Disney showed how to beat malaria in the Americas, without DDT

February 26, 2017

Still photo from Walt Disney's "Winged Scourge," a wanted poster for "Anopheles, alias Malaria Mosquito." The 1943 film short suggested ways to cut populations of the malaria-spreading mosquitoes of the genus Anopheles. Disease prevention would aid the war effort in 1943, it was hoped.

Still photo from Walt Disney’s “Winged Scourge,” a wanted poster for “Anopheles, alias Malaria Mosquito.” The 1943 film short suggested ways to cut populations of the malaria-spreading mosquitoes of the genus Anopheles. Disease prevention would aid the war effort in 1943, it was hoped.

Malaria’s scourge hobbled economic progress across the Americas, and critically in World War II, that hobbled the war effort to defeat the Axis powers, Germany and Japan.

U.S. government recruiting of Hollywood film makers to produce propaganda films hit a zenith in the war. Even animated characters joined in. Cartoonists produced short subject cartoons on seeveral topics.

In 1943 the Disney studios distributed this film starring the Seven Dwarfs, among the biggest Disney stars of the time. The film was aimed at Mexico, Central America and South America, suggesting ways people could actually fight malaria. Versions were made in Spanish and English (I have found no Portuguese version for Brazil, but I’m still looking.)

the lost Disney described the film:

The first of a series of health-related educational shorts produced by the Disney studios and the Coordinator of Inter-American Affairs for showing in Latin America. It was also the only one to use established Disney characters (the Seven Dwarfs).

In this propaganda short, the viewers are taught about how the mosquito can spread malaria. A young mosquito flies into a house and consumes the blood of an infected human. She then consumes the blood of a healthy human, transmitting the disease into him. It turns out that this is actually a film within a film and the Seven Dwarves are watching it. They volunteer to get rid of the mosquito by destroying her breeding grounds.

A Spanish-language version of the film:

Fighting malaria in the U.S. became a grand campaign in Franklin Roosevelt’s administration. Roosevelt administration officials saw malaria as a sapper of wealth, especially in the rural south. Part of the charge of the Tennessee Valley Authority was to wipe out malaria. By 1932, public health agencies in malaria-affected counties were beefed up to be able to promptly diagnose and treat human victims of malaria. TVA taught methods of drying up mosquito breeding places around homes and outdoor work areas. Sustained campaigns urged people to make their homes tighter, against weather, and to install screens on windows and doors to prevent mosquito entry especially at peak biting periods, dusk to after midnight.

U.S. malaria deaths and infections plunged by 90% between 1933 and 1942 — just in time to allow southern military bases to be used for training activities for World War II. After the war, the malaria-fighting forces of the government became the foundation for the Centers for Disease Control (CDC). With the introduction of DDT after 1945, CDC had another weapon to completely wipe out the remaining 10% of malaria cases and deaths.

It’s worth noting that in the end, it is the disease malaria that is eradicated, not the mosquitoes. In most places in the world, eradication of a local population of disease carriers is a temporary thing. A few remaining, resistant-to-pesticide-or-method mosquitoes can and do quickly breed a new population of hardier insects, and often surrounding populations will contribute new genetic material. Eradication of a vector-borne disease requires curing the disease in humans, so that when the mosquitoes come roaring back, they have no well of disease from which to draw new infection.





No, Rachel Carson didn’t cause an increase in malaria; bonus film to WGBH American Experience “Rachel Carson”

February 7, 2017

Rachel Carson at a microscope, American Experience/RetroReport image. Did Carson's work cause an increase in malaria? Is she to blame for continued malaria deaths? No, answers a short film bonus to "Rachel Carson," the 2017 PBS film.

Rachel Carson at a microscope, American Experience/RetroReport image. Did Carson’s work cause an increase in malaria? Is she to blame for continued malaria deaths? No, answers a short film bonus to “Rachel Carson,” the 2017 PBS film.

A straight up, historic look at the question of Rachel Carson’s fault in stopping malaria.

Anti-environmentalists and corporate hoaxsters argue that Rachel Carson should be blamed for an imaginary increase in malaria deaths, after the U.S. banned DDT use on crops.

In conjunction with WGBH’s American Experience film on Carson released early in 2017, this short film focusing on malaria as a continuing plague puts to rest the idea that Carson should be blamed at all.

Soaking in the bathtub, we find the film not strident enough in defense of Carson; but for those strident nuts who claim Carson a murderer, it may have some good effect. And of course, you, intelligent dear reader, will be persuaded more gently.

Where malaria is the question, DDT is not the answer. Where malaria still exists, it’s not Rachel Carson’s fault.


Fact sheet for World Malaria Report 2016

December 16, 2016

A woman shows the mosquito net that protects her and her family from malaria transmission, in India. India remains the world's top DDT user, but is switching to nets in an effort to bring malaria rates down and set up malaria eradication before the end of DDT in 2020. WHO image.

A woman shows the mosquito net that protects her and her family from malaria transmission, in India. India remains the world’s top DDT user, but is switching to nets in an effort to bring malaria rates down and set up malaria eradication before the end of DDT in 2020. WHO image.

World Health Organization publishes an annual World Malaria Report, with the year appended to the title. It summarizes the state of the fight against malaria worldwide, recording progress and setbacks.

In the tally of progress we get a clear indication of what is needed to continue or increase that progress, with the ultimate goal of controlling malaria to the point it poses no great economic risk, or health risk, to any nation, or better that human malaria is eradicated.

World Malaria Report 2016 is 184 pages, shorter than some previous reports but packed with figures and history, some of which requires greater background to understand completely.

For example, the 2016 publication notes that about 412,000 people died from malaria in 2016. This is a shocking figure. Most of the news coverage of the report mentions this death toll in the first paragraph.

It’s too many deaths. But it’s a more than 50% reduction in deaths from 1990s rates, and it’s a more than 90% reduction from the annual death tolls that shocked the world to concerted action after World War II. Most estimates are that about 5 million people a year died from malaria through the 1950s, and into the 1960s.

WHO concentrates on the malaria fight, and plays down the political aspects to encourage international cooperation to help fight the disease. But there are political statements made, if one has the background to understand them. There remains controversy over the use of DDT, with many people yelling far and wide that if ‘bans on DDT were removed’ then malaria would quickly become an eradicated disease. This position ignores the facts, that there were still 5 million people dying each year during peak DDT use; that death tolls plunged after the U.S. banned DDT use on crops; that the U.S. ban covered only crop use, and that DDT use against disease has never been banned anywhere in the world; and that DDT use continued long after the U.S. banned DDT, around the world. DDT use never stopped.

Taken together, we would understand that the 90% reduction in malaria deaths from peak DDT use years, was accomplished mostly without DDT, and that therefore DDT is not a panacea.

World Malaria Report 2016 also tallies the slow demise of DDT. Mosquito resistance to pesticides, especially DDT, is a major problem in the fight against the disease. But more DDT can’t fix that problem now that every mosquito on Earth carries alleles that make them resistant and wholly immune to the stuff. DDT will probably never be a panacea, even were its manufacture not scheduled to stop very soon.

History, and a complete assessment of the science and current conditions in the frontlines of the malaria fight, can help us put these things in perspective.

So far, only the Los Angeles Times in the U.S. provided any in-depth reporting on World Malaria Report 2016. We hope other media will take up the challenge to inform. They will find WHO’s Fact Sheet useful.

With that warning in mind, it’s good to look at the broad outlines of the report, which WHO has packaged into a fact sheet for our convenience.

Fact Sheet: World Malaria Report 2016

13 December 2016

The World Malaria Report, published annually by WHO, tracks progress and trends in malaria control and elimination across the globe. It is developed by WHO in collaboration with ministries of health and a broad range of partners. The 2016 report draws on data from 91 countries and areas with ongoing malaria transmission.

Global progress and disease burden (2010–2015)

According to the report, there were 212 million new cases of malaria worldwide in 2015 (range 148–304 million). The WHO African Region accounted for most global cases of malaria (90%), followed by the South-East Asia Region (7%) and the Eastern Mediterranean Region (2%).

In 2015, there were an estimated 429 000 malaria deaths (range 235 000–639 000) worldwide. Most of these deaths occurred in the African Region (92%), followed by the South-East Asia Region (6%) and the Eastern Mediterranean Region (2%).

Between 2010 and 2015, malaria incidence rates (new malaria cases) fell by 21% globally and in the African Region. During this same period, malaria mortality rates fell by an estimated 29% globally and by 31% in the African Region.

Between 2010 and 2015, malaria incidence rates (new malaria cases) fell by 21% globally and in the African Region. During this same period, malaria mortality rates fell by an estimated 29% globally and by 31% in the African Region.

Other regions have achieved impressive reductions in their malaria burden. Since 2010, the malaria mortality rate declined by 58% in the Western Pacific Region, by 46% in the South-East Asia Region, by 37% in the Region of the Americas and by 6% in the Eastern Mediterranean Region. In 2015, the European Region was malaria-free: all 53 countries in the region reported at least 1 year of zero locally-acquired cases of malaria.

Children under 5 are particularly susceptible to malaria illness, infection and death. In 2015, malaria killed an estimated 303 000 under-fives globally, including 292 000 in the African Region. Between 2010 and 2015, the malaria mortality rate among children under 5 fell by an estimated 35%. Nevertheless, malaria remains a major killer of under-fives, claiming the life of 1 child every 2 minutes.

Trends in the scale-up of malaria interventions

Vector control is the main way to prevent and reduce malaria transmission. Two forms of vector control are effective in a wide range of circumstances: insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS).

ITNs are the cornerstone of malaria prevention efforts, particularly in sub-Saharan Africa. Over the last 5 years, the use of treated nets in the region has increased significantly: in 2015, an estimated 53% of the population at risk slept under a treated net compared to 30% in 2010.

Indoor residual spraying of insecticides (IRS) is used by national malaria programmes in targeted areas. In 2015, 106 million people globally were protected by IRS, including 49 million people in Africa. The proportion of the population at risk of malaria protected by IRS declined from a peak of 5.7% globally in 2010 to 3.1% in 2015.


WHO recommends diagnostic testing for all people with suspected malaria before treatment is administered. Rapid diagnostic testing (RDTs), introduced widely over the past decade, has made it easier to swiftly distinguish between malarial and non-malarial fevers, enabling timely and appropriate treatment.

New data presented in the report show that, in 2015, approximately half (51%) of children with a fever who sought care at a public health facility in 22 African countries received a malaria diagnostic test compared to 29% in 2010. Sales of RDTs reported by manufacturers rose from 88 million globally in 2010 to 320 million in 2013, but fell to 270 million in 2015.


Artemisinin-based combination therapies (ACTs) are highly effective against P. falciparum, the most prevalent and lethal malaria parasite affecting humans. Globally, the number of ACT treatment courses procured from manufacturers increased from 187 million in 2010 to a peak of 393 million in 2013, but subsequently fell to 311 million in 2015.

Prevention in pregnancy

Malaria infection in pregnancy carries substantial risks for the mother, her fetus and the newborn child. In Africa, the proportion of women who receive intermittent preventive treatment in pregnancy (IPTp) for malaria has been increasing over time, but coverage levels remain below national targets.

IPTp is given to pregnant women at scheduled antenatal care visits after the first trimester. It can prevent maternal death, anaemia and low birth weight, a major cause of infant mortality. Between 2010 and 2015, there was a five-fold increase in the delivery of 3 or more doses of IPTp in 20 of the 36 countries that have adopted WHO’s IPTp policy – from 6% coverage in 2010 to 31% coverage in 2015.

Insecticide and drug resistance

In many countries, progress in malaria control is threatened by the rapid development and spread of antimalarial drug resistance. To date, parasite resistance to artemisinin – the core compound of the best available antimalarial medicines – has been detected in 5 countries of the Greater Mekong subregion.

Mosquito resistance to insecticides is another growing concern. Since 2010, 60 of the 73 countries that monitor insecticide resistance have reported mosquito resistance to at least 1 insecticide class used in nets and indoor spraying; of these, 50 reported resistance to 2 or more insecticide classes.

Progress towards global targets

To address remaining challenges, WHO has developed the Global Technical Strategy for Malaria 2016-2030 (GTS). The Strategy was adopted by the World Health Assembly in May 2015. It provides a technical framework for all endemic countries as they work towards malaria control and elimination.

This Strategy sets ambitious but attainable goals for 2030, with milestones along the way to track progress. The milestones for 2020 include:

  • Reducing malaria case incidence by at least 40%;
  • Reducing malaria mortality rates by at least 40%;
  • Eliminating malaria in at least 10 countries;
  • Preventing a resurgence of malaria in all countries that are malaria-free.

Progress towards the GTS country elimination milestone is on track: In 2015, 10 countries and areas reported fewer than 150 locally-acquired cases of malaria. A further 9 countries reported between 150 and 1000 cases.

However, progress towards other GTS targets must be accelerated. Less than half (40) of the 91 malaria-endemic countries are on track to meet the GTS milestone of a 40% reduction in malaria case incidence by 2020. Progress has been particularly slow in countries with a high malaria burden.

Forty-nine countries are on track to achieve the milestone of a 40% reduction in malaria mortality; this figure includes 10 countries that reported zero malaria deaths in 2015.

Funding trends

In 2015, malaria funding totalled US$ 2.9 billion, representing only 45% of the GTS funding milestone for 2020. Governments of malaria-endemic countries provided 32% of total funding. The United States of America and the United Kingdom are the largest international funders of malaria control and elimination programmes, contributing 35% and 16% of total funding, respectively. If the 2020 targets of the GTS are to be achieved, total funding must increase substantially.



Good news, or great challenge? U.S. could help eliminate malaria

December 13, 2016

World Malaria Report 2016, published December 13, offers great hope in progress made against malaria in the past 16 years.

But it also notes a severe challenge: Funding to beat malaria works well, but funding pledges sometimes are not met, and progress against the disease slowed some in 2016.

In 2000, nearly a million people died from malaria worldwide. In 2015, the death toll had been cut to ~470,000, a 50% reduction in 15 years.

In 2016, ~429,000 people died from malaria. It’s 40,000 fewer people than the year before. Malaria fighters had hoped for more.

Most deaths occur in Africa, most deaths occur to children, and most deaths occur in areas where distribution of insecticide-impregnated bednets has not been complete. Distribution was slowed in 2016 by lack of funds at steps in the process, from manufacturing the nets (now done significantly in Africa) to distributing the nets, to educating people how to use them. Nets are more effective than pesticide spraying, with DDT or the other 11 approved pesticides, and considerably less expensive.

A child shows off the mosquito bednet that keeps him malaria-free. Image from Nothing But Nets.

A child shows off the mosquito bednet that keeps him malaria-free. Image from Nothing But Nets.

WHO’s press release on the Report laid out the problem, with hints at a solution.

Sustained and sufficient funding for malaria control is a serious challenge. Despite a steep increase in global investment for malaria between 2000 and 2010, funding has since flat-lined. In 2015, malaria funding totalled US$ 2.9 billion, representing only 45% of the funding milestone for 2020 (US$ 6.4 billion).

Governments of malaria-endemic countries provided about 31% of total malaria funding in 2015. The United States of America is the largest international malaria funder, accounting for about 35% of total funding in 2015, followed by the United Kingdom of Great Britain and Northern Ireland (16%).

U.S. funding was just over $1 billion. That may sound like a lot, but it’s not even a drop in the U.S. federal budget bucket.

With a doubling of the U.S. contribution to $2 billion, the U.S. could again lead the world in fighting malaria, and set a good example of American democracy in action.

In doing that, another 100,000 lives might be saved each year.

Then, U.S. would have high moral ground to urge other nations to contribute to fighting malaria, either directly through WHO or through non-governmental organizations whose work goes too-often unsung, such as Malaria No More, Nothing But ‘Nets, and the Clinton Foundation.

$10 buys a net and distribution, and a net protects a child from malaria better than spraying dangerous insecticides, for two to five years.

What are the odds the Trump administration could be recruited to beat malaria? Let’s increase those odds.

WHO’s World Malaria Report 2016 shows great progress, but funding slowdown hurts the fight against malaria

December 13, 2016

Promotional poster for the World Malaria Report 2016, from WHO

Promotional poster for the World Malaria Report 2016, from WHO; poster shows a woman and her child, protected from mosquitoes behind a bednet.

Incidence of malaria dropped to a new, all-time low in 2016, with reductions in total infections to 212 million, and a drop in malaria deaths to 429,000, worldwide. Malaria fighters had hoped the decreases would be greater.

Cover of World Malaria Report 2016, from the World Health Organization (WHO). The report has been published annually since at least 2008, tracking progress in the fight to control and eradicate malaria, one of the greatest scourge diseases in human history.

Cover of World Malaria Report 2016, from the World Health Organization (WHO). The report has been published annually since at least 2008, tracking progress in the fight to control and eradicate malaria, one of the greatest scourge diseases in human history.

This news comes from the World Health Organization’s (WHO) World Malaria Report 2016, released this morning in Geneva, Switzerland.

Of concern to readers here, the report lists ten nations still using DDT, the same number as 2015. Nine African nations and India still find some utility in DDT, though resistance to the long-used pesticide is found in almost all populations of almost all varieties of mosquito.

India remains the world’s heaviest user of DDT and the only place DDT is manufactured. The nine DDT-using African nations are Botswana, Democratic Republic of Congo, Gambia, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe. Due to mosquito and other vector insect resistance to DDT, India will stop using DDT by 2020, and stop manufacturing at the same time.

Insecticide-impregnated bednets now are the chief tool used to prevent spread of new malaria infections. Nets have proven more effective than Indoor Residual Spraying (IRS), which has always been the chief use of DDT in the malaria fight. The report notes that mosquito resistance grows alarmingly to the preferred net pesticides, pyrethroids. Nets provide a physical barrier to mosquitoes, however, and work even when the insecticides wear off.

This years report is shorter than previous years, but still loaded with statistics and policy issues to be unpacked in the next few days.

WHO’s press release:


Malaria control improves for vulnerable in Africa, but global progress off-track

News release

WHO’s World Malaria Report 2016 reveals that children and pregnant women in sub-Saharan Africa have greater access to effective malaria control. Across the region, a steep increase in diagnostic testing for children and preventive treatment for pregnant women has been reported over the last 5 years. Among all populations at risk of malaria, the use of insecticide-treated nets has expanded rapidly.

But in many countries in the region, substantial gaps in programme coverage remain. Funding shortfalls and fragile health systems are undermining overall progress, jeopardizing the attainment of global targets.

Scale-up in malaria control

Sub-Saharan Africa carries a disproportionately high share of the global malaria burden. In 2015, the region was home to 90% of malaria cases and 92% of malaria deaths. Children under five years of age are particularly vulnerable, accounting for an estimated 70% of all malaria deaths.

Diagnostic testing enables health providers to rapidly detect malaria and prescribe life-saving treatment. New findings presented in the report show that, in 2015, approximately half (51%) of children with a fever seeking care at a public health facility in 22 African countries received a diagnostic test for malaria, compared to 29% in 2010.

To protect women in areas of moderate and high malaria transmission in Africa, WHO recommends “intermittent preventive treatment in pregnancy” (IPTp) with sulfadoxine-pyrimethamine. The treatment, administered at each scheduled antenatal care visit after the first trimester, can prevent maternal and infant mortality, anaemia, and the other adverse effects of malaria in pregnancy.

According to available data, there was a five-fold increase in the percentage of women receiving the recommended 3 or more doses of this preventive treatment in 20 African countries. Coverage reached 31% in 2015, up from 6% in 2010.

Insecticide-treated nets are the cornerstone of malaria prevention efforts in Africa. The report found that more than half (53%) of the population at risk in sub-Saharan Africa slept under a treated net in 2015, compared to 30% in 2010.

Last month, WHO released the findings of a major 5-year evaluation in 5 countries. The study showed that people who slept under long-lasting insecticidal nets (LLINs) had significantly lower rates of malaria infection than those who did not use a net, even though mosquitoes showed resistance to pyrethroids (the only insecticide class used in LLINs) in all of these areas.

An unfinished agenda

Malaria remains an acute public health problem, particularly in sub-Saharan Africa. According to the report, there were 212 million new cases of malaria and 429 000 deaths worldwide in 2015.

There are still substantial gaps in the coverage of core malaria control tools. In 2015, an estimated 43% of the population in sub-Saharan Africa was not protected by treated nets or indoor spraying with insecticides, the primary methods of malaria vector control.

In many countries, health systems are under-resourced and poorly accessible to those most at risk of malaria. In 2015, a large proportion (36%) of children with a fever were not taken to a health facility for care in 23 African countries.

“We are definitely seeing progress,” notes Dr. Pedro Alonso, Director of the WHO Global Malaria Programme. “But the world is still struggling to achieve the high levels of programme coverage that are needed to beat this disease.”

Global targets

At the 2015 World Health Assembly, Member States adopted the Global Technical Strategy for Malaria 2016-2030. The Strategy set ambitious targets for 2030 with milestones every 5 years to track progress.

Eliminating malaria in at least 10 countries is a milestone for 2020. The report shows that prospects for reaching this target are bright: In 2015, 10 countries and territories reported fewer than 150 indigenous cases of malaria, and a further 9 countries reported between 150 and 1000 cases.

Countries that have achieved at least 3 consecutive years of zero indigenous cases of malaria are eligible to apply for the WHO certification of malaria elimination. In recent months, the WHO Director-General certified that Kyrgyzstan and Sri Lanka had eliminated malaria.

But progress towards other key targets must be accelerated. The Strategy calls for a 40% reduction in malaria case incidence by the year 2020, compared to a 2015 baseline. According to the report, less than half (40) of the 91 countries and territories with malaria are on track to achieve this milestone. Progress has been particularly slow in countries with a high malaria burden.

An urgent need for more funding

Sustained and sufficient funding for malaria control is a serious challenge. Despite a steep increase in global investment for malaria between 2000 and 2010, funding has since flat-lined. In 2015, malaria funding totalled US$ 2.9 billion, representing only 45% of the funding milestone for 2020 (US$ 6.4 billion).

Governments of malaria-endemic countries provided about 31% of total malaria funding in 2015. The United States of America is the largest international malaria funder, accounting for about 35% of total funding in 2015, followed by the United Kingdom of Great Britain and Northern Ireland (16%).

If global targets are to be met, funding from both domestic and international sources must increase substantially.

Note to editors

RTS,S/AS01 malaria vaccine

Last month, WHO announced that the world’s first malaria vaccine would be rolled out through pilot projects in 3 countries in sub-Saharan Africa. Vaccinations will begin 2018. The vaccine, known as RTS,S, acts against P. falciparum, the most deadly malaria parasite globally, and the most prevalent in Africa. Advanced clinical trials have shown RTS,S to provide partial protection against malaria in young children.

WHO multi-country evaluation on LLINs

On 16 November 2016, WHO released the findings of a 5-year evaluation conducted in 340 locations across 5 countries: Benin, Cameroon, India, Kenya and Sudan. The findings of this study reaffirm the WHO recommendation of universal LLIN coverage for all populations at risk of malaria.

Will major media cover this news? Will your local newspapers and broadcast outlets even make note?


Report that malaria and DDT hoaxsters hope you never see

January 21, 2016

 Cover of World Health Organization's "World Malaria Report 2015," which reported dramatic progress controlling malaria.

Cover of World Health Organization’s “World Malaria Report 2015,” which reported dramatic progress controlling malaria.

World Malaria Report 2015 dropped in mid-December, with United Nations-style fanfare.

Which means, you probably heard little to nothing about it in U.S. media, and “conservatives” and anti-science hoaxsters hope you won’t ever see it, so they can claim contrary to the facts that liberals kill kids in Africa.

My cynicism about the fight against malaria dissipates some, but my cynicism about hoaxes substituting for political dialogue grows.

World Health Organization (WHO) releases an annual report near the end of every year, detailing the fight against malaria and progress or lack of it.

Good news this year: WHO estimates deaths to malaria fell below 500,000 per year in 2015. That’s at least a 50% reduction since renewed vigor in the malaria fight in 2000, and it’s a 90% reduction from peak DDT use years, 1958-1963, when WHO estimated 5 million people died each year from malaria.

About 80% of malaria deaths take children under the age of 5.

Bigger picture: Malaria is on the run. Humans are winning the fight against malaria. Much remains to be done, however. Plus, malaria fighters warn that malaria can come roaring back, if governments neglect to follow through on promises of funding, and with well-run programs to cure humans of malaria and prevent new cases.

World Malaria Report 2015 should influence policy discussions in U.S. elections. But generally, this report was ignored.

Millard Fillmore’s Bathtub will feature in-depth discussions of parts of the report, and simple repetition for the record of the report, as part our long-term battle against hoaxsters who claim the U.S. ban on use of DDT on U.S. farms somehow increased malaria in Africa, and killed millions, when malaria actually decreased and millions were saved from death.

Malaria loses only with hard work on the ground by medical people treating and curing humans of the disease, and by public health people working hard to prevent new infections. Most of that work is not glorious, occurs relatively anonymously and away from television cameras and photographers with access to social media.  Which is to say, the hard work of defeating malaria goes unsung around the world. We should work to change that.

What did others say about World Malaria Report?

A collection of Tweets, and other links, for your study.

How USA spends so much money to fight malaria in other nations

January 2, 2016

Fighting malaria is difficult, and complex, and expensive. No magic bullet can slow or stop malaria.

Reasonable people understand the stakes, not only for Africa, where $12 billion is lost every year to malaria illness and death, according to WHO records; but also for all nations who trade with Africa and other malaria endemic nations in the world.

What should we do about malaria?

Before we leap to solutions, let us look to see what the United States is already doing, according to USAID, the agency which has led U.S. malaria-fighting since the 1950s.

USAID explains on their website:

Fighting Malaria

A mother and child sit under the protection of malaria nets

A mother and child sit under the protection of malaria nets. Learn more about PMI’s contributions to the global fight against malaria. Maggie Hallahan Photography

Each year, malaria causes about 214 million cases and an estimated 438,000 deaths worldwide

While malaria mortality rates have dropped by 60 percent over the period 2000–2015, malaria remains a major cause of death among children. Although the disease is preventable and curable, it is estimated that a child dies every minute from malaria. In Asia and the Americas, malaria causes fewer severe illnesses and deaths, but antimalarial drug resistance is a serious and growing problem.

The U.S. Agency for International Development (USAID) has been committed to fighting malaria since the 1950s. Malaria prevention and control remains a major U.S. foreign assistance objective and supports the U.S. Government’s vision of ending preventable child and maternal deaths and ending extreme poverty. USAID works closely with national governments to build their capacity to prevent and treat the disease. USAID also invests in the discovery and development of new antimalarial drugs and malaria vaccines. USAID-supported malaria control activities are based on country-level assessments, and a combination of interventions are implemented to achieve the greatest public health impact – most importantly the reduction of maternal and child mortality. These interventions include:

  • Indoor residual spraying (IRS): IRS is the organized, timely spraying of an insecticide on the inside walls of houses or dwellings. It kills adult mosquitoes before they can transmit malaria parasites to another person.
  • Insecticide-treated mosquito nets (ITNs): An insecticide-treated mosquito net hung over sleeping areas protects those sleeping under it by repelling mosquitoes and killing those that land on it.
  • Intermittent preventive treatment for pregnant women (IPTp): Approximately 125 million pregnant women annually are at risk of contracting malaria. IPTp involves the administration of at least two doses of an antimalarial drug to a pregnant woman, which protects her against maternal anemia and reduces the likelihood of low birth weight and perinatal death.
  • Diagnosis and treatment with lifesaving drugs: Effective case management entails diagnostic testing for malaria to ensure that all patients with malaria are properly identified and receive a quality-assured artemisinin-based combination therapy (ACT).

The President’s Malaria Initiative (PMI) works in 19 focus countries in sub-Saharan Africa and the Greater Mekong Subregion in Asia. PMI is an interagency initiative led by USAID and implemented together with the U.S. Centers for Disease Control and Prevention. In 2015, PMI launched its next 6-year strategy for 2015–2020, which takes into account the progress over the past decade and the new challenges that have arisen. It is also in line with the goals articulated in the Roll Back Malaria (RBM) Partnership’s second generation global malaria action plan, Action and Investment to Defeat Malaria (AIM) 2016–2030: for a Malaria-Free World [PDF, 18.6MB] and The World Health Organization’s (WHO’s) updated Global Technical Strategy: 2016–2030 [PDF, 1.0MB]. The U.S. Government’s goal under the PMI Strategy 2015-2020 [PDF, 8.9MB] is to work with PMI-supported countries and partners to further reduce malaria deaths and substantially decrease malaria morbidity, toward the long-term goal of elimination. USAID also provides support to malaria control efforts in other countries in Africa, including Burkina Faso, Burundi and South Sudan, and one regional program in the Amazon Basin of South America. The latter program focuses primarily on identifying and containing antimalarial drug resistance.

Do you think the U.S. spends too much on foreign aid, even good aid to fight malaria? How much do you think is spent? Put your estimate in comments, please — and by all means, look for sources to see what the actual amount is.

Bednets enough enough to beat malaria in most places

October 8, 2015

Reuters caption:  A displaced child plays on a mattress under a mosquito net laid in the open at Tomping camp near South Sudan's capital Juba January 7, 2014. Reuters/James Akena/Files

Reuters caption: A displaced child plays on a mattress under a mosquito net laid in the open at Tomping camp near South Sudan’s capital Juba January 7, 2014. Reuters/James Akena/Files

Another blow to the DDT partisans.

In a report published last January, which I just reread, researchers found that bednets alone offer enough prevention of malaria that Indoor Residual Spraying (IRS) using DDT or one of the other 11 WHO-approved insecticides, offers no additional protection, but at additional cost.

Lancet study said bednets alone are effective against malaria transmission, and spraying insecticides gives no additional benefit.

Reuters reported:

Spraying insecticides indoors offers children no additional protection from malaria when bed nets are used, a study said on Tuesday, as malaria cases and deaths worldwide continue to fall.

A study by medical journal The Lancet said donors should invest their limited resources on additional bed nets as the most cost-effective solution to tackling malaria, costing an average of $2.20 per person compared to $6.70 for insecticide.

“High bed net use is sufficient to protect people against malaria in areas that have low or moderate levels of malaria,” lead author Steve Lindsay said in a statement.

Malaria, a mosquito-borne parasitic disease, kills more than 600,000 people a year, and most victims are children under five living in the poorest parts of sub-Saharan Africa.

The study coincided with the launch of the World Health Organisation’s (WHO) annual World Malaria Report, which said the number of global malaria deaths fell by 47 percent between 2000 and 2013, with malaria cases also steadily declining, due to improved access to testing, treatment and bed nets. (http://in.reuters.com/article/2014/12/09/health-malaria-nets-idINKBN0JN0YT20141209)


Reuters’s report is longer, at Reuters’s site.

But another report by June indicates that gains against malaria can still be tough to maintain, especially with global warming creeping up on us.

The fight’s not over.

Malaria No More notes milestone: Malaria at all time low

August 20, 2015

Remarkable progress against malaria marks the 21st century — but there was even more progress between 1960 and 2000. This progress usually is not noted in screeds against the World Health Organization (WHO), or Rachel Carson, or “crazy environmentalists.”

Through the 1950s, WHO estimated malaria deaths worldwide at about 5 million people each year. In about a decade of WHO’s malaria eradication campaign in temperate zones, the toll is estimated to have dropped to about 4 million dead each year.  WHO suspended the eradication campaign in 1963 when it was discovered that mosquitoes in central Africa were already resistant and immune to DDT, which was the chief pesticide used for Indoor Residual Spraying to temporarily knock down local mosquito populations. WHO tried to find substitutes for DDT, but by 1969 formally ended the program and stopped asking for money for eradication.

The fight against malaria continued, however. In 1972 the U.S. flooded malaria-prone nations with DDT which had been intended for use on U.S. crops, after the U.S. prohibited DDT on U.S. crops. For a dozen years all U.S. DDT production got channeled into Africa and Asia to fight disease.  U.S. makers had gotten out of DDT production by 1985 as production shifted to other nations.

Despite DDT’s failure, progress was made in medical care and especially in education on how to prevent mosquito bites.  The death toll dropped toward 1 million annually until about 1990. In the late 1980s, the medicines used to cure humans from malaria parasites failed, as the parasites developed their own resistance to the drugs. Through the 1990s, malaria deaths remained constant, or even rose.

A flood of concern in the late 1990s produced a coalition of malaria fighters with funding through the United Nations and non-governmental organizations (NGOs) such as the Gates Foundation and Wellcome Trust. In 1999, most of these groups agreed to fight harder, using “integrated vector management,” a variety of methods calculated to prevent mosquitoes from developing resistance to new pesticides, and prevent the malaria parasites from developing resistance to pharmaceuticals.

Plus, in nations where houses often were leaky to mosquitoes, these agencies provided bednets to prevent bites of malaria-carriers at peak biting periods, when people slept. By 2008, deaths dropped below a million each year for the first time, and progress has continued.

Beating malaria is a top goal of the United Nations’ Millennium Development Goals (MDGs); Malaria No More reported on a recently-completed report on those goals, which noted the progress against malaria.

Here is the press release from Malaria No More.

Malaria Deaths Reach All Time Low, U.N. Secretary General’s Final MDG Report Shows

NEW YORK, NY – July 6, 2015 – Malaria deaths have reached an all-time low and 6.2 million lives have been saved from the disease between 2000-2015, according to a new United Nations report announced by U.N. Secretary-General Ban Ki-moon’s office today. The final report on progress of the Millennium Development Goals (MDGs), which are set to expire this year, highlights an historic 69 percent decline in the rate of child deaths from malaria in Africa.

The report provides an update to all eight MDG Goals. The unprecedented global leadership over the past ten years to combat malaria has not only surpassed the disease-specific MDG target (Goal 6, Combat HIV/AIDS, Malaria and Other Diseases), but those efforts also contributed to critical progress toward achieving Goals 4 (Reduce Child Mortality) and 5 (Improve Maternal Health).

“Malaria is one of the standout successes of the MDGs thanks to continuous innovation, bold endemic country leadership and steadfast donor commitment,” said Ray Chambers, the U.N. Secretary-General’s Special Envoy for Malaria and Financing the Health MDGs. “We need to build on this success to ensure no child, woman or man dies from a mosquito bite and that we ultimately eradicate this disease.”

Thanks to the leadership of the United States, the Global Fund to Fight AIDS, Tuberculosis and Malaria and other international donors, malaria financing has grown dramatically from 2000-2015 to more than $3 billion annually, and political leadership has fueled the delivery of more than 1 billion mosquito nets to Africa along with hundreds of millions of effective tests and treatments.

Although these results have successfully surpassed the MDG target, the fight against malaria is not finished. Malaria remains a major global health security challenge with an estimated 3.3 billion people at risk globally. Thanks to recent success in achieving real and measureable progress, coupled with steadfast political leadership and a promising pipeline of transformative new technologies, malaria-affected regions have set ambitious goals for elimination including transformative 2020 targets in Southern Africa, Southeast Asia and the Caribbean.

“Malaria is one of the oldest and deadliest diseases in human history,” said Martin Edlund, CEO of Malaria No More. “For the first time in history we have the opportunity to capitalize on our success and end malaria within a generation; we can’t afford to miss that opportunity.”

Click here to download the full report.

Chart from USNews.com:

Estimated change in malaria incidence rate (cases per 1,000 population at risk) and malaria mortality rate (deaths per 100,000 persons at risk), 2000-2015. USNews.com chart, based on MDG report.

Estimated change in malaria incidence rate (cases per 1,000 population at risk) and malaria mortality rate (deaths per 100,000 persons at risk), 2000-2015. USNews.com chart, based on MDG report.

Malaria Twitterstorm, summer of 2015

August 18, 2015

Several good developments in the War on Malaria, worldwide — along with some alarming signs.  Maybe there will be time to blog seriously about each of these things later. Let’s get them known, and keep discussion going for the best way to beat malaria in a post-DDT world.

QPharm Tweeted about DSM 265, an experimental, one-dose treatment developed by the Medicines for Malaria Venture (MMV); the video is useful for the background those new to the issue can get on the problems of treating malaria, which make great hurdles for campaigns to eradicate malaria.

Here’s the video the Tweet leads to.

MMV said:

DSM265 is a selective inhibitor of the plasmodial enzyme called DHODH. DHODH is a key enzyme in the replication of the parasite. If we can inhibit that enzyme with DSM265, we can stop the life of the parasite.

Voice of America reported on Rollback Malaria’s call for $100 billion to be spent in the next 15 years, to stamp out the disease.

Malaria deaths are, in 2015, at an “all time low.” Deaths hover around 500,000 per year, most in Africa, and most among children under the age of 5. A staggering total, until compared to the post-World War II estimates of more than 5 million deaths per year, or the more than 3 million deaths per year in 1963, the year the World Health Organization (WHO) had to stop its ambitious campaign to eradicate malaria when pesticide DDT, upon which the campaign was based, produced resistance in mosquitoes in areas where the campaign had not yet reached.

Beating malaria is one of the Millennium Development Goals of the United Nations; this year’s report on MDG acknowledged the great progress already made.

Another non-governmental malaria-fighting organization discussed the news; see the press release from Malaria No More.

Medical News Today Tweeted out a tout for its own coverage of malaria — notable for a good, basic explanation of malaria and how to fight it.  I wish critics of Rachel Carson and WHO were familiar with half of these basic facts.

Medical News Now's Fast Facts on Malaria

Medical News Now’s Fast Facts on Malaria. Notable, that annual deaths now are way below the million mark. Good news!

One malaria vaccine has won approval for final testing. Good news, though anyone who follows vaccines knows it will take a while to test, and anyone who knows malaria fighting knows there are four different parasites, and delivery of any medical care is tough in far too many parts of the world where any form of malaria is endemic. Even small good news is good news.

Are we better informed about malaria now? Do we understand spreading a lot more DDT is not the answer?


Wellcome Trust interactive on malaria parasites’ lifecycle

August 12, 2015

Screen capture of the Wellcome Trust HTML presentation on the life cycle of malaria parasites. Malaria fighters know all this almost instinctively; too often policy makers fail to understand it, and so they recommend policies that do not make medical or economic sense in fighting the disease. Click image to go to Wellcome Trust site for full presentation.

Screen capture of the Wellcome Trust HTML presentation on the life cycle of malaria parasites. Malaria fighters know all this almost instinctively; too often policy makers fail to understand it, and so they recommend policies that do not make medical or economic sense in fighting the disease. Click image to go to Wellcome Trust site for full presentation.

Britain’s Wellcome Trust takes as one of its key missions the fight against malaria.  The Trust is a charitable foundation created from profits of pharmaceutical development and sales.

Recently I found this HTML animation presentation on the life cycle of the malaria parasite, something all malaria fighters must know to be effective.

It’s also something that DDT advocates seem unable to comprehend.  Malaria is not a virus, nor is it a venom mosquitoes manufacture, but it is a parasite that infects (and disables) both mosquitoes and humans. Mosquitoes catch the parasite from an infected human host. After the malaria parasite completes a couple of cycles in the gut of the mosquito, the parasite can be transmitted back to humans by a mosquito bite. And the cycle continues.

Since complete eradication of malaria-carrying mosquitoes is practically impossible in almost all cases, beating malaria requires an interruption in the cycle of transmission of the parasite, plus the curing of the disease in infected human hosts.

For example, the old World Health Organization (WHO) malaria eradication campaign, which operated from 1955 to 1963, DDT was used to temporarily knock down a population of mosquitoes, with hopes human hosts would be ridded of malaria parasites so that, in six months or so, when the mosquito populations roared back, there would be no malaria in local humans to infect mosquitoes. Consequently, mosquitoes can’t transmit a parasite they don’t have.

Lost on far too many people: Humans must be cured of malaria to prevent transmission. Beating malaria takes a lot more than just killing mosquitoes.

Check out the interactive:  Malaria parasite life cycle

While you’re there, snoop around to see what else Wellcome Trust is up to in the malaria fight.


India, world’s top DDT user, socked with malaria increase

July 22, 2015

Were it true that DDT is a magic solution to malaria, by all measures India should be malaria free.

Not only is India not malaria-free, but the disease increases in infections, deaths, and perhaps, in virulence.

Map showing location of Odisha, or Orissa, state, in India. Wikipedia image

Map showing location of Odisha, or Orissa, state, in India. Wikipedia image

Since the late 1990s a small, well-funded band of chemical and tobacco industry propagandists conducted a campaign of calumny against Rachel Carson, environmentalists in general, scientists and health care workers, claiming that an unholy and wrongly-informed conspiracy took DDT off the market just as great strides were beginning to be made against malaria.

As a consequence, this group argues, malaria infections and deaths exploded, and tens of millions of people died unnecessarily.

That’s a crock, to be sure. Rachel Carson’s 1962 book, Silent Spring, inspired an already-established campaign against DDT. But the malaria eradication program begun with high hopes by the World Health Organization in 1955, foundered in 1963 when the campaign turned to central, tropical Africa. Overuse of DDT in agriculture and minor pest control had bred DDT-resistant and immune mosquitoes.  Malaria fighters could not knock down local populations of mosquitoes well enough to let medical care cure infected humans.  (The campaign was not helped by political instability in some of the African nations; 80% of houses in an affected area need to be sprayed inside to stop malaria, and that requires government organizational skills, manpower and money that those nations could not muster.)

Detail map of Odisha state, India; map by Jayanta Nath, Wikipedia image

Detail map of Odisha state, India; map by Jayanta Nath, Wikipedia image

That was just a year after Carson’s book hit the shelves. DDT had been banned nowhere. WHO’s workers tried to get a campaign going, but complete failures stopped the program in 1965; in 1969 WHO’s board met and officially killed the malaria eradication program, in favor of control.

Malaria infections and deaths did not expand with the end of WHO’s campaign.  At peak DDT use, roughly 1958 to 1963, malaria deaths are estimated by WHO to have been as high as 5 million per year, 4 million by 1963. Total malaria infections, worldwide, were 500 million.

The first bans on DDT use came in Europe. When the U.S. banned DDT use on crops in 1972, okaying use to fight malaria, malaria deaths had fallen to more than 2 million annually by optimistic estimates.  Death rates and infection rates continued to fall without a formal eradication campaign. By the late 1980s, malaria killed about 1.5 million each year, a great improvement over the DDT go-go days, but still troubling.

Beating malaria is a multi-step program.  Malaria parasites must complete a life cycle in a human host, and then when jumping to a mosquito, another cycle of about two weeks in the mosquito’s gut, before being transmissible back to humans. Knocking down mosquito populations helps prevent transmission temporarily, but that is only useful if in that period the human hosts can be cured of the parasites.

In the late 1980s, malaria parasites developed strong resistance and immunity to pharmaceuticals given to humans to cure them.  Regardless mosquito populations, human hosts were always infected, ready to transmit the parasite to any mosquito and send drug-resistant malaria on to dozens more.

From about 1990 to about 2002, malaria deaths rose modestly to more than 1.5 million annually.

New pharmaceuticals, and new regimens of administration of pharmaceuticals, increased the effectiveness of human treatments; coupled with much better understanding of malaria vectors, the insects that transmit the disease, and geographical data and other technological advances to speed diagnosis and treatment of humans, and increase prevention measures, WHO and private foundations started a series of programs in malaria-endemic nations to reduce infections and deaths. Insecticide-impregnated bednets proved to be less-expensive and more effective than Indoor Residual Spraying (IRS) featuring DDT or any of the other 11 pesticides WHO authorizes for home spraying.  (Home spraying targets mosquitoes that carry malaria, and limits expensive overuse of pesticides, plus limits and prevents environmental damage.)

Health care workers and most nations made dramatic progress in controlling and eliminating malaria, between 2000 and 2015, mostly without using DDT which proved increasingly ineffective at controlling mosquitoes, and which also proved unpopular among malaria-affected peoples whose cooperation is necessary to fight the disease.

By 2014, fewer than 220 million people got malaria infections, worldwide, a reduction of about 55% over DDT’s peak-use years. This is remarkable considering the population of the planet more than doubled in that time, and population in malaria-endemic areas rose even more. Malaria deaths were reduced to fewer than 600,000 annually, a reduction of more than 80% over peak DDT years. By 2015, malaria-fighters once again spoke of eradicating malaria from the planet.

In contrast, India assumed the position of top producer of DDT in the world, still making it even after China and North Korea stopped making it. But malaria control in India weakened, despite greater application of DDT.  The world watches as DDT, once the miracle pesticide used in anti-malaria campaigns, became instead a depleted tool, unable to stop malaria’s spread despite increasing application.

Were DDT the magic powder, or even “excellent powder” its advocates claim, India should be free of malaria, totally. Instead, Indians debate how best to get control of the disease again, and start reducing infections and deaths, again. Below is one story, rather typical of many that crop up from time to time in India news; this is from the Odisha Sun Times. (Note: Lakh is a unit in the Indian number system equal to 100,000; crore is a unit equal to 10,000,000.)

Odisha has 36% of malaria cases in India; ranks third in deaths

Odisha Sun Times Bureau
Bhubaneswar, Mar 15:

Odisha has earned the dubious distinction of having a hopping 36% share of all malaria cases in India and ranking third in the list of states with the most number of deaths leaving most of its neighbours way behind.

Malaria Mosquito

These startling revelations have been made in a report tabled by the Union Health and Family Welfare department in the Parliament.

What is more disturbing is that the number of persons getting afflicted with the disease in the state is rising every year despite the state government spending crores of rupees to arrest the spread of the disease.

The state government has been spending crores of rupees on a scheme christened ‘Mo Masari’ (“My Mosquito Net’) and has been claiming that the number of afflicted has been falling in the state. But the Central government report has exposed the hollowness of the claim.

According to the report, out of the 10.70 lakh people who were afflicted with malaria in India in the year 2014, about 3.88 lakh (36.26%) were from Odisha. In 2010, around 3.95 lakh were afflicted with the disease. The number had come down to 3.08 lakh in 2011 and had further scaled down to around 2.62 lakh in 2012, the report says.

But the number of malaria patients in Odisha is again rising at a faster pace since then, according to the Health Ministry report.

Even though the neighbouring states of Jharkhand and Chhattisgarh are identified as malaria prone states, much less people are afflicted with malaria in these states as compared to Odisha. In 2014, only 1.22lakh people were affected with the disease in Chhattisgarh while only 96,140 persons were affected by malaria in Jharkhand in the same year.

Statistics cited in the report also reveal that Odisha has left many states behind and has marched ahead of others in the matter of number of deaths due to malaria. It ranks third on this count in the country.

In the year 2014, a total of 535 persons had died of malaria across the country. Out of them 73 (13.64%) were from Odish while Tripura had the maximum number of deaths in terms of percentage at 96 (17.94%) followed by Meghalaya, another hilly state, with a toll count of 78 (14.58%).

Another disturbing fact that has emerged from the report is that out of those who have died of malaria in Odisha, 80 percent are from tribal dominated areas.

The districts of Gajapati , Kalahandi , Kandhamal, Keonjhar, Koraput, Malkangiri, Mayurbhanj, Nabarangpur, Nuapada, Rayagada and Sundargarh account for both the maximum number of deaths due to malaria and maximum number of persons afflicted with the disease.

Hoax victims afraid to discuss their misplaced DDT & malaria anger . . .

July 20, 2015

We see it almost daily — probably because we’ve got searches set to find comments on malaria and DDT.

British robin, or robin redbreast. Image found on Pinterest, and also ironically used to illustrate Pointman's screed for DDT.

British robin, or robin redbreast. Image found on Pinterest, and also ironically used to illustrate Pointman’s screed for DDT. Ironic, because Britain didn’t use as much DDT, and European robins were not so badly affected as U.S. robins. Not sure if Pointman knew that and used the photo to intentionally mislead, or if he’s just really bad at identifying species.

Some well-meaning guy (or woman) writes a long piece about conscience, and then claims to have lost respect for science, or medicine professionals, or the World Health Organization (WHO), or Rachel Carson or environmentalists, or all of them at once, because Rachel Carson’s ban on DDT meant malaria infections and deaths exploded, and libruls just won’t allow anyone to fix it.

If you’re a regular reader, you know that story is impossible, because:

The standard rant against Rachel Carson in favor of DDT is impossible in three ways:

  1. EPA’s regulation cannot travel back in time to cause an end to WHO’s malaria eradication campaign (1963) nine years before the rule was made (1972); nor can history and international law be changed to make EPA’s campaign stop the use of DDT outside the U.S.
  2. Mosquitoes do not migrate thousands of miles, across oceans. EPA’s ban on spraying U.S. crops with DDT, chiefly cotton, did not cause mosquitoes to migrate from Arkansas to Africa to spread malaria.  Had they done so, DDT in Africa had a pretty good chance to getting them, anyway.
  3. A reduction of malaria deaths from 4 million to 584,000, is not an increase in deaths.

These impossibilities do not even act as speed bumps to people in a hurry to condemn science, Rachel Carson, malaria fighters and environmentalists, in a mad rush to praise DDT, a deadly poison that doesn’t do what we hoped it would, any more.

Those undeterred from slandering Rachel Carson and environmentalists often don’t want to be informed of any errors in their rant. And so, Pointman, with a nasty false indictment of science, law and environmentalists, refuses to allow my posts to correct his errors.

His screed here.  It contains at least 6 gross errors, repeating all the impossibilities listed above, and slandering both Rachel Carson and William Ruckelshaus as “mass murderers,” with the false claim that EPA stopped DDT use against malaria.

My response, dealing with a small part of the errors, below (and here at Pointman’s blog; but in moderation, so you can’t see it, at the time of this posting).

EPA’s order banning DDT use in the U.S., on crops, specifically lifted the court-imposed ban on DDT manufacture, and specifically allowed use of DDT in the U.S. or anywhere else on Earth to fight vector-borne diseases — that is, malaria.

DDT manufacture continued in the U.S. until late 1984, when a new law made DDT manufacturers responsible for not poisoning their neighbors and neighborhoods. Most DDT manufacturing arms of larger chemical companies were spun off as separate enterprises, and they declared bankruptcy rather than assume any liability for the poisons they made for huge profits.

See description of EPA order and links to the original documents here: https://timpanogos.wordpress.com/2014/10/29/oh-look-epa-ordered-ddt-to-be-used-to-fight-malaria-in-1972/

I waited several days, and send two notices asking to spring the comment from moderation. I don’t think “Pointman” is interested in discussion.

Further reflection, a further thought — “Pointman” probably is not interested in discussion, not because he fears it — he’s probably armed, what does he have to fear? — but because he no longer caresHe’s seen the effects of good intentions gone wrong, and if it ever occurs to him it’s not his intentions, nor his going, that might be wrong, he’ll never let on.


I get e-mail: Nothing But Nets needs your help with Congress, to fight malaria

May 26, 2015

Money, not DDT.

Among other goals of the hoaxsters who claim Rachel Carson was wrong and evil, and that the imaginary ban on DDT to fight malaria causes “millions of deaths,” is the erosion of trust in international  organizations that lead the fight against malaria, especially WHO, UNICEF and USAID.  Sadly, the hoaxsters have friends in Congress who threaten to withhold funding to fight malaria, often insisting that now-mostly-ineffective DDT be used instead of good, working preventive measures and medicines to cure humans of malaria.

And so, Nothing But Nets writes to ask for help:

Email your members of Congress and let them know that you support full funding for malaria prevention programs.                                       

Dear Ed,

Imagine this: working from 4:00 AM until well into the night, getting very little sleep, traveling along unpaved roads for hours at a time – all to deliver 2,000 bednets per day to the hardest-to-reach children and families.

Email your members of Congress and let them know that you support full funding for malaria prevention programs.

Take Action

In Mozambique, this is a typical day for health workers as they distribute nets to save lives as part of a campaign funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Thanks to the work of the Global Fund and other partners – including UN agencies and local communities on the ground – bednet coverage in Mozambique has gone from less than 5 percent of the population in 2000 to an impressive 60 percent today.

But without continued support from Congress, the life-saving impact of these nets could be lost.

Your member of Congress will vote soon on how much assistance the U.S. will provide to the Global Fund, along with partners like the President’s Malaria Initiative and the United Nations, the core agencies leading the fight against malaria. By showing your support to your representatives in Washington, you can help to make them champions in the fight against malaria and ensure that these bednets continue to make it to families who need them the most.

Thousands of people have already asked their members of Congress to support the crucial work of the Global Fund and other partners in the fight against malaria—will you join them today?

From all of us at Nothing But Nets, thanks for helping community health workers reach the last mile!

Dan Skallman
Senior Campaign Associate, Nothing But Nets

Original story and photo from The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Take Action

WHO’s malaria fact sheet, April 2015 edition

May 17, 2015

Progress against the diseases we know as malaria — parasitic infections — is dramatic and rapid since several non-governmental organizations (NGOs) entered the fight seriously at the turn of the last century. But problems arise and also rapidly become serious.

Bednets prove the best single method of preventing the spread of malaria. Distribution of bednets in malaria-prone regions greatly aided the 47% reduction in malaria deaths since 1999.  WHO photo.

Bednets prove the best single method of preventing the spread of malaria. Distribution of bednets in malaria-prone regions greatly aided the 47% reduction in malaria deaths since 1999. WHO photo.

For political reasons often obscure, there is an industry in creating misinformation and propaganda against malaria-fighting groups like the World Health Organization, the Bill and Melinda Gates Foundation, and other groups who advocate bednet preventive measures. The propagandists often make absurd and false claims against medical workers, against scientists and activists including people they pejoratively call environmentalists, and in favor of the deadly poison DDT.

Factual matter takes longer to spread — truth has a smaller public relations budget.

What are the facts about malaria?

Here is WHO’s fact sheet on malaria, current as of the first of this month 2015.

WHO’s fact sheet is almost dull in its recitation of the facts.  What you don’t see recorded here is that the death toll of over 500,000 last year, is the lowest death toll from malaria since World War II, the lowest death toll estimated in the past 120 years, and perhaps the lowest death toll in recorded human history.  Similarly, while nearly 200 million malaria infections seems an enormous number, that number records a dramatic reduction from the 500 million estimated in the 1960s.

Malaria is not Rachel Carson’s fault. DDT is not a magic cure for the disease. It’s beatable, but beating a disease requires constant vigilance, militant prevention and treatment — and that costs money. The propagandists won’t tell you those facts, and malaria wins when bad information chases out the good.

For the record:


Fact sheet N°94
Reviewed April 2015

Key facts

  • Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes.
  • In 2013, malaria caused an estimated 584 000 deaths (with an uncertainty range of 367 000 to 755 000), mostly among African children.
  • Malaria is preventable and curable.
  • Increased malaria prevention and control measures are dramatically reducing the malaria burden in many places.
  • Non-immune travellers from malaria-free areas are very vulnerable to the disease when they get infected.

According to the latest estimates, released in December 2014, there were about 198 million cases of malaria in 2013 (with an uncertainty range of 124 million to 283 million) and an estimated 584 000 deaths (with an uncertainty range of 367 000 to 755 000). Malaria mortality rates have fallen by 47% globally since 2000, and by 54% in the WHO African Region.

Most deaths occur among children living in Africa where a child dies every minute from malaria. Malaria mortality rates among children in Africa have been reduced by an estimated 58% since 2000.

Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected Anopheles mosquitoes, called “malaria vectors”, which bite mainly between dusk and dawn.

There are four parasite species that cause malaria in humans:

  • Plasmodium falciparum
  • Plasmodium vivax
  • Plasmodium malariae
  • Plasmodium ovale.

Plasmodium falciparum and Plasmodium vivax are the most common. Plasmodium falciparum is the most deadly.

In recent years, some human cases of malaria have also occurred with Plasmodium knowlesi – a species that causes malaria among monkeys and occurs in certain forested areas of South-East Asia.


Malaria is transmitted exclusively through the bites of Anopheles mosquitoes. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.

About 20 different Anopheles species are locally important around the world. All of the important vector species bite at night. Anopheles mosquitoes breed in water and each species has its own breeding preference; for example some prefer shallow collections of fresh water, such as puddles, rice fields, and hoof prints. Transmission is more intense in places where the mosquito lifespan is longer (so that the parasite has time to complete its development inside the mosquito) and where it prefers to bite humans rather than other animals. For example, the long lifespan and strong human-biting habit of the African vector species is the main reason why about 90% of the world’s malaria deaths are in Africa.

Transmission also depends on climatic conditions that may affect the number and survival of mosquitoes, such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees.

Human immunity is another important factor, especially among adults in areas of moderate or intense transmission conditions. Partial immunity is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will cause severe disease. For this reason, most malaria deaths in Africa occur in young children, whereas in areas with less transmission and low immunity, all age groups are at risk.


Malaria is an acute febrile illness. In a non-immune individual, symptoms appear seven days or more (usually 10–15 days) after the infective mosquito bite. The first symptoms – fever, headache, chills and vomiting – may be mild and difficult to recognize as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness often leading to death. Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria. In adults, multi-organ involvement is also frequent. In malaria endemic areas, persons may develop partial immunity, allowing asymptomatic infections to occur.

For both P. vivax and P. ovale, clinical relapses may occur weeks to months after the first infection, even if the patient has left the malarious area. These new episodes arise from dormant liver forms known as hypnozoites (absent in P. falciparum and P. malariae); special treatment – targeted at these liver stages – is required for a complete cure.

Who is at risk?

Approximately half of the world’s population is at risk of malaria. Most malaria cases and deaths occur in sub-Saharan Africa. However, Asia, Latin America, and to a lesser extent the Middle East and parts of Europe are also affected. In 2014, 97 countries and territories had ongoing malaria transmission.

Specific population risk groups include:

  • young children in stable transmission areas who have not yet developed protective immunity against the most severe forms of the disease;
  • non-immune pregnant women as malaria causes high rates of miscarriage and can lead to maternal death;
  • semi-immune pregnant women in areas of high transmission. Malaria can result in miscarriage and low birth weight, especially during first and second pregnancies;
  • semi-immune HIV-infected pregnant women in stable transmission areas, during all pregnancies. Women with malaria infection of the placenta also have a higher risk of passing HIV infection to their newborns;
  • people with HIV/AIDS;
  • international travellers from non-endemic areas because they lack immunity;
  • immigrants from endemic areas and their children living in non-endemic areas and returning to their home countries to visit friends and relatives are similarly at risk because of waning or absent immunity.

Diagnosis and treatment

Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission.

The best available treatment, particularly for P. falciparum malaria, is artemisinin-based combination therapy (ACT).

WHO recommends that all cases of suspected malaria be confirmed using parasite-based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment. Results of parasitological confirmation can be available in 15 minutes or less. Treatment solely on the basis of symptoms should only be considered when a parasitological diagnosis is not possible. More detailed recommendations are available in the “Guidelines for the treatment of malaria” (second edition). An updated edition will be published in 2015.

Antimalarial drug resistance

Resistance to antimalarial medicines is a recurring problem. Resistance of P. falciparum to previous generations of medicines, such as chloroquine and sulfadoxine-pyrimethamine (SP), became widespread in the 1970s and 1980s, undermining malaria control efforts and reversing gains in child survival.

In recent years, parasite resistance to artemisinins has been detected in 5 countries of the Greater Mekong subregion: Cambodia, Laos, Myanmar, Thailand and Viet Nam. While there are likely many factors that contribute to the emergence and spread of resistance, the use of oral artemisinins alone, as monotherapy, is thought to be an important driver. When treated with an oral artemisinin-based monotherapy, patients may discontinue treatment prematurely following the rapid disappearance of malaria symptoms. This results in incomplete treatment, and such patients still have persistent parasites in their blood. Without a second drug given as part of a combination (as is provided with an ACT), these resistant parasites survive and can be passed on to a mosquito and then another person.

If resistance to artemisinins develops and spreads to other large geographical areas, the public health consequences could be dire.

WHO recommends the routine monitoring of antimalarial drug resistance, and supports countries to strengthen their efforts in this important area of work.

More comprehensive recommendations are available in the “WHO Global Plan for Artemisinin Resistance Containment (GPARC)”, which was released in 2011. For countries in the Greater Mekong subregion, WHO has issued a regional framework for action titled “Emergency response to artemisinin resistance in the Greater Mekong subregion” in 2013.


Vector control is the main way to reduce malaria transmission at the community level. It is the only intervention that can reduce malaria transmission from very high levels to close to zero.

For individuals, personal protection against mosquito bites represents the first line of defence for malaria prevention.

Two forms of vector control are effective in a wide range of circumstances.

Insecticide-treated mosquito nets (ITNs)

Long-lasting insecticidal nets (LLINs) are the preferred form of ITNs for public health distribution programmes. WHO recommends coverage for all at-risk persons; and in most settings. The most cost effective way to achieve this is through provision of free LLINs, so that everyone sleeps under a LLIN every night.

Indoor spraying with residual insecticides

Indoor residual spraying (IRS) with insecticides is a powerful way to rapidly reduce malaria transmission. Its full potential is realized when at least 80% of houses in targeted areas are sprayed. Indoor spraying is effective for 3–6 months, depending on the insecticide used and the type of surface on which it is sprayed. DDT can be effective for 9–12 months in some cases. Longer-lasting forms of existing IRS insecticides, as well as new classes of insecticides for use in IRS programmes, are under development.

Antimalarial medicines can also be used to prevent malaria. For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing malaria disease. In addition, WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine for pregnant women living in high transmission areas, at each scheduled antenatal visit after the first trimester. Similarly, for infants living in high-transmission areas of Africa, 3 doses of intermittent preventive treatment with sulfadoxine-pyrimethamine is recommended delivered alongside routine vaccinations. In 2012, WHO recommended Seasonal Malaria Chemoprevention as an additional malaria prevention strategy for areas of the Sahel sub-Region of Africa. The strategy involves the administration of monthly courses of amodiaquine plus sulfadoxine-pyrimethamine to all children under 5 years of age during the high transmission season.

Insecticide resistance

Much of the success to date in controlling malaria is due to vector control. Vector control is highly dependent on the use of pyrethroids, which are the only class of insecticides currently recommended for ITNs or LLINs. In recent years, mosquito resistance to pyrethroids has emerged in many countries. In some areas, resistance to all 4 classes of insecticides used for public health has been detected. Fortunately, this resistance has only rarely been associated with decreased efficacy, and LLINs and IRS remain highly effective tools in almost all settings.

However, countries in sub-Saharan Africa and India are of significant concern. These countries are characterized by high levels of malaria transmission and widespread reports of insecticide resistance. The development of new, alternative insecticides is a high priority and several promising products are in the pipeline. Development of new insecticides for use on bed nets is a particular priority.

Detection of insecticide resistance should be an essential component of all national malaria control efforts to ensure that the most effective vector control methods are being used. The choice of insecticide for IRS should always be informed by recent, local data on the susceptibility target vectors.

In order to ensure a timely and coordinated global response to the threat of insecticide resistance, WHO has worked with a wide range of stakeholders to develop the “Global Plan for Insecticide Resistance Management in malaria vectors” (GPIRM), which was released in May 2012. The GPIRM puts forward a five-pillar strategy calling on the global malaria community to:

  • plan and implement insecticide resistance management strategies in malaria-endemic countries;
  • ensure proper and timely entomological and resistance monitoring, and effective data management;
  • develop new and innovative vector control tools;
  • fill gaps in knowledge on mechanisms of insecticide resistance and the impact of current insecticide resistance management approaches; and
  • ensure that enabling mechanisms (advocacy as well as human and financial resources) are in place.


Tracking progress is a major challenge in malaria control. In 2012, malaria surveillance systems detected only around 14% of the estimated global number of cases. Stronger malaria surveillance systems are urgently needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences, to track progress, and to hold governments and the global malaria community accountable.


Malaria elimination is defined as interrupting local mosquito-borne malaria transmission in a defined geographical area, i.e. zero incidence of locally contracted cases. Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by a specific agent; i.e. applies to a particular malaria parasite species.

On the basis of reported cases for 2013, 55 countries are on track to reduce their malaria case incidence rates by 75%, in line with World Health Assembly targets for 2015. Large-scale use of WHO-recommended strategies, currently available tools, strong national commitments, and coordinated efforts with partners, will enable more countries – particularly those where malaria transmission is low and unstable – to reduce their disease burden and progress towards elimination.

In recent years, 4 countries have been certified by the WHO Director-General as having eliminated malaria: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), and Armenia (2011).

Vaccines against malaria

There are currently no licensed vaccines against malaria or any other human parasite. One research vaccine against P. falciparum, known as RTS, S/AS01, is most advanced. This vaccine has been evaluated in a large clinical trial in 7 countries in Africa and has been submitted to the European Medicines Agency under art. 58 for regulatory review. A WHO recommendation for use will depend on the final results from the large clinical trial and a positive regulatory review. The recommendation as to whether or not this vaccine should be added to existing malaria control tools is expected in late 2015.

WHO response

The WHO Global Malaria Programme (GMP) is responsible for charting the course for malaria control and elimination through:

  • setting, communicating and promoting the adoption of evidence-based norms, standards, policies, technical strategies, and guidelines;
  • keeping independent score of global progress;
  • developing approaches for capacity building, systems strengthening, and surveillance;
  • identifying threats to malaria control and elimination as well as new areas for action.

GMP serves as the secretariat for the Malaria Policy Advisory Committee (MPAC), a group of 15 global malaria experts appointed following an open nomination process. The MPAC, which meets twice yearly, provides independent advice to WHO to develop policy recommendations for the control and elimination of malaria. The mandate of MPAC is to provide strategic advice and technical input, and extends to all aspects of malaria control and elimination, as part of a transparent, responsive and credible policy setting process.

WHO is also a co-founder and host of the Roll Back Malaria partnership, which is the global framework to implement coordinated action against malaria. The partnership mobilizes for action and resources and forges consensus among partners. It is comprised of over 500 partners, including malaria endemic countries, development partners, the private sector, nongovernmental and community-based organizations, foundations, and research and academic institutions.

For more information contact:

WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int

WHO provides a short video summary of many of these facts.

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