NIH notes progress against malaria on World Malaria Day 2012

Press release from the National Institutes of Health, for World Malaria Day (April 25, 2012):

For Immediate Release
Tuesday, April 24, 2012

NIH statement on World Malaria Day – April 25, 2012

B. F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D.
National Institute of Allergy and Infectious Diseases

On World Malaria Day, we stand at a critical juncture in our efforts to control a global scourge. This year’s theme “Sustain Gains, Save Lives: Invest in Malaria” stresses the crucial role of continued investment of resources to maintain hard-won gains. Lives have indeed been saved. According to World Health Organization (WHO) estimates, annual deaths from malaria decreased from roughly 985,000 in 2000 to approximately 655,000 in 2010. Improvements were noted in all regions that WHO monitors, and, since 2007, four formerly malaria-endemic countries — the United Arab Emirates, Morocco, Turkmenistan and Armenia — have been declared malaria-free. However, about half of the world’s population is at risk of contracting malaria, and the disease continues to exact an unacceptably high toll, especially among very young children and pregnant women.

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), is committed to maintaining the research momentum needed to eradicate this mosquito-borne parasitic disease. Our investments include programs designed to strengthen research capacity in those countries most affected by malaria. For example, through the 2010 International Centers of Excellence for Malaria Research initiative, NIAID has established 10 research centers in malaria-endemic regions around the world. NIAID also provides access for U.S. and international scientists to multiple research resources as well as training for new investigators. Additionally, NIAID supports the Global Malaria Action Plan (GMAP), an international framework for coordinated action designed to control, eliminate and eradicate malaria.

NIAID’s research portfolio includes an array of projects aimed at better understanding the disease process and finding new and improved ways to diagnose and treat people with malaria, control the mosquitoes that spread it, and prevent malaria altogether through vaccination.

Earlier this month, an international team including NIAID-funded investigators reported that resistance to artemisinin — a frontline malaria drug — has spread from Cambodia to the border of Thailand and Burma, underscoring the importance of continued efforts to detect artemisinin resistance and slow its spread. Other grantees have identified a major region of the malaria parasite genome associated with artemisinin resistance, raising the possibility that scientists will have a new way to monitor the spread of drug resistance in the field.

The spread of artemisinin-resistant malaria highlights the need for new and improved malaria drugs. Two recently completed drug screening projects offer some hope. In one project, NIH scientists screened nearly 3,000 chemicals, and found 32 that were highly effective at killing numerous genetically diverse malaria parasite strains. Another screening project identified a new class of compounds that inhibits parasites in both the blood stage and in the liver. The research could lead to the development of malaria drugs that attack the parasite at multiple stages in its lifecycle, which would hamper the parasite’s ability to develop drug resistance.

Work continues on a novel anti-malaria compound, NITD609, first described by NIAID-supported researchers in 2010. A mid-stage clinical trial to assess NITD609′s activity in people began in Thailand this year. Research on NITD609 is a continuing collaboration among NIH-funded scientists, the pharmaceutical company Novartis, and the nonprofit Medicines for Malaria Venture.

Because the risk of childhood malaria is related to exposure before birth to the malaria parasite through infected mothers, NIAID scientists recently initiated a program on malaria disease development in pregnant women and young children that could yield new preventive measures and treatments for these most vulnerable groups.

The mosquitoes that spread malaria are also the target of NIAID-supported science. In 2011, researchers identified bacteria that render mosquitoes resistant to malaria parasites. Further study is needed, but it may one day be possible to break the cycle of infection by reducing the mosquito’s ability to transmit malaria parasites to people.

A vaccine to prevent malaria has been frustratingly elusive, and so initial positive results reported last year by the PATH Malaria Vaccine Initiative, GlaxoSmithKline Biologicals and their collaborators came as welcome news. In a late-stage clinical trial in approximately 6,000 African children, the candidate vaccine, known as RTS,S, reduced malaria infections by roughly half. Currently, eight other vaccine candidates are being tested in NIAID-supported clinical trials. One of them uses live, weakened malaria parasites delivered intravenously to prompt an immune response against malaria. An early-stage clinical trial of this vaccine candidate began at NIH earlier this year.

Whether the remarkable returns on investment in malaria control will continue in years ahead depends on our willingness to commit needed financial and intellectual resources to the daunting challenges that remain. On World Malaria Day, we join with our global partners in affirming that commitment and rededicating ourselves to the efforts to defeat malaria worldwide.

For more information on malaria, visit NIAID’s malaria Web portal.

Lee Hall, M.D., Ph.D., is Chief of the Parasitology and International Programs Branch in the NIAID Division of Microbiology and Infectious Diseases. Anthony S. Fauci, M.D., is Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.

NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health

April 25 is World Malaria Day

From the World Health Organization, for World Malaria Day 2012:

World Malaria Day

25 April 2012

In 2010, about 3.3 billion people – almost half of the world’s population – were at risk of malaria. Every year, this leads to about 216 million malaria cases and an estimated 655 000 deaths. People living in the poorest countries are the most vulnerable.

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

World Malaria Day – which was instituted by the World Health Assembly at its 60th session in May 2007 – is a day for recognizing the global effort to provide effective control of malaria. It is an opportunity:

• for countries in the affected regions to learn from each other’s experiences and support each other’s efforts;
• for new donors to join a global partnership against malaria;
• for research and academic institutions to flag their scientific advances to both experts and general public; and
• for international partners, companies and foundations to showcase their efforts and reflect on how to scale up what has worked.

Related links

• More about World Malaria Day
• Roll Back Malaria Partnership
• WHO Global Malaria Programme
• More about malaria

Fewer than 700,000 deaths?  That’s significantly fewer than most reports of more than a million per year — significant progress has been made it fighting malaria.  Keep up those efforts, whatever they are.

Watch your news outlets.  Will the pro-DDT, anti-Rachel Carson hoaxsters hold sway, or will the facts on fighting malaria, from the malaria fighters, get top billing?

Related articles:

• malaria world day (madekreations.wordpress.com)
• Elimination of Widespread and Deadly Disease Will Help American Troops, Tourists (claycountymsgop.com)
• World Malaria Day – you can make a difference (endlesslyrestless.wordpress.com)
• 6 Days to World Malaria Day!!! (todaysnaira.wordpress.com)
• New frontiers in the battle against malaria – Financial Times (drugstoresource.wordpress.com)
• Roll Back Malaria (firstaidtosavealife.com)
• Plan to rid country of malaria (thehimalayantimes.com)
• What We’re Reading: Fighting malaria is a full-time job (one.org)
• Mosquito Squad of Grand Rapids Joins Malaria No More (grandrapidsmosquitosquad.wordpress.com)

Annals of DDT: Pesticide starred in 1944 Army film

In 1944, DDT seemed like a great idea.  The U.S. Army made this film extolling the virtues of the stuff, “DDT:  Weapon Against Disease.”  It runs just over 14 and a half minutes, from the Army Signal Corps.

The film recently found its way to the Internet Archives; I assume this YouTube version comes from there (I can’t embed the Internet Archives version).

Though the film does not discuss the dangers of DDT in any appreciable way, it’s a valuable contribution to the historical canon, simply to show what DDT advocates hoped the substance could do, near the end of World War II.

A transcript of the film is available at the National Library of Medicine on-line version.

 

DDT news: Ethio Sun reports, “Ethiopia and Botswana in banned DDT pesticide deal”

How many hoax claims of Steven Milloy, Roger Bate and other DDT advocates are exposed in this one news story?

Somebody count.  The story reveals

1. African nations still use DDT.
2. There’s a lot of DDT in Africa to be used.
3. Some nations don’t use DDT due to fear of health effects on people; they appear to have weighed the alternatives, and found better ways to fight malaria without DDT.
4. DDT is cheap in Africa (US$4.50/kilogram).
5. Despite the U.S. ban on DDT use on U.S. crops, some nations in Africa kept using DDT (the article misstates the case for a worldwide ban — there has never been a worldwide ban).
6. DDT use is not assumed in Africa to be a great way to fight malaria.

I don’t mean to suggest EthioSun as a sterling source of information; but it’s not difficult to find stories like this with frequency, out of Africa.  Each of them refutes the case for more DDT, so that there really is no good case to be made for more DDT, anywhere.

Ethiopia and Botswana in banned DDT pesticide deal

Posted By EthioSun On Thursday, January 12, 2012 06:32 AM.

Ethiopia is set to export about 15 tonnes of the banned pesticide, DDT, to Botswana, it has been revealed.

This follows a recent suspension on the use of the pesticide by the Horn of Africa nation, which cited adverse effects of human health and the environment as reasons for the decision.

Adami Tulu Pesticide, a state owned company has huge stocks of DDT, which it will reportedly sell to Botswana at US$4.50 per kilogramme.

It is estimated the company has 450 tonnes of DDT in stock.

The US led a worldwide ban on the use of DDT as a pesticide in 1972 following reports of adverse side effects on humans.

However, Ethiopia along with a few other countries continued the use of DDT in the fight against malaria.

Activists have demanded that the ban be lifted, in order to allow the use DDT in the elimination of malaria, especially in developing countries.

More than half of the estimated 80 million people in Ethiopia are said to be at risk of contracting malaria.

According to the World Health Organisation some countries still use DDT to fight malaria.

The disease killed over half a million people worldwide last year, most of them in Africa.

There was no immediate confirmation from Botswana about the planned export.

Steve Milloy, Roger Bate, Richard Tren, Henry I. Miller and others hoax us when they say DDT can save mankind, or even help save mankind.  See also Tim Lambert’s takedown of Goklany’s post.

Burt Folsom’s blog distorts history of DDT

I hadn’t thought Burt Folsom, author of FDR Goes to War, much of an ideologue, but a post at his blog makes me wonder about whether he is so grossly inaccurate on other things, too.

The post, written by Anita Folsom, said:

Fast-forward to the post-World War II period. In 1962, Rachel Carson published her best-selling text, Silent Spring, in which she protested the effects of pesticides on the environment.  Ten years later, DDT was banned.

Thomas Sowell points out that such bans, while passed with the best of intentions, have unleashed growth in the numbers of mosquitoes and a huge recurrence of malaria in parts of the world where it had been under control. The same is true of modern pesticides in the U.S. today.  One reason for the rise in the incidence of bedbugs, which bite humans and  spread disease, is that the federal government has banned the use of chemicals that were effective against such insects.

The issue is one of balance.  While it is every citizen’s responsibility to take an interest in a clean environment, it is also a responsibility to avoid over-zealous regulators who cause harm by banning useful chemicals.  Perhaps what is needed is a substance that will cause bureaucrats to leave citizens alone, both immediately and in the future.

Perhaps the trouble comes from relying on Thomas Sowell as a source here — on DDT and Rachel Carson, Sowell appears to be  just making up false stuff.

First, the “DDT ban” mentioned here was by U.S. EPA.  Consquently, it applies ONLY to the U.S., and not to any nation where malaria is a problem.

Second, the order banning DDT in the U.S. restricted the ban to agricultural use on agricultural crops, almost solely cotton at the time.  DDT use to fight malaria would still be legal in the U.S.

Third, the order banning DDT use in the U.S. specifically exempted manufacture of DDT — so in effect, the order more than doubled the amount of DDT available to fight malaria mosquitoes because all U.S. production was dedicated to export, specifically to allow DDT to be used to fight malaria.

Fourth, and probably most critically, it is simply false that malaria resurged when DDT was banned.  By 1972, malaria infections were about 500 million annually, worldwide.  Malaria deaths were about 2 million.  Even without U.S. spraying DDT on cotton crops in Texas and Arkansas, and to be honest, without a lot of DDT use except in indoor residual spraying as promoted by the World Health Organization (WHO), malaria infections have been reduced by 50%, to about 250 million annually — and malaria deaths were reduced by more than 50%, to fewer than 900,000 annually, worldwide.  WHO estimates more than 700,000 African children were saved from malaria deaths in the decade from 2001 through 2010.

Malaria deaths and malaria infections decreased after DDT was banned in the U.S., and continue to decline.

Fifth, while it is true that reports generally claim that DDT limited bedbug infestations in the 1960s, the truth is that bedbugs became immune to DDT in the 1950s, and DDT is perfectly useless against almost all populations of the beasties today, and since 1960, 51 years ago.  Also, the evolution to be immune to DDT primed bedbugs to evolve resistance to other pesticides very quickly.  DDT didn’t stop bedbugs, and lack of DDT didn’t contribute to bedbug infestations after 1960.

(Maybe worst, and odder, 111 people have been injured by pesticides used to control bedbugs, one fatally, in the past ten years.  Which is worse?)

Sixth, bedbugs do not spread disease, at least not so far as is known to medical and entomological science.

Sowell’s claims endorsed by Folsom are exactly wrong, 180-degrees different from the truth.  Sowell and Folsom are victims of the DDT Good/Rachel Carson Bad Hoaxes.

Since malaria has been so dramatically reduced since the U.S. banned the use of DDT, perhaps Rachel Carson should be given full credit for every life saved.  It’s important to remember that Carson herself did not suggest that DDT be banned, but instead warned that unless DDT use were restricted, mosquitoes and bedbugs would evolve resistance and immunity to it.  DDT use was not restricted enough, soon enough, and both of those pests developed resistance and immunity to DDT.

Ms. Folsom urges restraint in regulation, she says, because over-enthusiastic banning of DDT brought harm.  Since her premise is exactly wrong, would she like to correct the piece to urge more regulation of the reasonable kind that EPA demonstrated?  That would be just.

Good sources of information on malaria, DDT, and Rachel Carson and EPA:

• The Fever, How malaria has ruled mankind for 500,000 years, by Sonia Shah; also see her brass tacks discussion of claiming victory too early, especially with regard to DDT
• Sonia Shah answers questions about DDT and malaria at Freakonomics blog
• Alex Perry is a former Time Africa correspondent with a new book, Lifeblood: How to change the world one dead mosquito at a time. Read or listen to his October 12 interview on Marketplace  
• Also check out these other excellent sources:
  Bug Girl’s Blog, “DDT, Junk Science, and the attack on Rachel Carson;” “DDT, Junk Science, and Malaria Resistance;” “Malarial Resistance: Exciting new development;” “Rachel Carson and Chemical News;” “New York Times, DDT, and an a–hole“
  Laelaps, “Something stinks over at National Geographic;”
  Deltoid, “Hundreds of Millions Killed by Rachel Carson;” “Creationists Claim Rachel Carson Killed Millions;” “The Rachel Carson Telephone Game;” “Reaction to Tierney’s Bad Science;” “John Tierney’s Bad Science;” “Raw Story Follows the Money on Rachel Carson Smears;” “Taking Aim at Rachel Carson” (describing the unsavory sources of the campaign against Carson)
  Rabbet Run, “Who Ordered That?“
  Obsidian Wings, “Junk Science: DDT“

Fighting malaria with indoor use of insecticides, with USAID money

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

Sideshow of DDT and malaria

Not exactly a DDT/Malaria carnival.  Just enough for a sideshow.

First, the controversy over use of DDT in Uganda continues, even as DDT is applied daily there.  This demonstrates that DDT remains freely available for use in Africa.  It also demonstrates that Africans are not clamoring for more DDT.

Uganda offers a key proving ground for the propaganda campaign against environmentalists, against scientist, against medical care officials, and for DDT.  Though malaria plagues Uganda today and has done so for the past 200 years at least, it was not a target of the World Health Organization’s (WHO) campaign to eradicate malaria in the 1950s and 1960s, because the nation lacked the governmental structures to mount an effective campaign.  DDT was used to temporarily knock down mosquito populations, so that medical care could be improved quickly and malaria cured among humans.  Then, when the mosquitoes came roaring back as they always do with DDT, there would be no pool of the disease in humans from which the mosquitoes could get infected.  End of malaria problem.

Plus, for a too-long period of time, Uganda was ruled by the brutal dictator Idi Amin.  No serious anti-malaria campaigns could be conducted there, then.

Uganda today exports cotton and tobacco.  Cotton and tobacco interests claim they cannot allow any DDT use, because, they claim, European Union rules would then require that the tobacco and cotton imports be banned from Europe.  I can’t find any rules that require such a ban, and there are precious few incidents that suggest trace DDT residues would be a problem, but this idea contributes to the political turmoil in Uganda.  Businessmen there sued to stop the use of even the small amounts of DDT used for indoor residual spraying (IRS) in modern campaigns.  They lost.  DDT use continues in Uganda, with no evidence that more DDT would help a whit.

Much of the anti-malaria campaign aimed at soldiers, to convince them to use Atabrine, a preventive drug, or to use nets, or just to stay covered up at night, to prevent mosquito bites. Mother Jones compilation of posters and photos.

Second, the website for Mother Jones magazine includes a wonderful 12-slide presentation on DDT in history.  Malaria took out U.S. troops more effectively than the Japanese in some assaults in World War II.  DDT appeared to be a truly great miracle when it was used on some South Pacific islands.  Particularly interesting are the posters trying to get soldiers to help prevent the disease, some done by the World War II-ubiquitous Dr. Seuss.  Good history, there.  Warning:  Portrayals of Japanese are racist by post-War standards.

Third, a new book takes a look at the modern campaigns against malaria, those that use tactics other than DDT.  These campaigns have produced good results, leading some to hope for control of malaria, and leading Bill Gates, one of the biggest investors in anti-malaria campaigns, to kindle hopes of malaria eradication again.  Here is the New York Times  review of  Alex Perry’s Lifeblood: How to Change the World One Dead Mosquito at a Time (PublicAffairs, $25.99).   Perry is chief Africa correspondent for Time Magazine.

This little gem of a book heartens the reader by showing how eagerly an array of American billionaires, including Bill Gates and the New Jersey investor Ray Chambers (the book’s protagonist), are using concepts of efficient management to improve the rest of the world. “Lifeblood” nominally chronicles the global effort to eradicate malaria, but it is really about changes that Mr. Chambers, Mr. Gates and others are bringing to the chronically mismanaged system of foreign aid, especially in Africa.

These three snippets of reporting, snapshots of the worldwide war on malaria, all diverge dramatically from the usual false claims we see that, but for ‘environmentalist’s unholy and unjust war on DDT,’ millions or billions of African children could have been saved from death by malaria.

The real stories are more complex, less strident, and ultimately more hopeful.

Poisoning the children: Study shows mothers give DDT to their children from breastmilk

Too many in the U.S. bury their heads in the sands about the issues, but researchers in Spain and Mozambique wondered whether indoor residual spraying (IRS) with DDT, to fight malaria-carrying mosquitoes, might produce harms to children in those homes.  They studied the issue in homes sprayed with DDT in Mozambique.

It turns out that young mothers ingest DDT and pass a significant amount of it to their children when the children breast feed.

The study itself is behind Elsevier’s mighty paywall, but the abstract from Chemosphere is available at no cost:

Concentration of DDT compounds in breast milk from African women (Manhiça, Mozambique) at the early stages of domestic indoor spraying with this insecticide

Maria N. Manaca^{a, b, c}, Joan O. Grimalt^{b, ,} , Jordi Sunyer^{d, e}, Inacio Mandomando^{a, f}, Raquel Gonzalez^{a, c, e}, Jahit Sacarlal^a, Carlota Dobaño^{a, c, e}, Pedro L. Alonso^{a, c, e} and Clara Menendez^{a, c, e}

^a Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique

^b Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Jordi Girona 18, 08034 Barcelona, Catalonia, Spain

^c Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Rosselló 132, 4a, 08036 Barcelona, Catalonia, Spain

^d Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain

^e Ciber Epidemiología y Salud Pública, Spain

^f Instituto Nacional de Saúde, Ministerio de Saúde, Maputo, Mozambique

Received 6 November 2010;

revised 19 March 2011;

accepted 1 June 2011.

Available online 20 July 2011.

Abstract

Breast milk concentrations of 4,4′-DDT and its related compounds were studied in samples collected in 2002 and 2006 from two populations of mothers in Manhiça, Mozambique. The 2006 samples were obtained several months after implementation of indoor residual spraying (IRS) with DDT for malaria vector control in dwellings and those from 2002 were taken as reference prior to DDT use. A significant increase in 4,4′-DDT and its main metabolite, 4,4′-DDE, was observed between the 2002 (median values 2.4 and 0.9 ng/ml, respectively) and the 2006 samples (7.3 and 2.6 ng/ml, respectively, p < 0.001 and 0.019, respectively). This observation identifies higher body burden intakes of these compounds in pregnant women already in these initial stages of the IRS program. The increase in both 4,4′-DDT and 4,4′-DDE suggest a rapid transformation of DDT into DDE after incorporation of the insecticide residues. The median baseline concentrations in breast milk in 2002 were low, and the median concentrations in 2006 (280 ng/g lipid) were still lower than in other world populations. However, the observed increases were not uniform and in some individuals high values (5100 ng/g lipid) were determined. Significant differences were found between the concentrations of DDT and related compounds in breast milk according to parity, with higher concentrations in primiparae than multiparae women. These differences overcome the age effect in DDT accumulation between the two groups and evidence that women transfer a significant proportion of their body burden of DDT and its metabolites to their infants.

Highlights

► DDT increases in pregnant women at the start of indoor spraying with this compound. ► Rapid transformation of DDT into DDE occurs in women after intake of this insecticide. ► The DDT increases in breast milk of women due to indoor spraying are not uniform. ► Breast milk DDT content in primiparae women is higher than in multiparae women. ► Women transfer a high proportion of their DDT and DDE body burden to their infants.

“Primiparae” women are those with one child, their first; “multiparae” women are those who have delivered more than one child.

Without having read the study, I suggest there are a few key points this research makes:

1. Claims that DDT has been “banned” from Africa and is not in use, are patently false.
2. Spraying poisons in homes cannot be considered to have no consequences; poisons in in very small concentrations get into the bodies of the people who live in those homes.
3. We should not cavalierly dismiss fears of harms to humans from DDT, because it appears that use of even tiny amounts of the stuff exposes our youngest and most vulnerable children.
4. Beating malaria has no easy, simple formula.

Women, even poor women in malaria-endemic areas, should not have to worry about passing poisonous DDT or its breakdown products to their children, through breastfeeding.  The national Academy of Sciences was right in 1970:  DDT use should be stopped, and work should be hurried to find alternatives to DDT.

Resources: 

• PubMed reference to the study
• Abstract of a 2010 article in Science of the Total Environment, showing significant DDT exposures in all aspects of households treated with DDT in IRS
• Abstract of a 1991 study published in the Central African Journal of Medicine showing significant DDT exposure from breast milk from mothers in Zimbabwe
• PubMed article explaining DDT was reintroduced to Mozambique in 2005, after a determination that local mosquito populations were susceptible to DDT

DDT “costly for Uganda”

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.

 

PestAway: Exterminator deals with DDT, honestly

Here’s a cool breeze:  Pest Away Exterminators in New York explains, patiently, that DDT no longer works against bedbugs, and is otherwise ill-advised in most applications.

Try to find an error in this short post:

DDT

The truth about DDT…

• It was highly effective when it was first introduced.
• It nearly wiped out bed bugs in America.
• It is NO LONGER effective in treating bed bugs.
• It is more dangerous than people realized.

In 1939, DDT (Dichloro-Diphenyl-Trichloroethane) was introduced as the “miracle pesticide.” It was effectively used in military and civilian arenas to control lice, malaria, mosquitoes and bed bugs. It nearly wiped out all bed bugs in an allegedly “safe” method, but by the 1960’s, bed bugs had built up a resistance and potential immunity to DDT.

In 1962, Rachel Carson wrote Silent Spring, which essentially demonized DDT and helped launch the environmental movement. By 1972, DDT was banned in the USA, but DDT is still used very effectively in other countries to control Malaria. Although there is a public outcry to bring DDT back, it’s very unlikely that it would have any meaningful effect on controlling bed bugs.

Jeff Eisenberg founded the company in 1991, after a career with a large accounting firm.  It appears his training on the importance of accuracy in numbers, and honesty in facing tough situations, carried over to his new business.  Good on him.

Sowell wrong about DDT and Rachel Carson

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

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 DDT.  Jonathan 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.

Monday is World Malaria Day; watch out for the pro-DDT hoaxes

A letter to the editor of the Cape Cod Times:

DDT unnecessary to fight malaria

April 23, 2011

Monday, April 25,is World Malaria Day. Across the globe, public health and malaria experts will be highlighting the urgent need to do more to tackle this preventable disease that kills more than 800,000 people (mostly in Africa) every year.

Here in the United States, a small group of advocates will, once again, use the day to call for widespread use of the pesticide DDT to control malaria. This despite broad, global agreement that widespread spraying of DDT inside people’s homes is not the best way to tackle malaria and can harm human health.

Those pressing for DDT’s widespread use are few, but they are loud and persistent. They are not public health experts, and they are all closely affiliated with right-wing think tanks. These calls to “bring back DDT” are a dangerous distraction from true malaria prevention.

Debbie West
Barnstable

Ms. West is right.

Anecdotal evidence: Malaria spreads to Tanzania highlands, warming climate blamed

Here’s one story that critics of science and scientists who study global warming will try to avoid mentioning:  Malaria’s spread in Tanzania appears to be due to deforestation plus a warming climate that altered historic rainfall patterns.

It’s anecdotal evidence, partly.  The case reinforces the point Al Gore made in An Inconvenient Truth, that climate change can smooth the path for the spread of diseases like malaria.

Via AllAfrica.com, from The Citizen in Dar es Salaam (Sunday Citizen News):

Malaria Threatens Nation’s Highlands

Felix Mwakyembe, 6 March 2011

Opinion

Mbeya — Tanzania’s southern highlanders have long worried about pneumonia and other respiratory illnesses brought on by the cool, wet weather. But as climate change contributes to warmer temperatures in the region, residents are facing a new health threat: malaria.

In Rungwe, a highland district in the south-western Mbeya region bordering Malawi and Zambia, malaria is fast replacing coughs, fever and pneumonia as the most serious local health problem. The change has taken by surprise the region’s residents, who live over 1,000 metres (3,200 feet) above sea level and outside Tanzania’s traditional malarial zones.

Ms Asha Nsasu, 32, of Isebe village, had no idea she had contracted malaria when she was sent to Makandana District Hospital in late December. “I felt weak. I thought it was pneumonia,” Nsasu said. “Then they told me it was malaria.”

In 2009, health centres in Rungwe district reported 100,966 malaria cases, a jump of 25 per cent from 2006, hospital records show.

Malaria is now the biggest public health threat facing Rungwe district, which lies about 940 kilometres (590 miles) southwest of Dar es Salaam, according to the Tukuyu Medical Research Centre, part of the National Institute for Medical Research. One third of outpatients visiting the hospital were diagnosed with the mosquito-borne illness in 2007, according to records from that year, making it the most common disease for outpatients.

Most highland areas in Tanzania are experiencing a growing burden of malaria cases, officials at the Tukuyu Centre said. Climatic changes brought on in part by local environmental degradation are contributing to the growing prevalence of malaria in the district, said Mr Gideon Ndawala, Rungwe district’s malaria coordinator.

“People have cleared the forests, rain has decreased, temperatures have risen,” Mr Ndawala said in an interview. “(When) I first reported on the district in 1983, it was very cold and it rained throughout the year except from mid-September to early November. The weather was not favourable for mosquito breeding,” he said.

Now, however, temperatures are higher and rain more erratic, he said, and mosquito populations – which thrive on warmer temperatures and breed in pools of stagnant water – are on the rise. Worst hit by the surge in malaria are Tukuyu district town, Ikuti, Rungwe Mission and Ilolo, according to district health officials.

Half a century ago, these traditionally cool areas saw no mosquitoes and did not register any malaria cases, but now the weather is warmer, said Mr Ambakisye Mwakatobe, a 76-year-old man from Bulyaga village in Rungwe.

“In the past, we never saw mosquito nets here. I saw a net for the first time at the age of 20, when I joined Butimba Teachers College in 1957,” he said, in an interview at his village home.

Mzee Mwakatobe said cases of malaria began to appear several decades ago but residents did not relate them to warming temperatures, believing the mosquitoes instead were arriving on buses from lower regions.

“It was in the 1970s when we started getting malaria here. I thought it was the buses from Kyela and Usangu that brought mosquitoes,” he admitted. But “the weather also started to change in those years,” he said.

A half-century ago, “it was very cold here and it rained throughout the year. Three things were compulsory: a sweater, pullover or heavy jacket; an umbrella or raincoat; and gumboots,” he added. “There was frost all day long and cars had to put their lights on.

“But today things have changed,” he said. “Look, now we even put on light shirts. There is no need for sweaters, gumboots or umbrellas.”

Scientists agree that the changing weather is feeding into Rungwe’s worsening malaria problem.

“Up until 1960, districts like Rungwe, Mbeya, Mufindi, Njombe, Makete and Iringa in the southern highland regions were malaria free. Today is quite different – malaria prevalence is high,” said Mr Akili Kalinga, a research scientist at Tukuyu Medical Research Centre.

Malaria accounts for 30 per cent of the burden of disease in Tanzania and is a huge drain on productivity, according to a report produced by research scientists for the Sixth Africa Malaria Day in 2006. In response to the rising malaria caseload, the government is taking steps to stem the disease’s expansion.

Measures include public health education in newly vulnerable districts on home cleanliness and water storage, how to eliminate the places of still water where mosquitoes live and breed, and the use of mosquito nets and fumigation, said Dr Sungwa Ndagabwene, Rungwe’s medical officer.

“The government is taking serious measures to fight malaria. We started with a ‘mosquito nets for all’ campaign – saying every person should sleep under bed nets,” Mr Ndagabwene said.

The government also has begun spraying the inside of homes with insecticide, first in the Kagera Region and now throughout the Lake zone, near Lake Victoria, he said. It plans to expand the spraying programme, which has helped cut malaria transmission in Zanzibar, to the rest of the Tanzania’s malaria-affected regions.

Such spraying programmes aim to kill mosquitoes that land on the inside walls of homes. Spraying can protect homes for between four to ten months depending on the insecticide, according to the World Health Organisation (WHO).

WHO has approved 12 insecticides it considers safe for such spraying programmes, including DDT – a controversial endocrine disruptor that has proved one of the most effective ways to control mosquito populations but that has also been linked to environmental damage and health problems including cancer.

Mr Ndagabwene said spraying the chemical only indoors limited its environmental impact. WHO officials have said they believe the benefits of using the pesticide outweigh its risks. The Stockholm Convention bans the use of DDT but exempts countries that choose to use the chemical to control malaria.

Tanzania is one of the world’s worst malaria-affected countries, recording 14 to 18 million clinical cases annually and 60,000 deaths, 80 per cent of them in children under five years old, according to a 2010 malaria reduction plan put together by USAID.

Children under five and pregnant women are most affected by the disease, official health figures show. (AlertNet)

The author is a freelance writer based in Dar es Salaam

More:

• Also see this story, in which Tanzania’s health minister urges a continued focus on malaria, despite the decline in the disease in the country.

WHO, DDT and the Persistent Organic Pesticides Treaty: Historic view from the inside

Rollback Malaria (RBM) was established in 1998 in part to reinvigorate the worldwide fight against malaria, and in part to facilitate the negotiations for what became the Stockholm Convention, the Persistent Organic Pesticides Treaty of 2001.

Remember: World Malaria Day, April 25, 2011

That’s about the time the ungodly assault on WHO and Rachel Carson started, by hysterical DDT advocates.  We now know that Roger Bate, Richard Tren, Donald Roberts and their comrades in pens are stuck in that 1998 fight.

Here’s a short account, from RBM, about just what happened:

The DDT Controversy

In 1999 the RBM Secretariat was called upon to help resolve a controversy emerging from intergovernmental negotiations to establish an international environmental treaty. At the centre of this controversy was DDT, former hero of the malaria eradication campaign and current totemic villain of the environmental movement. The treaty being negotiated was intended to eliminate the production and use of twelve persistent organic pollutants. DDT, still used for malaria control in over 20 countries, was included among ‘the dirty dozen’ chemicals slated for elimination, eliciting a strong reaction from public health activists and malaria specialists who claimed that its elimination would result in unacceptable increases in malaria morbidity and mortality. Environmental specialists and others claimed that environmentally friendly alternatives to DDT, although more expensive, could easily be deployed to guard against such a negative impact.

The controversy over the role of DDT in malaria vector control and the dangers posed to the environment escalated and attracted considerable media attention. The controversy was perpetuated in part because of a relatively weak evidence base on the human toxicity of DDT, the cost-effectiveness of proposed alternatives, and the probable impact of public health use of DDT (compared to agricultural use) on the environment. Resolution was also hampered by the relative lack of public health expertise among the Intergovernmental Negotiating Committee delegates, who were primarily active in the fields of foreign and environmental policy.

The challenges presented to the RBM Secretariat in responding to the controversy were many and varied. They included: evaluation of the evidence base and the drafting of policy guidance (a WHO normative role); a major communications effort; and the establishment of new cross-sectoral partnerships and working relationships. In the process, RBM formed new and highly effective ‘partnerships’ or ‘working relations’ with the United Nations Environment Programme (UNEP), the US Environmental Protection Agency, the environmental policy apparatus of core RBM partners, as well as a variety of health and environmental NGOs. RBM conducted country and informal expert consultations and convened and chaired a special working group on DDT which was able to establish a position on the use of the insecticide in public health and the process for evaluating and moving to alternatives. The weight of WHO’s technical authority contributed greatly toward establishing the credibility of the working group. Information about the treaty negotiations and the WHO position on DDT was disseminated to health specialists via the WHO regional networks and to treaty focal points via UNEP.

The RBM Secretariat led the WHO delegation to all meetings of the Intergovernmental Negotiating Committee and prepared information and media events for each, supporting the participation of health/malaria specialists from a number of countries. The RBM Secretariat also served as the media focal point on malaria and DDT and provided interviews and information to all major media, as well as presentations to professional meetings and interest groups.

RBM’s objectives throughout this process were:

• to establish consensus on the present and future role of DDT and alternatives in malaria control;
• to encourage greater involvement of public health specialists in country-level discussions about the treaty and in country delegations to the negotiating sessions;
• to provide information to negotiators and others that would reduce controversy and result in a win-win situation for public health and the environment (in which the longer term goal of DDT elimination is achieved through strengthened, more robust malaria control);
• to benefit from the media attention to inform the public about malaria; and
• to mobilize resources to support malaria control from outside the health sector.

All of these objectives have been met and the final treaty, known as the ‘Stockholm Convention on Persistent Organic Pollutants’ provides for the continued public health use of DDT and international assistance for the development and implementation of alternatives.

Resources to support the initial work of the RBM Secretariat were provided by environmental agencies/offices. In addition, the Pan American Health Organization (PAHO) and the WHO Regional Office for the Americas (AMRO) and most recently the WHO Regional Office for Africa (AFRO) have been awarded project development grants from the Global Environment Facility (GEF) to promote regional efforts to strengthen malaria control and reduce reliance on DDT.

From Final Report of the External Evaluation of RBM, Roll Back Malaria to Date, Chapter 2, page 15 (circa 2001).