One could quibble, and point out that it’s the malaria parasite that does the dirty work, more than the mosquito; but it’s only a quibble.
Short film from Bill Gates explaining why he helps wage war on the lowly mosquito. Use of science to find ways to defeat mosquito-borne disease transmission is especially important in the post-DDT world, since DDT resistance now aids every mosquito on Earth.
There are about a dozen different diseases that are spread to humans by mosquito bites including dengue, yellow fever, Zika, chikungunya, and malaria. This little mosquito actually kills more humans than any other thing.
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.
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.
Spread the word; friends don't allow friends to repeat history.
I get e-mail from Texas Gov. Greg Abbott, and all too often it leaves me shaking my head in disgust.
This one came today. I suppose one needs to understand that the e-mail is intended to mislead the recipients about what Gov. Abbott is doing.
In the War on Cancer, Abbott has sided with cancer. As Attorney General in the later stages of the wilting administration of the beleaguered Rick Perry, Abbott refused to investigate a Texas Constitutionally-established, billion-dollar fund to support cancer research whose administration then-Gov. Perry had turned over to old political friends.
Abbott should have recused himself from any investigation by his office, because under the laws setting up the research fund, he was on the board. Any investigation would need to answer the question about what Abbott had done to be sure the funds were spent as the law intended.
Conflicts of interest don’t bother Greg Abbott, though, so long as the conflicts work in favor of his friends, and political donors.
Fortunately for Texas, there is another, separate office to investigate public wrongdoing in state agencies, the Public Integrity Unit of the Travis County District Attorney’s office. That office indicted one of the cancer agency’s officials (he was convicted of misappropriating $11 million in public funds), and promised to indict more.
You get the idea. Cancer research is political in Texas, and probably not all that serious a concern to GOP elected officials. Cancer is something poor people get. Republicans have health insurance.
For years, Planned Parenthood clinics in Texas and the rest of the nation offered free cancer screenings and checkups to women who otherwise could not get them for lack of money. These services have nothing to do with abortion, but a lot to do with obstetrical and gynecological care poor women cannot get otherwise.
Read Abbott’s fund-raising letter — yes, he wants me (and you) to donate to his unholy campaign against women’s health care — and pay particular attention to how he avoids any mention of what kinds of services this funding cut-off will kill. He wants you to think he’s fighting abortion.
Which might be oddly and rarely true, if his denial of cancer screenings enables cancer to kill a woman who might have later gotten an abortion, or destroy her ability to conceive at all.
See the letter, sent with the subject, “Another win against Planned Parenthood”:
So there you have it. Greg Abbott wants you to send him money, because he’s stopped poor women in Texas from getting cancer screenings.
Because, abortion, liberty, guns, and probably, illegal immigrants.
And, because he can get away with it.
How stupid must a Texas politician be to think promoting cancer will help any of those problems? How conniving must one be to try to hoodwink Texans into sending him money, neglecting to mention it’s money to support cutting medical care to women who need it?
How stupid must Texas voters be, if they don’t see through this corrupt ruse?
In the 1850s a Hungarian doctor and professor of obstetrics named Ignaz Semmelweis [pictured at left] ordered his interns at the Viennese Lying-in Hospital to wash their hands after performing autopsies and before examining new mothers. The death rate plummeted from 22 out of 200 to 2 out of 200, prompting the following reception from one of Europe’s most respected medical practitioners:
“It may be that it [Semmelweis’ procedure] does contain a few good principles, but its scrupulous application has presented such difficulties that it would be necessary, in Paris for instance, to place in quarantine the personnel of a hospital during the great part of a year, and that, moreover, to obtain results that remain entirely problematical.”
– Dr. Charles Dubois (Parisian obstetrician), memo to the French Academy September 23, 1858
Semmelweiss’ superiors shared Dubois’ opinion; when the Hungarian physician insisted on defending his theories, they forced him to resign his post on the faculty.
Gotta wonder what Dr. Dubois would make of the suits and sanitation procedures required today for health professionals who treat Ebola victims.
As a journalist, this guy has a piece of a world-wide scoop.
India is probably the last nation on Earth producing DDT. In the last decade other two nations making the stuff got out of the business — North Korea and China. For several years now India has been the largest manufacturer of DDT, and far and away the greatest user, spraying more DDT against malaria-carrying mosquitoes, sand flies, and agricultural and household pests than the rest of the world combined.
As if an omen, India’s malaria rates did not drop, but instead rose, even as malaria rates dropped or plunged in almost every other nation on Earth.
Under the 2001 Stockholm Convention on Persistent Organic Pollutants (POPs) signed by more than 150 nations (not including the U.S.), DDT was one of a dozen chemicals targeted to be phased out due to its extremely dangerous qualities, including long-term persistence in the environment and bioaccummulation, by which doses of the stuff increase up the food chain, delivering crippling and fatal doses to top predators.
A perfect substitute for DDT in fighting some disease-carrying insects (“vectors”) has never been developed. Health officials asked, and the Stockholm negotiators agreed to leave DDT legally available to fight disease. Annex B asked nations to tell the World Health Organization if it wanted to use DDT. Since 2001, as DDT effectiveness was increasingly compromised by resistance evolved in insects, fewer and fewer nations found it useful.
The site Mr. Nazakat linked to is up and down, and my security program occasionally says the site is untrustworthy. It’s obscure at best. Shouldn’t news of this type be in some of India’s biggest newspapers?
I found an article in theDeccan Herald, confirming the report, but again with some
India-United Nations pact to end DDT use by 2020
India-United Nations pact to end DDT use by 2020
New Delhi, August 26, 2015, DHNS:
It would be better to switch to another insecticide, says expert
India has launched a $53 million project to phase out DDT by 2020 and replace them with Neem-based bio-pesticides that are equally effective.
India is the lone user of DDT, though only in the malaria control programme, while rest of the world got rid of the chemical that has a lasting adverse impact on the environment.
India on Tuesday entered into a $53 million (Rs 350 crore) partnership with the United Nations Industrial Development Organisation (UNIDO), United Nations Environment Programme and the Global Environment Facility to replace DDT with safer, more effective and green alternatives.
“As per the plan, the National Botanical Research Organisation, Lucknow, tied up with a company to produce Neem-based alternatives for the malaria programme. The production will start in six months,” Shakti Dhua, the regional coordinator of UNIDO told Deccan Herald.
Till last year, the annual DDT requirement was about 6,000 tonnes that has now been cut down to 4,000 tonnes as the government decided to stop using it in the Kala-Azar control programme.
A recent study by an Indo-British team of medical researchers found that using DDT without any surveillance is counter-productive as a vector control strategy as sand flies not only thrive but are also becoming resistant to DDT.
“It would be better to switch to another insecticide, which is more likely to give better results than DDT,” said Janet Hemingway, a scientist at the Liverpool School of Tropical Medicine. While the Health Ministry wanted to bring in synthetic pyrethroids, the United Nation agencies supports the bio-pesticides because of their efficacy and long-lasting effects.
“The new initiative would help check the spread of malaria and other vector-borne diseases. These include botanical pesticides, including Neem-based compounds, and long-lasting insecticidal safety nets that will prevent mosquito bites while sleeping,” Dhua said.
Ending the production and use of DDT is a priority for India as it is a signatory to the Stockholm Convention on Persistent Organic Pollutants (POP) of 2002 that seeks to eliminate the use of these chemicals in industrial processes, drugs and pesticides. DDT is one of the POPs.
The clock is counting down the last years of DDT. Good.
If events unroll as planned, DDT making will end by 2020, 81 years after it was discovered to kill bugs, 70 years after it was released for civilian years, 70 years after problems with its use was first reported by the U.S. Fish and Wildlife Service, 58 years after the publication of Rachel Carson’s Silent Spring, 50 years after European nations banned some uses, 48 years after the famous U.S. ban on agricultural use, 19 years after the POPs Treaty.
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.
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.”
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.
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.
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.
We've been soaking in the Bathtub for several months, long enough that some of the links we've used have gone to the Great Internet in the Sky.
If you find a dead link, please leave a comment to that post, and tell us what link has expired.