View Full Version : Malaria worldwide
PaleMelanesian 12-10-2008, 04:44 PM This is in response to History of the US Environmental Movement (http://www.cleanmpg.com/forums/showthread.php?t=18008). I couldn't read past the line mentioning "Rachel Carson's book, Silent Spring". I'm breaking this out into another thread to avoid hijacking that one.
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Very few things make me angry. The mere mention of that book makes me furious. :mad::angry::ccry: It makes me angry like violence against my family would make me angry. Why?
Malaria.
The ban on DDT, a direct result of that book, has allowed malaria to kill, and continue killing, many millions worldwide. Children are the most sensitive to it. Conveniently, the ban came AFTER malaria was wiped out in places like the USA. Malaria is one of the top 3 deadliest diseases on the planet, along with AIDS and tuberculosis.
I've lost close friends and numerous acquaintances to malaria. I've personally suffered from it dozens of times. Fortunately, I had access to adequate treatment. Most of the population where it's common does not have that access. There is no cure and there is no vaccine. The parasite is tough, so for any treatment to be effective, it is harsh on the patient as well. I have a constant ringing in my ears, combined with some hearing loss, from the treatments.
Breaking the mosquito-borne reproduction cycle is the best hope to eliminate it. This was completed here in the United States. The best weapon for this process, DDT, was banned before the project was completed worldwide.
National Geographic had an excellent article on malaria last year. Malaria - National Geographic (http://ngm.nationalgeographic.com/2007/07/malaria/finkel-text) (single-page print version here (http://ngm.nationalgeographic.com/print/2007/07/malaria/finkel-text).) It's long, but enlightening. I've pulled out a few points.
This year malaria will strike up to a half billion people. At least a million will die, most of them under age five, the vast majority living in Africa. That's more than twice the annual toll a generation ago.
The outcry over this epidemic, until recently, has been muted. Malaria is a plague of the poor, easy to overlook. The most unfortunate fact about malaria, some researchers believe, is that prosperous nations got rid of it.
Armed with the twin weapons of chloroquine and DDT, the World Health Organization in 1955 launched the Global Malaria Eradication Programme. The goal was to eliminate the disease within ten years. More than a billion dollars was spent. Tens of thousands of tons of DDT were applied each year to control mosquitoes. India, where malaria had long been a plague, hired 150,000 workers, full-time, to spray homes. Chloroquine was widely distributed. It was probably the most elaborate international health initiative ever undertaken.
The campaign was inspired by early successes in Brazil and the United States. The U.S. had recorded millions of malaria cases during the 1930s, mostly in southern states. Then an intensive antimalaria program was launched. More than three million acres (1.2 million hectares) of wetlands were drained, DDT was sprayed in hundreds of thousands of homes, and in 1946 the Centers for Disease Control was founded in Atlanta specifically to combat malaria.
America's affluence was a major asset. Almost everyone could get to a doctor; windows could be screened; resources were available to bulldoze mosquito-breeding swamps. There's also the lucky fact that the country's two most common species of Anopheles mosquitoes prefer feeding on cattle rather than humans. By 1950, transmission of malaria was halted in the U.S.
The global eradication effort did achieve some notable successes. Malaria was virtually wiped out in much of the Caribbean and South Pacific, from the Balkans, from Taiwan. In Sri Lanka, there were 2.8 million cases of malaria in 1946, and a total of 17 in 1963. In India, malaria deaths plummeted from 800,000 a year to scarcely any.
In 1962 Rachel Carson published Silent Spring, documenting this abuse and painting so damning a picture that the chemical was eventually outlawed by most of the world for agricultural use. Exceptions were made for malaria control, but DDT became nearly impossible to procure. "The ban on DDT," says Gwadz of the National Institutes of Health, "may have killed 20 million children."
In several places where malaria had been on the brink of extinction, including both Sri Lanka and India, the disease came roaring back.
Compare our malaria-free country to this:
In Zambia, a nationwide health survey in 2005 concluded that for every thousand children under age five living in the North-Western Province, there were 1,353 cases of malaria. An annual rate of more than 100 percent seems impossible, a typo. It is not. What it means is that many children are infected with malaria more than once a year.
phoebeisis 12-10-2008, 06:53 PM I'm not wanting to sound too hard hearted, but...
1) Why don't these countries manufacture DDT, if it is so important to them? The manufacturing process isn't terribly difficult, and isn't terribly expensive. I suspect it would be dirt cheap to make it. I isn't much harder than cooking up methamphetamine. Sometimes countries have to "do for themselves." They are sovereign countries, they can do what they want.
Don't tell me that they are too poor to do it. Sometimes you have to just "do it"
I suspect that maybe it wouldn't be as simple as soaking the country with DDT. It will kill every bug in the country-some are good bugs and pollinate food crops-.
If they need it- manufacture it. This sounds like more "blame the west for all our problems" The West didn't "invent malaria" to infect Africa. It is endemic everywhere it is warm and wet.
Many of those countries are spending millions on weapons- they should divert a bit of it for the good of their citizens.
Charlie
PS- Yes malaria is terrible, but it isn't my fault, and it isn't Rachel Carson's fault. Somalia isn't the fault of the west, Darfar isn't the fault of the west, the Hutu on Tutsi genocide isn't our fault. Africa is roughly like 17th Century Europe-kinda tribal- with lots of tribal hatreds. They are in for hard ride until they can put tribal differences aside.
PPS- I know the above is harsh, but...must be the dreary weather around here. I am not joking about DDT being reasonably simple and cheap to make. Not joking about the DIY either. If the leaders thought it was as important as you do, then they would do just that.
PPS- I just did a quick search-DDT is still widely used-25 countries have a" wavier" to use it, and it is widely available to use for mosquito control in the 3rd world!! So why the post?? Resistance is developing to it of course. It is still widely used and widely available,so.......?? Yes, it is cheap and easy to make, but why bother if you can just buy it?
worthywads 12-10-2008, 07:28 PM Unfortunately and criminally many of those the pushed the DDT scare knew full well that it meant death to millions but thought that was a good thing, since Erlich and the population bomb preachers said we'd have mass famine in a few years anyway if population wasn't controlled.
Yet someone Paul Ehrlich and Carson are still looked at favorably? Ehrlich blamed pesticides, among others, on the population bomb that hasn't happened.
Somehow he missed the idea that populations with very high infant and child mortality (places with malaria etc.) are usually poorer BECAUSE of the mortality and death and parents hoping to get 1 or 2 to of their 10 children to puberty. Countries with low infant mortality have much lower birth rates and productive economies. If the US had malaria like many countries we would be a third world country very quickly.
Ehrlich now dismisses his early predictions as just "scenarios" because of course they were all very wrong.
worthywads 12-10-2008, 07:30 PM I'm not wanting to sound too hard hearted, but...
1) Why don't these countries manufacture DDT, if it is so important to them? The manufacturing process isn't terribly difficult, and isn't terribly expensive. I suspect it would be dirt cheap to make it. I isn't much harder than cooking up methamphetamine. Sometimes countries have to "do for themselves." They are sovereign countries, they can do what they want.
Don't tell me that they are too poor to do it. Sometimes you have to just "do it"
With threats of embargoes on food exports from 1st world countries it not as easy as "do it" for many countries.
The UN has failed in it's perpetual claim to be ridding the world of malaria, but I agree it has a lot to do with the corrupt dictators that don't want any interference from the UN or anyone and may be all for mass death.
phoebeisis 12-10-2008, 07:39 PM Hey, 25 countries have "permission" to use DDT for exactly EXACTLY what Palemelanesian wants to use it for-MOSQUITO CONTROL!!!
I did a quick search; it it is needed, it is available. The reason it is still available for mosquito/malaria control is that it is cheap,and still effective on many mosquitoes.
Do a quick search-
Pale- which country are you talking about??
Charlie
PS- If they-the countries-don't do the other control measures-drain swamps, don't leave standing water, mosquito nets-they won't get a good result. Besides, it is toxic to all bugs and lots of other organisms- no free lunch. If they have crops that require "bug" pollination, it could cause a problem. It hurts fish populations also-so... never a free lunch.
PPS-We did have malaria until well into the 1900's-we weren't a 3rd world country then. We had plenty of yellow fever epidemics also- especially NOLA-but not in the 1900's that I can remember. The 1918 flu epidemic killed 500,000 people in the USA- about 1/200(in about one year). Didn't make us a 3rd world country.
warthog1984 12-10-2008, 07:53 PM Hey, 25 countries have "permission" to use DDT for exactly EXACTLY what Palemelanesian wants to use it for-MOSQUITO CONTROL!!!
I did a quick search; it it is needed, it is available. The reason it is still available for mosquito/malaria control is that it is cheap,and still effective on many mosquitoes.
Charlie-
Many of these countries are locked into needed agreements to export food to the UK and other 1st world countries. Many of these countries will reject food shipments if GM crops or chemicals like DDT are sprayed anywhere Near "their" cropland, let alone on it.
D***ed if you don't, D***ed if you do.
phoebeisis 12-10-2008, 09:00 PM Warthog-Yellow fever is another mosquito borne illness .It put paid to the French attempt to build a the Panama canal- killed 10's of thousands of workers(malaria was probably endemic there also, but it doesn't kill adults as readily). The USA's effort finally succeeded , but only after the mosquitoes were controlled.This was 1908 or so, well before the 1st insecticides.
When I was a kid-50's-, we all would play in the clouds of insecticide spewing behind the spray trucks. Our parents threatened us of course, but we were kids,so...
So, they have a choice- let their children die from malaria, or sell food to western Europe?? I feel a smart ass answer coming on -that doesn't seem like a hard choice to me. Who is benefiting from these food sale agreements ?
Heck,sell it -the food-to China.DDT isn't particularly poisonous to humans, it would be a step up from what the Chinese do to their own infants-selling poison baby formula. Yeah ,they would get less $$, but them their children would live?? Is it really a hard choice?
Plan A If DDT is a malaria cure all-the choice just isn't that hard. Use DDT, and save their children-sell the food crops for a little less to less discriminating buyers.
Plan B do what was done during the building of the Panama canal- no insecticides were used then.
This borders on more "blame the evil WEST" for the problems of the 3rd world. Their problems are much deeper than that. Tribal cultures don't do a good job running multi tribe "countries". It always ends up with one slaughtering another-like the Balkans ,or Iraq, or the Philippines with their Muslim insurgency (which is actually a tribal insurgency that has festered for 120+ years-huks etc).
Charlie
PaleMelanesian 12-10-2008, 09:32 PM DDT for malaria control doesn't have to be a "nuke everything" approach. Light indoor spraying is enough to repel mosquitos from that residence. The mosquito doesn't become infected from that sick person, and then doesn't go on to infect another person. Enough of that happening can break the cycle.
What chafes me the most is that there WAS a global effort to combat malaria. It was successful in some areas. It was making progress in other areas. Then it was simply halted. Valuable time was wasted, and now there are more resistant strains of the disease, specifically because there was some exposure but not enough to finish the job. DDT was a good answer then. It's not as easy a solution now. Water under the bridge; ground lost that had to be regained another way now.
It's not the West's fault, entirely.
It's not the 3rd world countries' fault, entirely.
There's plenty of blame to go around. Not the least is the 3rd world overuse of DDT in the 50's. If that hadn't happened, it would not have been seen as an environmental threat.
There are efforts going on now, that are making progress. It's nothing like the scale of the operation in the 50's, though. If half as much effort had been made in this area as has been made for environmental causes, malaria would be history today.
P.S. I grew up in Papua New Guinea, in the south pacific.
msirach 12-10-2008, 09:41 PM Papua New Guinea??? Just got a couple of pounds yesterday!!!:woot:
PaleMelanesian 12-10-2008, 09:44 PM That's why I was asking you about it last week! Nothing like the good stuff from home! :D
msirach 12-10-2008, 09:55 PM I've tried about 20 different beans in the last few months and Papau pb & Papau x are a couple of my favorites
PaleMelanesian 12-10-2008, 10:01 PM That's cool to hear someone objectively agree with my thoughts about the PNG coffee. Of course I think it's great... ;)
warthog1984 12-10-2008, 10:17 PM So, they have a choice- let their children die from malaria, or sell food to western Europe?? I feel a smart ass answer coming on -that doesn't seem like a hard choice to me. Who is benefiting from these food sale agreements ?
Plan B do what was done during the building of the Panama canal- no insecticides were used then.
Charlie-
Many of these agreements with Malaria are/were conditions of receiving loans and other aid. They can't get out from under them too easily without defaulting on even more loans and suffering yet more. Gov's that default on international loans are pretty much S.O.L.
As for Plan B- Draining Swamps and Controlling Mosquitos can be done, but very resource intensive- something these countries usually don't have.
phoebeisis 12-10-2008, 11:38 PM Warthog- the agreements spelled out '"you can't use DDT to prevent malaria, or we will call in our loan"? Surely they must have offered/suggested some alternative?? Usually busybody governments are waaaaay to publicity sensitive to make a " you have to let your babies die from malaria if you want this loan" agreement. They must have offered other pesticides or other preventive mesures-DDT -or even DEET- impregnated nets??
There must be more here than"you can't use pesticides-too bad about the infants"??
Something is missing from this story. I suspect that the busybody western governments are probably pushing some other malaria prevention programs that they want these countries to get on board with??
I never seen Rachel Carson pilloried before-certainly not on a leftish site like this. The book was boring(I read a few pages years ago), but factual, right?? DDT interfered with bird breeding , and it had a very long 1/2 life was the gist of it??
There are plenty of pesticides that will kill mosquitoes-not as cheap as DDT and certainly not as long lasting, but that is a mixed blessing.
If I search for "tons of DDT used in New Guinea" am I going to find out that more DDT was used there per square mile than in the USA?? How much was used in New Guinea, and isn't it still being used there ?
Charlie
PaleMelanesian 12-11-2008, 09:58 AM The point is, there was a large-scale global effort to wipe out Malaria. There is not now. The effort is more now than it was 10 years ago, but still only a fraction of what happened in the 50's.
Agricultural use of DDT was a real problem. This attitude was common: "If a little is good, more must be better, so TONS must be great!" And those tons did go into the food chain and cause problems. Stopping that was a good thing. It's the unintended consequences that are my issue. In areas where malaria was not eliminated, the efforts only served to make the mosquitoes more resistant. That ship has sailed, and now other options are needed.
In most of the places where malaria is a problem, it has always been a problem. When you come from that background, it's just the way things are. It's hard for the people and even the leaders of these nations to envision something better, because they've never known anything else. Like explaining the concept of color to a blind man.
Even if they wanted to "just do it themselves", it's not so simple. In countries where access to clean, safe drinking water is a problem, how do you expect a large-scale eradication program to even begin? Many of these countries have a GDP per capita less than 5% that of the United States - some less than $1000 per person. $1000 a year - how much of that do you think is available for anything beyond basic needs? (GDP data - Wikipedia) (http://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal)_per_capita)
According to the WHO's 2008 Global Malaria Report (http://www.who.int/malaria/mediacentre/wmr2008/), 98% of the resources in Papua New Guinea are for bed nets, with very little going toward insecticide spraying. Unfortunately, the total is only reaching about 20% of the population. DDT usage is next to nothing today.
Let me turn this around a bit - New Orleans' levees. Let the people fix it themselves. There's plenty of commerce going through the city. They should have enough money to take care of it. Sometimes you have to "just do it".
phoebeisis 12-11-2008, 04:30 PM Palemelanesian,
Yes, I can see that it is hard for folks to "see it differently" , if it has been that way for the entire 20,000 or so years that New Guinea has been inhabited.
Yes, I see your point on New Orleans, but it isn't quite the same thing.
If New Orleans was allowed to keep just a tiny percent more of the revenue we generate thru oil, natural gas, and port activities we would easily be able to "do it ourselves". In truth a lot of our problem is the endemic banana republic attitude we have here. We NOLA would have been much better off if we had "done it ourselves". The engineering on the floodwalls was laughable. Louisiana is extremely rich in resources- oil, gas, water, arable land, mild climate with 55" a year of rainfall -we should be the richest state in the union. We aren't because- well, a lotta' reasons but the main one being we aren't rich because we are ourselves-endemic poverty, educational system isn't good, and we have many,many fractured families.
Back to malaria- was it permanently eradicated from anywhere where it was "hard" to eradicate? I wondering if there is an example of any African country that permanently eradicated malaria?? There are more than 4 types of malaria that infect humans, and usually there is more than one "type' of mosquito vector. The eradicate it you have to
1)Either kill off all the mosquito vectors- EXTREMELY DIFFICULT
2) Cure almost everyone in the geographic area of malaria so the mosquitoes no longer become infected. In some areas animals other than humans can act as reservoirs, so they need to be cured also.
Has malaria made a comeback in any of the areas where it was eradicated?? If the weather becomes warmer, mosquitoes will move north- not a good thing.
Smallpox is the only "scourge" that has been eradicated; polio is almost eradicated. Unfortunately there isn't a malaria vaccine, and since it is a single cell protozoa much like our cells, it is much much harder to make a vaccine that works. In theory TB should be easier to eradicate, but we are a long way from that.
What are New Guinea's export crops- coffee you mentioned. It it cashing in on biofuels- "tropical oils"? If so ,that probably is a net" bad thing" since tropical areas generally have kinda' poor soils for commercial agriculture, and it usually involves clear cutting trees that if properly culled could provide a continuous revenue stream( and suck up plenty of CO2).
I not too optimistic about CO2 reduction.Once the world economy improves China and the rest of the 3rd world will pretty much follow our path with high energy consumption/high CO2 output.
We-USA are lucky in that we have HUGE renewable resource potential.
1)-Wind- Just 2,000,000 turbines- covering just a 200x200 mile square of TX,OK could provide all our electricity needs,and the extra needs for electric cars.
2) Solar- most of the SW.
3) Tidal- 1000's of miles of coastline.
It will actually be easy for us to switch to renewable energy-For poor countries- not so easy.
Sorry I was so harsh, but one kinda' boring book more or less couldn't have caused New Guineas problems.
Charlie
PaleMelanesian 12-11-2008, 04:59 PM Louisiana is extremely rich in resources- oil, gas, water, arable land, mild climate with 55" a year of rainfall -we should be the richest state in the union. We aren't because- well, a lotta' reasons but the main one being we aren't rich because we are ourselves-endemic poverty, educational system isn't good, and we have many,many fractured families.
That could very well describe PNG and a number of other countries worldwide. I think the problem is people. PNG has a lot of mineral resources, but poor soil. Copper and gold are the biggest.
Sri Lanka is an example where it was almost eradicated. Down from 2.8 million annual cases to 17. Quick searching gives numbers in the 200,000-300,000 range annually today.
Africa is a much harder case. It's simply not possible for one country to contain malaria within their borders. All neighboring countries have to be attacking it at the same time. This means they must not be attacking each other, within or across national borders. It has to be an international thing, which is difficult.
You're right. There is no vaccine, and likely will not be. It's a parasite, and as such, more complex and resilient than a bacteria or virus. Wiping out mosquitoes, even one variety (anopheles, the one that carries malaria), is simply unrealistic. So we're left with option 2 that you listed - breaking the cycle long enough to make the break permanent.
This is just one more example of secondary unintended consequences. DDT overuse was a bad thing, but underuse has also had negative results. You're right, though. It wasn't all due to Carson and her book. Funding dwindled, and resistance to DDT was an increasing problem.
phoebeisis 12-11-2008, 05:47 PM On the bright side PNG is an island,so that should make it a little easier to eradicate. On the not so bright side it is surrounded by many other islands, islands that might be within a high wind mosquito flight of it. It would have to be wiped out on all the islands at once.
Like you say- lotta $$ in a poor world wide economy. No reason to think that Global warming- if it happens- will improve the mosquito outlook. There is plenty of reason to think they will range farther north.
Countries, and states that rely on mining-oil or minerals- for wealth never seem to develop their citizens.Louisiana is a pretty good example of this. We were literally floating on oil and oil $$ in the 50's,60's 70's but we didn't make to most of it. We have a poorly educated population-despite all the $$. We are still a really blessed state in respect to geographic tangibles.
PNG has poor soils-that is usually the case in high rainfall areas, and usually the case in tropical rain forests. Louisiana has everything going for it, but we are the laughingstock of the USA. Poor soil is a HUGE problem. I'm guessing it has a fishing industry, but usually large factory ships from Japan , Russia and other industrialized nations "clear cut" the oceans around smaller countries. Big problems if you can't even grow enough food to support your population.
Luck,
Charlie
PaleMelanesian 12-11-2008, 06:03 PM I'm guessing it has a fishing industry, but usually large factory ships from Japan , Russia and other industrialized nations "clear cut" the oceans around smaller countries.
Bingo! Malaysia, mainly, but that's a minor detail.
phoebeisis 12-11-2008, 07:06 PM Wow, those Pacific Islands generally rely on fish for high biological value protein and PNG can't even depend on that??
There are just a handful of nations that "clear cut" all the oceans of the world.Not only are they practically stealing the resource, but in some cases they are killing it for all time.
Lotta problems,
Charlie
ILAveo 12-12-2008, 12:31 AM From what I've read, DDT has been no silver bullet for malaria control. Apparently the evolution of resistant strains of insects has been the downfall of the DDT approach with environmental concerns playing at most a secondary role.
From Wikipedia:
"In 1955, the World Health Organization commenced a program to eradicate malaria worldwide, relying largely on DDT. The program was initially highly successful, eliminating the disease in "Taiwan, much of the Caribbean, the Balkans, parts of northern Africa, the northern region of Australia, and a large swath of the South Pacific"[16] and dramatically reducing mortality in Sri Lanka and India.[17] However resistance soon emerged in many insect populations as a consequence of widespread agricultural use of DDT. In many areas, early victories against malaria were partially or completely reversed, and in some cases rates of transmission even increased.[18] The program was successful in eliminating malaria only in areas with "high socio-economic status, well-organized healthcare systems, and relatively less intensive or seasonal malaria transmission".[19]
DDT was less effective in tropical regions due to the continuous life cycle of mosquitoes and poor infrastructure. It was not pursued at all in sub-Saharan Africa due to these perceived difficulties, with the result that mortality rates in the area were never reduced to the same dramatic extent, and now constitute the bulk of malarial deaths worldwide, especially following the resurgence of the disease as a result of microbe resistance to drug treatments and the spread of the deadly malarial variant caused by Plasmodium falciparum. The goal of eradication was abandoned in 1969, and attention was focused on controlling and treating the disease. Spraying programs (especially using DDT) were curtailed due to concerns over safety and environmental effects, as well as problems in administrative, managerial and financial implementation, but mostly because mosquitoes were developing resistance to DDT.[18] Efforts were shifted from spraying to the use of bednets impregnated with insecticides and other interventions.[20][19]
As a historical fact the US anti-malarial effort was largely complete before DDT use was adopted in the 1940's. The main pesticide used before the 40's was Paris Green (and to a lesser extent lead arsenate.)
Wikipedia thinks that due to widespread DDT resistance in mosquitos, Pyrethroid group insecticides represent the most effective technology for malaria control today.
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