a triumphant grassroots victory in the special election in NY-26.

Victories like this are what happen when we fight together to protect our core Democratic values.

Congresswoman-elect Hochul’s victory in a staunchly-Republican district has shocked the political world and sent an unmistakable sign that the American people will not stand for the Republicans’ reckless and extreme agenda to end Medicare.

This is our third straight special election victory in New York — and it is truly one for the ages. All of the Republicans’ right-wing outside groups with their secret money and dishonest attacks were no match for the combined strength of grassroots Democrats.

Thank you again for fighting to protect and defend Medicare and bringing us one step closer to regaining our Democratic House Majority.

Nancy Pelosi
Democratic Leader

Is there a lesson in the election?  Yes, there is:  Republicans overreached when they started their march against Medicare.

See the story in the New York Times:

Two months ago, the Democrat, Kathy Hochul, was considered an all-but-certain loser in the race against the Republican, Jane Corwin. But Ms. Hochul seized on the Republican’s embrace of the proposal from Representative Paul D. Ryan, Republican of Wisconsin, to overhaul Medicare, and she never let up.

On Tuesday, she captured 48 percent of the vote, to Ms. Corwin’s 42 percent, according to unofficial results. A Tea Party candidate, Jack Davis, had 8 percent.

Voters, who turned out in strikingly large numbers for a special election, said they trusted Ms. Hochul, the county clerk of Erie County, to protect Medicare.

Kathy Hochul on election night, May 24, 2011 - New York Times photo by Michael Appleton

Kathy Hochul claimed victory at an election party in Amherst, New York, on Tuesday night. Hochul won a seat in Congress in what has traditionally been a Republican district in New York. New York Times photo by Michael Appleton


Sowell wrong about DDT and Rachel Carson

May 16, 2011

Thomas Sowell bolloxed it up at National Review Online:

Who blames Rachel Carson, an environmentalist icon, because her crusading writings against DDT led to the ban of this insecticide in countries around the world — followed by a resurgence of malaria that killed, and continues to kill, millions of people in tropical Third World countries?

To which I responded:

Who blames Rachel Carson?

Only someone ignorant of malaria and DDT, or someone with a real political axe to grind.

Malaria did not “resurge” when DDT was banned on cotton crops in the U.S.  The U.S. ban did not extend to Africa, and DDT has never been banned in Africa nor most of Asia.

Malaria deaths have declined steadily over the past 50 years, generally as DDT use was reduced.  In 1959 and 1960, the peak years of DDT use, 4 million people died from malaria, worldwide.  WHO cut back on DDT use in 1965 when mosquitoes began showing serious resistance and immunity to the stuff, but by 1972, when the U.S. banned agricultural use of DDT (but continued exports), about 2 million people died annually from malaria.

Today, largely without DDT, malaria deaths are down to under 900,000 — a 75% reduction in deaths from peak DDT use.

Instead, since 2000 we’ve been using integrated vector management (IVM) to hold mosquito populations down, and we’ve been using improved medical care to treat humans who have malaria.  IVM and beefed up medical care was what Rachel Carson recommended in her book, <i>Silent Spring</i>, in 1962.

So, there is no cause-effect relationship between Ms. Carson and the U.S. ban on DDT, nor between that ban and malaria deaths.  In fact, there are fewer malaria deaths now than when DDT was used irresponsibly.

Carson was right.  It’s a good thing wise people listened to her.

More information?  See Millard Fillmore’s Bathtub:
http://timpanogos.wordpress.com/ddt-chronicles-at-millard-fillmores-bathtub/

Who knows what comments see the light of day over there?

How many times will conservative commentators of all stripes abuse the DDT/Rachel Carson story before they start getting it right?  How much does that skew their views from the accurate and wise view?


Heritage Foundation urges that Africa be poisoned

May 7, 2011

Oh, not outwardly anti-Africa, but stupidly so.

The extreme right-wing Heritage Foundation lashed out at health care workers and scientists fighting malaria in Africa and Asia for World Malaria Day, April 25 (HF’s post showed up on May 5).  If these malaria fighters really were smart, HF’s Jane Abel wrote, they’d just poison Africa with DDT instead of protecting children with bednets and working to improve medical care.  According to Abel, DDT is safe for everyone but mosquitoes, and more effective than anything else malaria fighters use — so they are stupid and venal, she asserts, for not using DDT.

Here’s her post:

Environmentalists celebrated World Malaria Day last week (and Earth Day the week prior). Meanwhile, thousands of African children died of malaria.

While these activists may make themselves feel like they’re saving the world, they are ignoring the best possible solution to Africa’s malaria problem: the use of DDT to wipe out the Anopheles mosquito.

Even though the World Health Organization resumed promotion of DDT in September 2006—realizing it had the best track record for saving the lives of 500 million African children—environmentalists are still emphasizing the use of bed nets instead. DDT treatments almost completely eradicated the disease in Europe and North America 50 years ago, but today an African child dies every 45 seconds of malaria.

Providing sub-Saharan Africans with bed nets has had far from acceptable success in delivering the amount of protection needed from mosquitoes. The World Bank touts the fact that 50 percent of children in Zambia are now sleeping under nets as a good thing, but what about the other half who are left defenseless against a killer disease? The Democratic Republic of the Congo had only 38 percent of children under nets in 2010.

One would question why, in the 21st century, people should have to live inside of a net in order to be safe from malaria. The world has a better solution, and it’s not the quarantine of African infants. Dr. John Rwakimari, as head of Uganda’s national malaria program, described DDT, which is nontoxic to humans, as “the answer to our problems.”

World Malaria Day 2011 had the theme of “Achieving Progress and Impact” and aims to have zero malaria deaths by 2015. If the world really wants to make progress and increase the number of lives saved from malaria, it needs to embrace for Africans the best possible technologies available today, and that means DDT.

Here’s my response, which I predict will not show up at HF’s blog in any form*:

DDT is toxic to humans — just not greatly and acutely so.  Ms. Abel should be aware of recent studies that indicate even limited, indoor use of DDT in the end produces a death toll similar to malaria.  But we digress on just one of the errors assumed by Ms. Abel.

If DDT could wipe out malaria-carrying mosquitoes, WHO would not have slowed or stopped its use in 1965, years before anyone thought about banning the stuff.  By 1965 it was clear that overuse of DDT in agriculture had bred mosquitoes that are resistant and even immune to DDTJonathan Weiner noted in his Pulitzer Prize-winning book, The Beak of the Finch, that today every mosquito on Earth carries at least a few copies of the alleles that allow mosquitoes to digest DDT as if it were a nutrient.

DDT cannot be a panacea for malaria.

Please do not forget that malaria is a parasite disease, and that mosquitoes are only the carriers of it.  To truly eradicate malaria, we need to cure the humans — and if we do that, the mosquitoes do not matter.  With no infected humans, mosquitoes have no well of disease to draw from.  Without infected humans, mosquitoes cannot spread malaria.

Only 38 percent of children in Congo sleep under bednets?  I’ll wager that’s twice the percentage of kids that were ever protected from malaria in Congo by DDT.  In actual tests in Africa over the past decade, bednets have proven to reduce malaria by 50 to 85 percent; DDT, on the other hand, reduces malaria only 25 to 50 percent under the best conditions.  If we have to go with one and not the other, bednets would be the better choice.  Nets are much, much cheaper than DDT, too.  DDT applications must be repeated every 6 months, at a cost of about $12 per application per house.  Nets cost about $10, and they last five years.  Nets protect kids for $2 a year, better than DDT; DDT protects kids for $24 a year (that’s 12 times the cost), but not as effectively as nets.

Also, it’s important to remember that DDT has never been banned in Africa.  DDT non-use is much more a result of the ineffectiveness of DDT in many applications — why should we expect Africans to throw away hard-earned money on a pesticide that doesn’t work?

Finally, it’s also good to understand that, largely without DDT, malaria deaths are, today, at the lowest point in human history.  Fewer than 900,000 people a year die from malaria today.  That’s 25% of the death toll in 1960, when DDT use was at its peak.

Ms. Abel assumes that all Africans are too stupid to use DDT, though it might save their children.  He states no reason for this assumption, but we should question it.  If Africans do not use DDT, it may well be because the local populations of mosquitoes are not susceptible; or it could be because other solutions, like bednets, are more effective, and cheaper.

Ms. Abel has not made a case that DDT is the best solution to use against malaria.  DDT cannot improve a nation’s medical care delivery systems, to quickly diagnose and appropriately treat malaria in humans.  DDT cannot make mosquitoes extinct, we know from 66 year of DDT use that mosquitoes always come roaring back.  DDT cannot prevent mosquitoes from spreading malaria as effectively as bednets.

Maybe, just maybe, as evidenced by the dramatic reductions in malaria deaths, we might assume that modern Africans and health care workers know what they’re doing fighting malaria — and they do not need, want, or call for, a lot more DDT than is currently in use.

It’s too bad Heritage Foundation fell victim to so much junk science, and that the otherwise august press release operation pushes the grand DDT hoaxes.  Just once, wouldn’t it be nice if these conservative echo chambers would, instead of recycling the old, wrong press releases of other conservatives, would do a little research on their own, and get the facts right?

_______________

*  It’ll be fun to watch.  I sent my response early, early in the morning while rushing to get a presentation ready, and I made a couple of egregious typos, including identifying Jonathan Weiner as “Stephen Weiner.”  If HF wished to embarrass me, they’d publish that one out of their moderation queue — but I’ll bet that even with my typos, they can’t allow the facts through.  Also, for reasons I can’t figure, some guy named Thurman showed as the author of HF’s piece on May 5.  So I had referred to Mr. Thurman instead of Ms. Abel.  Interesting technical glitch, or story, there.

_______________

Update, May 8:  As we should have expected, Steven Milloy’s Junk Science Side Bar also went on record as favoring the poisoning of Africa rather than the fighting of malaria.  Milloy makes claims that DDT will beat malaria (ostensibly before it kills all life in Africa), but his sources don’t support the claim.  Milloy is always very careful to never mention that, largely without DDT, the death toll from malaria is at the lowest point in human history.  Instead he notes that while malaria fighters promoted World Malaria Day, lots of African kids died of malaria.  That’s true, but misleading.  Because of the malaria-fighting efforts of those Milloy tries to impugn, far fewer African kids die.  Contrary to Milloy’s insane and offensive claims, it’s not alright that “only people” die.  Milloy asserts implicitly that, but for environmentalists, thousands or millions of children would survive that do not know.  That’s not true:  Because of the work that Milloy denigrates, millions fewer die.  It wasn’t environmentalists who overused DDT and rendered it ineffective in the fight against malaria, it was Milloy’s funders.  Follow the money.


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