Saturday, January 29, 2005

DDT or Nets?

Sharon Stone raises $1 Million in five minutes.

All to save the children of Tanzania we are told.

We also learn:

. . . a UN official said 150,000 African children were dying of malaria every month because they didn't have bed nets.

First, time for some Old Math:

UN statistics for Tanzanian malaria death rates (2001): 676 per 100,000.

Present population of Tanzania: 35,560,732.

That yields roughly 240,000 per year dying from malaria.

Now, if 150,000 are dying each month, that would mean 1.8 Million are dying each year.

Conclusion: The UN doesn't do math.

Now, I do not doubt that "insecticide-treated bed nets [ITNs], which have been shown to cause dramatic drops in the incidence of malaria," are a good thing.

However, the government of Tanzania notes that nearly $12 Million has been set aside by The Global Fund.

Throw in Stone's impromptu collection of $1 Million, and you have roughly $13 Million that has or can be used for ITNs.

This Africa Malaria Report from 2003 says ITNs are $5 per net. Let's assume $7 per net for inflation, etc.

There should be over 1.8 Million nets protecting the beds of Tanzanians today.

It is not immediately obvious to me that malaria death rates are falling dramatically as a result (have the nets been provided, or is some bureaucrat trading them for favors, etc.?).

The obvious question: Why aren't countries using DDT instead -- attacking the source of the dreaded disease?

This argument is not convincing to me:

Preventive measures such as modifying the environment and spraying DDT and other insecticides indoors have worked in specific areas including southern Africa (e.g. Botswana). Other countries have used these methods to reduce malaria transmission significantly (e.g. Brazil and Sri Lanka) or to eliminate it (e.g. United States), however, these resulted from the eradication era with widespread and costly effort. Malaria elimination has mainly been achieved in wealthy countries. Resistance to DDT as well as technical, economic and structural problems has limited the achievements of the residual spraying programmes of the post-war eradication era in much of Africa where transmission is hyperendemic to holoendemic and effective control programmes are rare. For the first time in insecticide treated nets, we have a malaria prevention method which is simple, safe and effective and can be organised and conducted locally by lay persons.

You cannot find DDT in a search of the 2003 Africa Malaria Report Executive Summary, while there is a complete section on ITNs.

In the end, it all comes down to not all people will get the nets.

This article puts it best:

   Though African governments spend heavily on education about the disease, many poor people cannot afford even the cheapest preventive methods, such as mosquito nets.


   Public health authorities say HIV/AIDS, tuberculosis and malaria are crippling their budgets. In the case of malaria, the search for cheap weapons is unending.
   Now, argument over the use of DDT (dichlorodiphenyltrichloroethane) has been revived by an article published recently in South Africa by Dr. Kelvin Kemm, spokesman there for the Washington-based Committee for a Constructive Tomorrow (CFACT).
   CFACT is a vocal lobby group that argues scientific breakthroughs should be used to improve quality of life. It maintains health and safety risks cited by environmental groups (particularly in relation to chemicals) are often without foundation.
   Dr. Kemm, who also helped found the movement Africa Fighting Malaria, wrote that worldwide opposition to DDT is crash-landing on the African continent. He said the number of Africans dying every day from malaria could fill seven Boeing 747s.
   "When such an aircraft smashes into the ground, killing all on board, it makes massive international news headlines," he continued. "But there are no international headlines lamenting the huge malaria death toll."
   Since the banning of DDT in the United States in 1973, the incidence of malaria has soared around the world, Dr. Kemm said.
   In South Africa, strictly controlled DDT spraying was recently resumed as a method of wiping out malaria-carrying mosquitoes. (In some other parts of the world, mosquitoes are resistant to DDT.)
   "But (South Africa's) neighbours, Mozambique, who have a worse malaria problem, do not use DDT because (foreign) funding won't allow it, for fear of upsetting Green political opinions back home.
   "So Mozambicans die to keep U.S. politics stable at home. So much for the Green mantra of 'Think globally, act locally.' "

Here are some very interesting observations:

In 1995 I went on television and radio to call for the reintroduction of DDT to fight malaria. I received hate mail and threatening phone calls. The government whispered in my ear that they were on my side, because one African child dies every 40 seconds from malaria, but explained that they would not be seen to agree with me in public. I felt rather good a few days ago when the Health Minister stated that DDT was needed for malaria, and the President attended the start of a prevent-malaria cross-Africa rally.

But people still think that DDT is harmful, when it is not. I met a woman who took a teaspoonful of DDT every week of her life as vitamins until they banned it, and now she is 83. There is also not one single case in the whole world of any person dying from DDT or even getting sick from it. But will you find companies willing to be seen to be telling the truth to the public? Not a chance.

One child every 40 seconds, and we worry about what the Environmental Whackos think.

We live in an odd age of irrational thought.

Where is science when we need it?