World Malaria Report 2014: Dramatic progress (no call for DDT)

December 9, 2014

World Malaria Report 2014 dropped this week.  It’s the annual report from the World Health Organization (WHO) on the fight against malaria, the problems, critical needs — and this year, wonderful news of progress.

Cover of WHO's World Malaria Report 2014, a child, and the red blood cells the malaria parasites attack.

Cover of WHO’s World Malaria Report 2014, a child, and the red blood cells the malaria parasites attack.

Copies of the report in .pdf format come in English, French and Spanish.  A host of supplemental materials and statistical compilations accompany the report every year.

The World Malaria Report 2014 summarizes information received from malaria-endemic countries and other sources, and updates the analyses presented in the 2013 report.

It assesses global and regional malaria trends, highlights progress towards global targets, and describes opportunities and challenges in controlling and eliminating the disease. The report was launched in the United Kingdom Houses of Parliament on 9 December 2014.

The press release on the report, from WHO:

Scale-up in effective malaria control dramatically reduces deaths

News release

The number of people dying from malaria has fallen dramatically since 2000 and malaria cases are also steadily declining, according to the World malaria report 2014. Between 2000 and 2013, the malaria mortality rate decreased by 47% worldwide and by 54% in the WHO African Region – where about 90% of malaria deaths occur.

New analysis across sub-Saharan Africa reveals that despite a 43% population increase, fewer people are infected or carry asymptomatic malaria infections every year: the number of people infected fell from 173 million in 2000 to 128 million in 2013.

“We can win the fight against malaria,” says Dr Margaret Chan, Director-General, WHO. “We have the right tools and our defences are working. But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

Between 2000 and 2013, access to insecticide-treated bed nets increased substantially. In 2013, almost half of all people at risk of malaria in sub-Saharan Africa had access to an insecticide-treated net, a marked increase from just 3% in 2004. And this trend is set to continue, with a record 214 million bed nets scheduled for delivery to endemic countries in Africa by year-end.

Access to accurate malaria diagnostic testing and effective treatment has significantly improved worldwide. In 2013, the number of rapid diagnostic tests (RDTs) procured globally increased to 319 million, up from 46 million in 2008. Meanwhile, in 2013, 392 million courses of artemisinin-based combination therapies (ACTs), a key intervention to treat malaria, were procured, up from 11 million in 2005.

Moving towards elimination

Globally, an increasing number of countries are moving towards malaria elimination, and many regional groups are setting ambitious elimination targets, the most recent being a declaration at the East Asia Summit to eliminate malaria from the Asia-Pacific region by 2030.

In 2013, 2 countries reported zero indigenous cases for the first time (Azerbaijan and Sri Lanka), and 11 countries succeeded in maintaining zero cases (Argentina, Armenia, Egypt, Georgia, Iraq, Kyrgyzstan, Morocco, Oman, Paraguay, Uzbekistan and Turkmenistan). Another 4 countries reported fewer than 10 local cases annually (Algeria, Cabo Verde, Costa Rica and El Salvador).

Fragile gains

But significant challenges remain: “The next few years are going to be critical to show that we can maintain momentum and build on the gains,” notes Dr Pedro L Alonso, Director of WHO’s Global Malaria Programme.

In 2013, one third of households in areas with malaria transmission in sub-Saharan Africa did not have a single insecticide treated net. Indoor residual spraying, another key vector control intervention, has decreased in recent years, and insecticide resistance has been reported in 49 countries around the world.

Even though diagnostic testing and treatment have been strengthened, millions of people continue to lack access to these interventions. Progress has also been slow in scaling up preventive therapies for pregnant women, and in adopting recommended preventive therapies for children under 5 years of age and infants.

In addition, resistance to artemisinin has been detected in 5 countries of the Greater Mekong subregion and insufficient data on malaria transmission continues to hamper efforts to reduce the disease burden.

Dr Alonso believes, however, that with sufficient funding and commitment huge strides forward can still be made. “There are biological and technical challenges, but we are working with partners to be proactive in developing the right responses to these. There is a strong pipeline of innovative new products that will soon transform malaria control and elimination. We can go a lot further,” he says.

While funding to combat malaria has increased threefold since 2005, it is still only around half of the US$ 5.1 billion that is needed if global targets are to be achieved.

“Against a backdrop of continued insufficient funding the fight against malaria needs a renewed focus to ensure maximum value for money,” says Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “We must work together to strengthen country ownership, empower communities, increase efficiencies, and engage multiple sectors outside health. We need to explore ways to do things better at all levels.”

Ray Chambers, who has served as the UN Secretary-General’s Special Envoy for Malaria since 2007, highlights the remarkable progress made in recent years. “While staying focused on the work ahead, we should note that the number of children dying from malaria today is markedly less than 8 years ago. The world can expect even greater reductions in malaria cases and mortality by the end of 2015, but any death from malaria remains simply unacceptable,” he says.

Gains at risk in Ebola-affected countries

At particular risk is progress on malaria in countries affected by the Ebola virus. The outbreak in West Africa has had a devastating impact on malaria treatment and the roll-out of malaria interventions. In Guinea, Sierra Leone and Liberia, the 3 countries most severely affected by the epidemic, the majority of inpatient health facilities remain closed, while attendance at outpatient facilities is down to a small fraction of rates seen prior to the outbreak.

Given the intense malaria transmission in these 3 countries, which together saw an estimated 6.6 million malaria cases and 20 000 malaria deaths in 2013, WHO has issued new guidance on temporary measures to control the disease during the Ebola outbreak: to provide ACTs to all fever patients, even when they have not been tested for malaria, and to carry out mass anti-malaria drug administration with ACTs in areas that are heavily affected by the Ebola virus and where malaria transmission is high. In addition, international donor financing is being stepped up to meet the further recommendation that bednets be distributed to all affected areas.

Note to editors

Globally, 3.2 billion people in 97 countries and territories are at risk of being infected with malaria. In 2013, there were an estimated 198 million malaria cases worldwide (range 124-283 million), 82% of which were in the WHO African region. Malaria was responsible for an estimated 584 000 deaths worldwide in 2013 (range: 367 000 – 755 000), killing an estimated 453 000 children under five years of age.

Based on an assessment of trends in reported malaria cases, a total of 64 countries are on track to meet the Millennium Development Goal target of reversing the incidence of malaria. Of these, 55 are on track to meet Roll Back Malaria and World Health Assembly targets of reducing malaria case incidence rates by 75% by 2015.

The World malaria report 2014 will be launched on 9 December 2014 in the United Kingdom Houses of Parliament. The event will be co-hosted by the All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases (APPMG) and Malaria No More UK.

Contacts for press queries will be found at the link above.

Canadian-educated, Dr. Margaret Chan of the Peoples Republic of China heads the World Health Organization.

Canadian-educated, Dr. Margaret Chan of the Peoples Republic of China heads the World Health Organization, the world’s leading anti-malaria organization.

You may note that the press release says nothing about DDT, the pesticide most famous in the malaria fight after World War II.  WHO abandoned its ambitious campaign to eradicate malaria from the Earth, in the mid-1960s, when it was discovered that mosquitoes in central Africa and other malaria-endemic regions near the tropics were already resistant or immune to the pesticide.  DDT had been used by super-mosquito fighter Fred Soper, in campaigns by the Rockefeller Foundation and WHO, to knock down mosquito populations temporarily, to get breathing room to beat malaria.  While the populations were temporarily reduced, health workers would frantically work to diagnose and completely treat to a cure, malaria infections in humans. Then, when the mosquito populations came roaring back, the bugs would have no well of disease from which to draw parasites for new infections.

Soper’s methods used DDT sprayed on walls of homes, to specifically get those mosquitoes that bite humans. Anopheles spp. mosquitoes carry malaria parasites through a critical part of the parasites’ life cycle; those mosquitoes typically bite from about dusk to just after midnight.  After a blood meal, mosquitoes pause to rest on nearby vertical structures — walls in this case — to squeeze out excess water from the blood they’ve ingested, so they’re light enough to fly.  When the mosquito encounters DDT on the walls, the hope is that the DDT kills the mosquito, ending the transmission cycle.

A brutal public relations campaign in Africa, the U.S. and Europe through the late 1990s to now, has vilified science writer Rachel Carson for her indictment of DDT in Silent Spring, her brilliant book on the dangers of indiscriminate use of untested new chemicals.

So it’s important to note that the world’s leading organization that fights malaria makes no call for more DDT.  Professional health care workers worldwide have not been hornswoggled by pro-DDT, anti-environment, anti-science, anti-WHO propaganda.  That’s good news, too.

More:


November is National Malaria Awareness Month in Philippines

November 9, 2014

Education is still a key tool in the fight against malaria.  In that spirit, the President of the Philippines declares November as National Malaria Awareness Month.

Philippines President Gloria Macapagal-Arroyo

Philippines President Gloria Macapagal-Arroyo – Wikipedia image

Hope it works.

Proclamation from the President of the Philippines:

MALACAÑANPALACE

MANILA

BY THE PRESIDENT OF THE PHILIPPINES

PROCLAMATION NO. 1168

DECLARING THE MONTH OF NOVEMBER OF EVERY YEAR AS MALARIA AWARENESS MONTH

WHEREAS, Malaria is the 8th leading cause of morbidity in the Philippines, affecting most Filipinos of productive age group, and vulnerable groups which includes pregnant women, children and indigenous population groups, and continue to be a major impediment to human and economic development in area where it persists;

WHEREAS, Malaria remains endemic in 65 of the 79 provinces affecting 12.5 million Filipinos, with pockets of high endemicity along municipal/provincial borders, in far flung remote areas and barangays populated by indigenous cultural groups and areas with socio-political conflicts;

WHEREAS, Malaria, with morbidity rate of 55 per 100,000 population and mortality rate of 0.17 per 100,000 population, has to be reduced and controlled by effective malaria prevention and treatment measures, such as increase in the use of insecticide-treated mosquito nets and early diagnosis and prompt treatment in malaria risk areas;

WHEREAS, Goal six of Millennium Development Goals aims to combat HIV/AIDS, malaria and other diseases, with the target of halting and reversing the incidence of malaria and other diseases by 2015;

WHEREAS, the WHO/UNICEF Regional Child Survival Strategy focuses on the implementation of an Essential Package for Child Survival, one of which is the use of insecticide-treated mosquito nets of children 0-59 months in malarious areas;

WHEREAS, Malaria is one of the 5 diseases to be targeted under the disease-free zones initiative of service delivery component of “FOURmula One for Health”, an implementation strategy for health reforms;

WHEREAS, recent advances in the field of diagnosis, treatment and vector control makes the disease preventable and curable despite increasing trends of drug and insecticide resistance;

WHEREAS, the main strategies to reduce morbidity and mortality against malaria are through early diagnosis and prompt treatment, vector control through the use of insecticide treated mosquito nets supplemented by indoor residual spraying of insecticides, and early detection and management of epidemics;

WHEREAS, Republic Act No. 7160, otherwise known. as the Local Government Code, devolves the provision of basic health services to prevent and control malaria to the local government units. Enhancement on the program management capacity of the LGUs will be one of the major thrusts of the Department of Health and its partners;

WHEREAS, to facilitate program management and inculcate better health-seeking behaviors among the general population especially the high risk population on prevention and control of malaria, the National Malaria Control Program in consultation with the Regional Coordinators, Provincial Health Offices, LGUs, and other stakeholders, recommends that the month of November of every year be declared for the creation of awareness on the prevention and control of malaria.

NOW, THEREFORE, I, GLORIA MACAPAGAL-ARROYO, President of the Republic of the Philippines, by virtue of the powers vested in me by law, do hereby order:

SECTION 1.            Lead agency. — The Department of Health (DOH) shall lead in the implementation of the Malaria Awareness Month every November of the year starting 2006. As such, it shall call upon all government agencies/organizations for assistance in the implementation of this Proclamation, including but not limited to the following:

a.              Department of the Interior and Local Government

b.              Department of Education

c.              Department of National Defense

d.              National Disaster and Coordinating Council

e.              Department of Tourism

f.               Local Government Units/Organizations

1.              Liga ng mga Barangay

2.              League of Municipalities

3.              League of Provinces

g.              Philippine Information Agency

h.              National Commission on Indigenous Peoples

As the lead agency, the Department of Health shall formulate and disseminate guidelines and procedures on the implementation of the campaign, provide technical assistance to LGUs and/or implementing units or organizations, conduct national/regional advocacy and social mobilization in endemic provinces, augment local logistics for malaria prevention and control, and monitor LGU activities in all phases of the campaign. The DOH will also coordinate activities with major donor funded programs such as Global Fund to Fight AIDS, Tuberculosis and Malaria — Malaria Component and Australian Agency for International Development — WHO-RBM [Roll Back Malaria] projects.

SECTION 2.            Responsibilities of the. Department of the Interior and Local Government (DILG). — The DILG, through its Secretary, shall issue and disseminate appropriate memorandum, circulars to all local chief executives, mobilize field offices, and assist in the supervision and monitoring of malaria awareness campaign and other prevention and control activities.

SECTION 3.            Responsibilities of the Department of Education (DepEd). — The DepEd, through its Secretary, shall incorporate or integrate malaria prevention and control into the school curriculum, provide a venue in schools for treatment or re-treatment of mosquito nets through school children (each pupil will bring their mosquito net for re-treatment) in coordination with local health officials. The DepEd shall issue and disseminate appropriate circulars for the purpose.

SECTION 4.            Responsibilities of the Department of National Defense (DND). — The DND, through its Secretary, shall issue and disseminate appropriate memorandum circulars to its regional and provincial units to conduct activities in raising the awareness on malaria prevention and control among their personnel and staff especially in endemic areas. The Armed Forces of the Philippines, through the Surgeon General, must ensure that military personnel assigned to endemic areas should undergo the pre- and post- malaria smear test. Provide assistance in terms of transportation and security support to local health personnel in the implementation of the campaign. Strengthen management of severe malaria to prevent deaths in its hospitals in partnership with DOH.

SECTION 5.            Responsibilities of the National Disaster Coordinating Council (NDCC). — The NDCC, through the Office of Civil Defense (OCD), shall coordinate the implementation of the malaria awareness month activities with the LGUs through the Barangay/Municipal/City Disaster Coordinating Councils, Regional Disaster Coordinating Councils, and Provincial Disaster Coordinating Councils.

SECTION 6.            Responsibilities of the Philippine Information Agency (PIA). — The PIA, through its Director-General, shall guide, integrate and supervise the public communication activities including advertisements of the malaria awareness communication campaign.

SECTION 7.            Responsibilities of the Local Government Units (LGUs). — The LGUs shall lead the local implementation of the malaria awareness campaign and allocate appropriate resources for the purpose. Ensure that basic quality health, services on the diagnosis, treatment, vector control (distribution of treated mosquito nets, re-treatment, indoor residual spraying) are sustained until 2015. Further, the LGUs shall coordinate with partner NGOs and/or private sectors in the conduct of the campaign and establish a network of all partners at the local level. The concerned LGUs shall issue appropriate local ordinances, resolutions, memorandum circulars and other relevant orders.

SECTION 8.            Responsibilities of the League of Provinces/Municipalities/Barangays. — Through their presidents, shall issue circulars, memoranda and other issuances to their members on the local implementation of malaria awareness activities.

SECTION 9.            Responsibilities of the National Commission on Indigenous Peoples (NCIP). — The NCIP, through their Chairperson, shall issue memorandum circulars to the field offices to participate actively in the conduct of malaria awareness campaign among tribal minorities/indigenous communities in coordination with local health officials. The NCIP shall likewise support and help in coordinating field activities and help in the translation of IEC materials.

SECTION 10.         Responsibilities of the Department of Tourism (DOT). — The DOT, through its Secretary, shall issue and disseminate appropriate memorandum circulars to its regional field offices to conduct activities, in coordination with the Provincial Health Offices, in raising the awareness of tourists on malaria prevention especially in endemic areas.

SECTION 11.         Participation of the Civil Societies. — All non-government organizations, members of the civil societies, professional groups, business sectors and other concerned groups are encouraged to contribute to the success of the malaria awareness campaign through information dissemination, social mobilization, providing donations and other appropriate means.

SECTION 12.         Bilateral and multilateral agencies. — All donor partners will be encouraged to support malaria control program in line with the goals of Millennium Development Goal No. 6: Combat HIV/AIDS, malaria and other diseases at all levels. Integrated programs shall be encouraged.

IN WITNESS WHEREOF, I have hereunto set my hand and caused the seal of the Republic of the Philippines to be affixed.

DONE in the City of Manila, this 10th day of November, in the year of Our Lord, Two Thousand and Six.

(Sgd.) GLORIA MACAPAGAL-ARROYO


Yes, malaria is still a plague; it’s not Rachel Carson’s fault, and your saying so probably kills kids

May 30, 2014

May 27’s Google Doodle honoring Rachel Carson brought out a lot of those people who have been duped by the anti-Rachel Carson hoaxers, people who are just sure their own biased views of science and the politics of medical care in the third world are right, and Carson, and the people who study those issues, are not.

So comes “The Federalist,” what appears to me to be a reactionary site, which yesterday got great readership for a story from Bethany Mandel.  Mandel tells a story of a child in Cambodia suffering from malaria.  The suffering is horrible and the child most likely died.  It’s a tragic story of poverty and lack of medical care in the third world.

Erroneously, Mandel up front blames the suffering all on Rachel Carson, in a carp about the Google Doodle.

Here was my quick response between bouts in the dentist’s chair yesterday [links added here]:

[Bethany Mandel wrote:] Using faulty science, Carson’s book argued that DDT could be deadly for birds and, thus, should be banned. Incredibly and tragically, her recommendations were taken at face value and soon the cheap and effective chemical was discontinued, not only in the United States but also abroad. Environmentalists were able to pressure USAID, foreign governments, and companies into using less effective means for their anti-malaria efforts. And so the world saw a rise in malaria deaths.

Don’t be evil?

Start by not telling false tales.

1.  Carson presented a plethora of evidence that DDT kills birds.  This science was solid, and still is.

2.  Carson did not argue DDT should be banned.  She said it was necessary to fight disease, and consequently uses in the wild, requiring broadcast spraying, should be halted immediately.

3.  Scientific evidence against DDT mounted up quickly; under US law, two federal courts determined DDT was illegal under the Federal Insecticide, Fungicide, and Rodenticide Act; they stayed orders to ban the chemical pending hearings under a new procedure at the new Environmental Protection Agency.

EPA held hearings, adversary proceedings, for nine months. More than 30 DDT manufacturers were party to the hearings, presenting evidence totaling nearly 10,000 pages.  EPA’s administrative law judge ruled that, though DDT was deadly to insects, arachnids, fish, amphibians, reptiles, birds and mammals, the labeled uses proposed in a new label (substituted at the last moment) were legal under FIFRA — indoor use only, and only where public health was concerned.  This labeling would allow DDT to remain on sale, over the counter, with few penalties for anyone who did not follow the label.  EPA took the label requirements, and issued them as a regulation, which would prevent sales for any off-label uses.  Understanding that this would be a severe blow to U.S. DDT makers, EPA ordered U.S. manufacture could continue, for the export markets — fighting mosquitoes and malaria being the largest export use.

This ruling was appealed to federal courts twice; in both cases the courts ruled EPA had ample scientific evidence for its rule.  Under U.S. law, federal agencies may not set rules without supporting evidence.

4.  DDT was banned ONLY for agriculture use in the U.S.  It was banned in a few European nations.

5.  DDT has never been banned in Africa or Asia.

6.  USAID’s policy encouraged other nations to use U.S.-made DDT, consistent with federal policy to allow manufacture for export, for the benefit of U.S. business.

7.  U.S. exports flooded markets with DDT, generally decreasing the price.

Fred Soper, super malaria fighter, whose ambitious campaign to erase malaria from the Earth had to be halted in 1965, before completion, when DDT abuse bred mosquitoes resistant and immune to DDT.

Fred Soper, super malaria fighter, whose ambitious campaign to erase malaria from the Earth had to be halted in 1965, before completion, when DDT abuse bred mosquitoes resistant and immune to DDT.

8.  Although WHO had been forced to end its malaria eradication operation in 1965, because DDT abuse had bred mosquitoes resistant to and immune to DDT, and though national and international campaigns against malaria largely languished without adequate government funding, malaria incidence and malaria deaths declined.  Especially after 1972, malaria continued a year-over-year decline with few exceptions.

Note that the WHO campaign ended in 1965 (officially abandoned by WHO officials in 1969), years before the U.S. ban on DDT.

Every statement about DDT in that paragraph of [Mandel’s] article, is wrong.

Most important, to the purpose of this essay, malaria did not increase.  Malaria infections decreased, and malaria deaths decreased.

I’m sure there are other parts of the story that are not false in every particular.  But this article tries to make a case against science, against environmental care — and the premise of the case is exactly wrong.  A good conclusion is unlikely to follow.

Mandel was hammered by the full force of the anti-Rachel Carson hoaxers.  I wonder how many children will die because people thought, “Hey, all we have to do is kill Rachel Carson to fix malaria,” and so went off searching for a gun and a bullet?

You are not among them, are you?

Update: This guy, a worshipper of the Breitbart, seems to be among those who’d rather rail against a good scientist than lift a finger to save a kid from malaria. If you go there, Dear Reader, be alert that he uses the Joe Stalin method of comment moderation:  Whatever you say, he won’t allow it to be posted.  Feel free to leave comments here, where we practice First Amendment-style ethics on discussion.


Nothing But Nets invites you to join in the fight against malaria, for World Malaria Day

April 3, 2014

I get e-mail from Nothing But Nets, in preparation for World Malaria Day, April 25, 2014:

Compete to Beat Malaria Header with credit

Dear Ed,

As you know, World Malaria Day is April 25, and supporters will be taking action throughout April to help us send 25,000 bed nets to families in Africa.

Are you in?

Our champions are holding basketball tournaments, soccer games, and running in 5K races to get their friends, families, and communities involved in the fight against malaria.Megan Walter Jumpology

Megan Walter, our supporter from Richmond, Virginia, organized a unique event in her hometown. She partnered with her local trampoline park to jump for nets – and they raised $10 for every jumper who participated. The event was a huge success, raising more than $2,000 to send 200 bed nets to families in Africa. What made it even better is that Megan had fun doing it!

There are lots of ways to raise money and send nets while doing what you love. Every $10 you raise helps us purchase and distribute life-saving bed nets with our UN partners.

What sports challenge will you do this April?

Join us in sending nets and saving lives for World Malaria Day! Together, we can defeat malaria.

Sincerely,

Liz Wing
Senior Grassroots Officer, Nothing But Nets

P.S. Whether you run, swim, or play basketball, you can help raise critical funds and save lives. Take a challenge.

 

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You noted, of course:  No call for more DDT.  No slamming of science, scientists, medicine, medical workers, or Rachel Carson and environmental organizations.

This comes from people who fight malaria for a (meager) living, on non-profit basis, without political bias.  In short, these people need help, and consequently have no use for the pro-DDT, anti-Rachel Carson, anti-WHO, anti-science hoaxes.

Please give.  Every $10 can save a life.


World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing (but not DDT)

March 21, 2014

News release from the World Health Organization:

World malaria report 2013 shows major progress in fight against malaria, calls for sustained financing

News release

Cover of World Malaria Report 2013

Cover of World Malaria Report 2013

11 December 2013 | Geneva/Washington DC - Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally and by 49% in Africa, according to the “World malaria report 2013″ published by WHO.

An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa.

The large majority of the 3.3 million lives saved between 2000 and 2012 were in the 10 countries with the highest malaria burden, and among children aged less than 5 years – the group most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54%.

But more needs to be done.

“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” says Dr Margaret Chan, WHO Director-General. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century.”

In 2012, there were an estimated 207 million cases of malaria (uncertainty interval: 135 – 287 million), which caused approximately 627 000 malaria deaths (uncertainty interval 473 000 – 789 000). An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80% of malaria cases occur in Africa.

Long way from universal access to prevention and treatment

Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.

In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50% in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.

There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.

Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.

Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies – recommended for infants, children under 5 and pregnant women – has also been slow in recent years.

“To win the fight against malaria we must get the means to prevent and treat the disease to every family who needs it,” says Raymond G Chambers, the United Nations Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria. “Our collective efforts are not only ending the needless suffering of millions, but are helping families thrive and adding billions of dollars to economies that nations can use in other ways.”

Global funding gap

International funding for malaria control increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012. Domestic funding stood at around US$ 0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to US$ 2.5 billion in 2012 – less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.

Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in four countries in south-east Asia, and insecticide resistance has been found in at least 64 countries.

“The remarkable gains against malaria are still fragile,” says Dr Robert Newman, Director of the WHO Global Malaria Programme. “In the next 10-15 years, the world will need innovative tools and technologies, as well as new strategic approaches to sustain and accelerate progress.”

WHO is currently developing a global technical strategy for malaria control and elimination for the 2016-2025 period, as well as a global plan to control and eliminate Plasmodium vivax malaria. Prevalent primarily in Asia and South America, P. vivax malaria is less likely than P. falciparum to result in severe malaria or death, but it generally responds more slowly to control efforts. Globally, about 9% of the estimated malaria cases are due to P. vivax, although the proportion outside the African continent is 50%.

“The vote of confidence shown by donors last week at the replenishment conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria is testimony to the success of global partnership. But we must fill the annual gap of US$ 2.6 billion to achieve universal coverage and prevent malaria deaths,” said Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “This is our historic opportunity to defeat malaria.”

Notes for editors:

The “World malaria report 2013″ summarizes information received from 102 countries that had on-going malaria transmission during the 2000-2012 period, and other sources, and updates the analyses presented in 2012.

The report contains revised estimates of the number of malaria cases and deaths, which integrate new and updated under-5 mortality estimates produced by the United Nations Inter-agency Group for Child Mortality Estimation, as well as new data from the Child Health Epidemiology Reference Group.


Legacy of DDT abuse: Cleaning up old pesticide dumps

February 15, 2014

Contrary to science denialist claims, DDT is not harmless.  Users and abusers of DDT, abandoned stocks of DDT and other pesticides around the world, after the stuff had become essentially useless against insect or other pests originally targeted.

In the U.S., EPA moves in to clean up DDT dumps, under the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA), or Superfund.  In much of the world, various UN agencies find the old pesticides, and clean them up as funding allows.

The Food and Agricultural Organization (FAO) documents its cleanup efforts with photos of sessions training technicians to find and catalog dump sites, repackaging of old drums when necessary, extraction, packing and shipping to a disposal site.

Photos tell a story words on paper cannot.

Caption from FAO: TN (Tanzania) before: 40 tonnes of 50 year old DDT were found in Menzel Bourguiba Hospital, TN - : M. Davis

Caption from FAO: TN (Tanzania) before: 40 tonnes of 50 year old DDT were found in Menzel Bourguiba Hospital, TN – : M. Davis

Sometimes the toxic wastes did not stay neatly stacked.

FAO caption:  TN before: 40 tonnes of 50 year old DDT were found in Menzel Bourguiba Hospital, TN

FAO caption: TN before: 40 tonnes of 50 year old DDT were found in Menzel Bourguiba Hospital, TN View real size

DDT use against insect vectors of disease essentially halted in the mid-1960s.  The Rockefeller Foundation’s and UN’s ace mosquito fighter, Fred Soper, ran into mosquitoes in central Africa that were resistant and immune to DDT. Farmers and businesses had seized on DDT as the pesticide of choice against all crop pests, or pests in buildings.  By the time the UN’s malaria-fighting mosquito killers got there, the bugs had evolved to the point DDT didn’t work the malaria eradication campaign.

Also, there were a few DDT accidents that soured many Africans on the stuff.  Around lakes where local populations caught the fish that comprised the key protein in their diet, farmers used DDT, and the runoff killed the fish.

Use of DDT ended rather abruptly in several nations.  Stocks of DDT that had been shipped were abandoned where they were stored.

For decades.

FAO caption:    Obsolete DDT in Luanda, Angola - July 2008 -  : K. Cassam

FAO caption: Obsolete DDT in Luanda, Angola – July 2008 – : K. Cassam

Prevention and disposal of obsolete chemicals remains as a thorny problem throughout much of the world.  Since 2001, under the Persistent Organic Pollutants Treaty, (POPs), the UN’s World Health Organization (WHO) has coordinated work by WHO and a variety of non-governmental organizations (NGOs), as well as governments, to make safe the abandoned pesticides, and detoxify or destroy them to prevent more damage.  FAOs efforts, with photos and explanation, is a history we should work to preserve.

DDT provided powerful insect killing tools for a relatively short period of time, from about 1945 to 1965.  In that short period, DDT proved to be a deadly killer of ecosystems to which it was introduced, taking out a variety of insects and other small animals, on up the food chain, with astonishing power.  One of DDT’s characteristics is a long half-life — it keeps on killing, for months or years. Once that was thought to be an advantage.

Now it’s a worldwide problem.


Rachel Carson/DDT hoaxing from the Ayn Rand Institute

April 21, 2013

Welcome, refugees and truth-seekers from WUWT:  If this site seems a little unusual to you, you should know that at Millard Fillmore’s Bathtub we try to stick to science, and we don’t censor opposing opinions.  Genuinely interested in the DDT/Malaria issue?  See this collection.

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A couple of physicists get together in a podcast from the Ayn Rand Institute, Poke in Your Eye to Eye, and demonstrate that they don’t know biology well, they know less about history, but they don’t hesitate to tell whoppers about Rachel Carson and the value of DDT“Silent Spring 50 Years Later [a special Earth Day podcast].

English: An image of the main entrance of Rach...

A better indication of the legacy of Rachel Carson: Schools across America named after the woman, to inspire children to explore science, and to read and write. Here, the main entrance of Rachel Carson Middle School in Herndon, Virginia. (Photo: Wikipedia)

Earth Day must be coming up.  The usual suspects trot out their usual disinformation and hoax campaigns — and it will continue through Earth Day on April 22, International Malaria Day on April 25, through Rachel Carson’s birthday, and probably all summer.

Mencken warned us that hoaxes, once out of the bottle, can’t be put back.  Twain (and others) remind us that whopping falsehoods travel around the world “while truth is getting its boots on.”  Amanda Maxham, who is listed as an astrophysicist at the Rand site, interviewed physicist Keith Lockitch — and they repeat almost all the hoary old false fables invented by Gordon Edwards and Steven Milloy about malaria, DDT, and Rachel Carson.

A few of the errors committed by the polemicists at the Ayn Rand Institute:

  • ‘DDT doesn’t breed mosquitoes more resistant to the stuff, but instead weakens the population through reducing diversity.’  Absolutely wrong.  Turns out the new alleles mosquitoes pick up that makes them resistant and immune to DDT, are ALSO the alleles that make mosquitoes resistant to the whole class of chemicals, and thereby foul up efforts to develop new pesticides.

    Tanzania - Removing DDT

    Cleaning up DDT in Africa: 40 tons of 50 year old DDT were found in Menzel Bourguiba Hospital, Tanzania – FAO photo

  • ‘Rachel Carson didn’t account for the value of DDT in eradicating malaria.’  They start out claiming DDT ended malaria in the U.S. (it didn’t; CDC had won the fight will just mop up operations left, by 1939; DDT wasn’t even available for another seven years), and run through the false claim that DDT alone had almost eradicated malaria from Sri Lanka, but listening to Rachel Carson, the nation stopped spraying and malaria roared back (the nation stopped ALL of its malaria fighting efforts due to costs and civil war; when the fight was taken up again, DDT was not useful; largely without DDT, Sri Lanka has once again nearly wiped out malaria).
  • ‘Because of a lack of DDT use, malaria continues to ravage the world killing a million people a year.’  Actually, malaria is at the lowest level in human history, killing less than a million a year, with great progress being made against the disease using the methods Rachel Carson urged in 1962.  Had we listened to Carson earlier, we could have saved a few million more lives, and perhaps have eradicated malaria already.  Also, it’s important to remember that DDT was never banned in Africa nor Asia; the ban on use of DDT on cotton crops in the U.S. did not cause any increase in malaria anywhere; since the ban on DDT use in the U.S. malaria has constantly declined in incidence and deaths.
  • ‘DDT is very effective because it’s ALSO repellent to mosquitoes, after it ceases to kill them.’  So in the end, they urge the use of a poisonous-to-wildlife, mildly carcinogenic substance, because it repels mosquitoes?  Bednets are more effective, cheaper, not-poisonous to wildlife, and they aren’t even suspected of causing cancer.

Rachel Carson’s life is a model for budding scientists, aspiring journalists, and teachers of ethics.  That so many people spend so much time making up false claims against her, in favor of a deadly toxin, and against science, tells us much more about the subrosa intentions of the claim fakers than about Rachel Carson.

Want the facts about Rachel Carson?  Try William Souder’s marvelous biography from last year, On a Farther Shore.  Want facts on DDT?  Try EPA’s official DDT history online (or look at some of the posts here at Millard Fillmore’s Bathtub). Want the facts about malaria?  Check with the world’s longest running, most ambitious malaria fighting campaign operated by the good people at the World Health Organization, Roll Back Malaria,  or see Sonia Shah’s underappreciated history, The FeverHow malaria has ruled mankind for 500,000 years.

More:

Roll Back Malaria, World Malaria Day logo for 2013

Roll Back Malaria, World Malaria Day logo for 2013

Wall of Shame (hoax spreaders to watch out for this week):


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