Institutional Inertia

Institutional Inertia

The World Health Organization on October 30, 1998, announced the creation of an affiliated organization, that was named, Roll Back Malaria. The reduction of malaria in Africa by 50% within 10 years was the stated goal of this new organization.

Dr. Donald Roberts, Ph.D, an entomologist, Professor of Tropical Public Health at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, stated, "The Roll Back Malaria program, a partnership of WHO and UN organizations, has been an abysmal failure. Since the RBM founding in 1998, deaths from malaria have steadily increased". This statement was taken from an article showing a graph with a projection of actual malaria deaths at 30% increase over the baseline rate just 10 years ago.

The question is why the increase instead of the projected 50% decrease in mortality over the life of this project? Let us examine the mission statement attached to the press release announcing the inception of this program. It starts out on the first page with the claim "simple prevention and control methods has shown startling results: in trials conducted in the Gambia, Burkina Faso, Kenya and Ghana, the use of bed nets, which are treated with pyrethroid insecticide, was shown to effectively protect sleeping children from malarial mosquitoes, resulting in dramatic reductions in deaths among children under five years of age. Deaths were reduced by average of one fourth in these mega trials". Perhaps the term "dramatic" in this instance is shall we say; "dramatic", in its context, this method is much ado about nothing as in ineffective.

Let's see what other interventions, the Roll Back Malaria mission statement has for our consideration. "Simpler and more effective means of administering medicines" and the encouragement of "new anti-malaria drugs and vaccines", it sounds like a defensive strategy. First you hide under a net to avoid the mosquito, if that does not work; you take a pill to keep the malaria parasite from killing you. As in an American football expression goes, "the best defense resides in a good offense". Why not deep six the little suckers and be done with it.

The reference to development of "new anti-malaria drugs and vaccines" is a fools errand, and overlooks the incredibly complex nature of the malaria parasite. Some 9,000 genes. This parasite has the incredible ability to adapt to anything. Mr. Robert Desowitz, a medical research entomologist in his book, MALARIA CAPERS says, the search for a malaria vaccine has gone on for generations, and none will ever be found, to be effective. This research he says is for the sole purpose of getting grant money for universities, from wealthy individuals, foundations and governments. The cause is noble, however the goal is unobtainable. Meanwhile resources that could be applied to the elimination of this disease are wasted by academics. Even Bill Gates is a victim of this scam, having poured untold millions into this effort.

The failure to eliminate malaria is more than a humanitarian one, it also has a dramatic impact on economic development as well. Included in this Roll Back Malaria mission statement is a quote from Jeffrey Sachs, Professor at Harvard. and says in part "We and other groups of economist researchers are trying to determine the consequences of malaria on economic development" and "Our findings are striking. They point to Malaria as a major impediment to economic development" enough said. I once did an internet search and pulled up a colored graph of the poorest countries on planet earth and a corresponding colored graph of the countries with most malaria. To my amazement they were identical. In the arena of public health, the failure to eliminate malaria in the world is by far the greatest failure. It is not the failure of technology; it is a failure of leadership! The West has proven the technology is available. The Will to do something meaningful about this scourge is absent.

Let us examine the nature of the World Health Organization, the organization that has taken the lead as "expert" to the 80 or so sister organizations known as NGO's or Non Governmental Organizations. The WHO although it is a quasi governmental organization, is by nature a not for profit, additionally there is a kinship since they both provide public services. Any organization is of course a simple legal instrument, so to determine the personality of an organization you have to examine the personality profiles of its leaders.

A person known as a bureaucrat is in charge of this complex multi faceted organization, the nature of a bureaucrat is to keep steady the course of the organization. Stifling anyone who shows creativity or initiative; otherwise how can this organization maintain its identity, if it allows any creative actions on the part of its employees or anyone else for this matter? If any changes are made it is a committee that makes them. Of course in the recorded history of mankind there is no record of a monument ever being erected to a committee; regrettably, only to individuals.

An entomologist is the next personality type that needs examination. An entomologist is a person that studies insects, usually insects that transmit diseases, the WHO in this case would employ an entomologist that knows more than a person wants to know about malaria mosquitoes, mating habits etc. However an entomologist has no training in the art and science of killing mosquitoes only to identify them. The problem lies in the perception in their mind that he is an expert in this endeavor. Hence this is how you get a recommendation for the use of bed nets, an intervention that is only 25% effective. Then you have the medical doctors, with their prescriptions pads ever at the ready, to write a prescription for whatever ails you. In this case a prophylactic pill to keep the malaria you already have from killing you or modifying the disease in the event you get it.

The people who suffer from this misfeasance are of course, the victims of malaria here in Africa. Additionally the non-profit organizations that depend on the ‘’sound technical guidance’’ from WHO, in their attempts to obtain value for their contribution to the welfare of fellow humans.

The Solution, eliminate the mosquito! this is the only method that will free Africa from this scourge. By eliminating the mosquito means to suppress the population to such a low number there will not be enough mosquitoes left to maintain the transmission cycle. The elimination of the transmission cycle can be accomplished in about 30 days or so in Ghana. The elimination of the parasite from the human body will take at least two years. However there will be no more new infections in the population, perhaps only re-lapses of old infections. The method used to obtain this goal, is what is called in the US, "space spraying". that is the treatment of the atmosphere at night over a large area, when the malaria mosquito is out and about, flying. However the objection to this form of treatment has been cost. Admittedly it has been historically expensive. However over the past 10 years, in the US there have been dramatic advances in reduction of costs through improvements of insecticide dispersal systems and application methods. These improvements have made this process affordable for developing nations and Ghana should go in for it!

Hayford Siaw

Executive Director – VPWA Ghana (www.vpwa.org)

+233 24 3340112

2 persons die every minute! How long shall we continue to say it?

In his unprecedented efforts for policy change on malaria programmes in sub-Saharan Africa, the Executive Director of Volunteer Partnerships for West Africa (VPWA), Mr Hayford Siaw in an interview on Choice fm 102.3, an Accra radio station last Tuesday ,reiterated his call for civil society groups and governments in sub-Saharan Africa to take the opportunity of President Obama’s presence on the African soil as President for United States of America to call for policy change in the way Malaria is been handle by the powers that be.

He chronicled the methodology used by United States and Canada and some parts of Europe in eliminating the scourge of this deadly disease and hinted that, President Obama will ‘’by all means’’ mention his country’s efforts in combating diseases on the African continent including Malaria and as such, it is important to let him know that, the President’s Malaria Initiative (PMI) which is a direct contribution by the US government in fighting the disease along with Global Fund and other donors are not been used properly and it is time to stop the game of controlling the disease to a serious approach of eradicating the disease using same tools the United States implored in defeating Malaria.

Mr Siaw wondered why in the 21st century, we should be advocating to ‘’control’’ a disease we could eradicate if our leadership in Africa will be serious enough to work with proving methods. As he has always done, he emphasised that even if mosquito net were to be 100% used by an individual, it effectiveness is only part at 25% and that is why people are still dying and it is time we put the billions of dollars going to purchase net to control the disease into effective mechanisms of eradicating it. He buttresses this argument by asking the Host of the Programme if the World Health Organization (WHO) has stopped saying 2 persons die every minute. He recollects that, he got to know it 20 years ago and we still continue to say it as if human life is such a disposable commodity.

He mentioned that, despite the colossal expenditure of over $100 million to combat malaria in Ghana in 2006 and 2007, WHO still reports that there is no evidence of decrease in Malaria cases and reported deaths has increased. He questioned how the money was used and for what purpose.

The Host of the Choice FM Breakfast show, Mr Alfred Ocansey who had also enquire on the current state of Malaria in Ghana from National Malaria Control Programme (NMCP) quoted them as saying Malaria cases for 2008 was less but was however not able to give the figures. The Executive Director of VPWA ask how sustainable is their so call reduction in figures and quoted from a WHO Malaria report on Ghana that in 2002, there was total death of 1917 and it was less in 2003 at 1680 but in 2007, death from Malaria has risen to almost a triple at 4622.

Meanwhile, some critics have argued that the aerial insecticide dispensing system that the VPWA Executive Director is advocating to be introduced in Ghana to defeat Malaria in Ghana within three years is expensive and we should therefore concentrate on simple mechanism of distributing nets to as much people as possible. Speaking to this Reporter, Mr Siaw has described the critics as ‘’failures refusing to think outside the box’’. He also described critics as been ‘’brainwashed by Malthusians’’.

In his opinion, Human life is expensive than the method he is suggesting and society must not tolerate people who desire to suppress population growth in such a way. He also ask why net is been recommended and wondered how many mosquito nets was distributed in Europe and America during their fight to eradicate Malaria in those places. He wondered why the Global Fund will boast it success of fight against Malaria by posting the number of nets they have been able to distribute without calculating the life saved if any on their website.

Obama visit to Ghana, what it means for Civil Society in Africa.

The President of United States of America, Barack Obama will make a historic visit to Ghana between July 10 – July 11, 2009.

According to Ghana’s Foreign Ministry, the first Black US President will hold bilateral talks with Ghanaian President, John Evans Atta Mills aimed at strengthening the fraternal relations existing between the two countries.

The visit to be the first trip to sub-Sahara Africa by President Obama and wife Michelle Obama since assumption of office will be symbolic to advance the strategic role Ghana has grown to play on the world stage.

It is an indication of strong democratic governance and freedom that thrives in the fibre of Ghanaian society. It is also a manifestation of the fundamental role that governments and non-governmental organizations have played in moulding Ghana as a success story on the African continent.

Ghana should however take the opportunity of getting the first African-American President personally aware of the most challenging issues confronting the nation and the African continent. It is important that, we make clear cut statements with our needs with specific time frame and budget to achieving such goals. Simply asking for support without plan action and budget will be like making noise in the ears of the US President.

For those of us in the civil society and especially campaigning for Malaria Eradication in Ghana and Africa, White House Press Secretary Robert Gibbs, has indicated that President Obama will highlight critical role that ‘’good governance and civil society play in promoting development’’ and this affords us an opportunity to make our voice heard by requesting for new and refreshing strategy in tackling malaria through the President Malaria Initiative (PMI) by the United States. It is estimated that, Ghana alone will be receiving a $ 17million grant this year from PMI towards malaria projects and it is time we call for proper utilitarian of the US tax payer’s money on malaria in Ghana and Africa while urging African governments to take lead by adopting policies that is geared towards eradication of the disease which kills 1 person every 2 hours on average in Ghana and 2 people per minute globally with 90% of this deaths occurring in black Africa.

It is instructive to point to the US President whose authority, the PMI is been managed to consider adopting strategies that his country used after the second world war in eradicating the disease also on the African continent rather than going the conventional ways which has failed over the years hence an increase in Malaria deaths for instance in 2007 in Ghana according to the WHO.

In this vain, Ghana should take lead as it has always done in difficult times of the African continent to move from policies of controlling the disease to policies of eradicating the disease since it is that which will propel a change in donor rules of controlling the disease which has failed and continues to fail to a more compelling policy to eradicate it.

Ghana should therefore immediately call for a holistic approach in eradicating the disease by investing in treating people with existing malaria parasite, conduct aerial insecticide dispersal and embark on intensive public education.

This should help Ghana to eradicate the disease within 3 years.

Hayford Siaw

Executive Director

Volunteer Partnerships for West Africa (VPWA)

www.vpwa.org

info@vpwa.org

+233 24 3340112

DDT: Panel of Doctors lacks logic

In a report on Scientific American on 4th May 2009, a panel of doctors led by a University of California epidemiologist called for restriction in the use of DDT having regards to it widespread use in Africa especially after the endorsement in 2006 by the World Health Organization(WHO).
According to scientificamerican.com ‘’ The scientists reported that DDT ‘may’ have a variety of human health effects, including reduced fertility, genital birth defects, breast cancer, diabetes and damage to developing brains. Its metabolite, DDE, can

block male hormones’’.

‘’Based on recent studies, we conclude that humans are exposed to DDT and DDE, that indoor residual spraying can result in substantial exposure and that DDT may pose a risk for human populations," the scientists wrote in their consensus statement, published in the journal Environmental Health Perspectives.

"We are concerned about the health of children and adults given the persistence of DDT and its active metabolites in the environment and in the body, and we are particularly concerned about the potential effects of continued DDT use on future generations."

In 1947, shortly after the Second World War II, the United States decided to eradicate Malaria from its territory using DDT in an overwhelming aerial dispensing spree. By 1952, US had declared it 13 states in the southern eastern part which had perennial malaria reported cases as Malaria free.
The success of this exercise led to the WHO adopting the DDT strategy in a so called Global Malaria Eradication Campaign which however excluded Black African countries with an excuse that, our part of the world was ‘’not ready’’. While the United States method was aerial dispensing system, WHO opted for Indoor Residual Spraying system. Though not the best strategy having regards to the effectiveness of aerial dispensing system, the programme is reported to have saved 500 million lives in 8 years that would have otherwise have been lost due to Malaria. This number largely does not include black Africans and this explains why 90% of all Malaria illness now occurs in sub-Saharan Africa.

DDT was then praised in superlative terms by the American National Academy of Science and declared a ‘’miracle pesticide’’.

The success of this programme however did not go down with Malthusians. In 1972, United States declared a ban on the use of DDT twenty years later after it had declared Malaria Free. The ban was base on it agricultural use which was responsible for depopulation of birds. Environmental groups joined hands with Malthusians for an unprecedented war against DDT use till today even after WHO endorsement in 2006 under the leadership of Dr. Araka Kochi who admitted to WHO Malaria ‘’policy mess’’ and therefore allowed DDT to be used.

Now, the world has a new group of ‘’menticides’’ referring themselves as Panel of Doctors who want to cause change in priority for donors to push their cash into other interventions other than IRS for eradication. The panel of doctors with all their long paper works were clueless to give alternative to eradicating Malaria and went ahead to say that DDT should be used as a ‘’last resort’’.

This is deeply shocking and should send Black Africans on full scale demonstration against this panel of doctors and their allies. At what point will the world know to use DDT as the last resort? When 100 people are dying per second? Currently, WHO taunts that Malaria kills 2 persons each minute! Is it not enough to tell this Panel of doctors we are in the last resort?

They also had no authentic finding against DDT thereby referring to their disastrous wishes with a ‘’may’’ phrase.
There is no evidence that in the 1960s and 80s when DDT was widely used, it had any disastrous consequence on people.

A research finding in Uganda in 2007, emphatically indicates low levels of DDT in parts per billion (ppb) in the human blood samples, urine, soil, beans, and fish, even after being exposed to the chemical for a long time. The study further established that “there is also no associated environmental damage or human defects of infertility, impotence, neurological abnormalities and cancers.”

What is more, this research is African oriented – conducted on African soil, by African researchers and scientist and clothed with excellent reliability and validity of results. According to Dr Myers Lugemwa of the Department of Medicine, National referral Hospital, in Mulago, Uganda – a member of the team that conducted the research on the effects of DDT in humans and the environment – when the chemical is applied strictly for indoor spraying, it poses very little environmental threat.

After all, if the so call future health problems are to be true, then America should also not produce food and send to so call malnourished and starving children in Africa because it is likely to also cause obesity which has ill effects in the long run just as they claim DDT has ill effect in the future on humans.

I am not an advocate for DDT but found the findings and statement by the so call Panel of Doctors as unreasonable, ill conceived and a ploy against humanity. I am equally aware of effective and efficient technology and insecticides that could be used for a much more highly result oriented aerial dispensing to eradicate Malaria in the continent of Africa if resources going into researches sponsoring programmes like this panel of doctors and nets are channelled for an efficient aerial dispensing system and public education.


Signed:

Hayford Siaw

Executive Director

Volunteer Partnerships for West Africa

VPWA supports shake-up in Malaria Policy

Ghana's Health Minister Hon Dr. George Sipa-Adjah Yankey has called for a shake-up in the country's malaria control policy. Speaking to delegates at the Commemoration of World Malaria Day at the Accra International Conference Centre on 25 April, the Minister called for the creation of a 'Malaria Elimination Project' by July 2009 and described existing chain phases for malaria eradication as "too long".

His comments fly in the face of the UN-backed malaria project 'Roll Back Malaria (RBM) and it Global Malaria Action Plan (GMAP), which presently put Ghana in the control stage of the malaria eradication chain. RBM believes that, in the control stage ‘first scaling up appropriate interventions for all populations at risk and then sustaining control over time, malaria will cease to be a major source of deaths world-wide,’ principally through the distribution of nets.

His recommendations have been welcomed by Volunteer Partnerships for West Africa (VPWA), a development NGO based in Ghana, which recently launched its KICK MALARIA OUT (KMO) elimination project. The project is set to raise the public's awareness of simple malaria prevention methods across six West African countries including Ghana and aims to de-bunk the myth that using nets alone can achieve a significant drop in malaria cases.

VPWA's Executive Director Hayford Siaw, who has long campaigned for the implementation of aerial insecticide dispensing system, indoor residual spraying and public education, has applauded the Minister for including this three-pronged approach to fighting the disease. Mr Siaw also urged Ghana to learn from the successes of countries in North America, North Africa and the Middle East, which had successfully eliminated malaria by using these three methods.

"If resources that would be going into the purchase of nets are channelled into tackling the disease on these fronts, Ghana should be able to declare itself as malaria-free zone within three years,’’ he said.

Meanwhile, Mr Siaw also challenged the notion that consistent use of nets can lead to Ghana achieving a 0% malaria cases.

"’In every project proposal, sustainability to achieve real results both in the short-term and long-term is very crucial and this is why we need to adopt strategies that encompass the ability of a nation to achieve both short-term and long-term objectives.

"It is in this vein that, our organization is calling on governments all over the continent of Africa to channel the taxpayers’ money that has been spent on nets to be re-directed into adopting a three-phase approach to eliminating and eradicating malaria from the continent," he said.



According to Dr Constance Bart-Plange, Head of Malaria Control Programme of Ghana, who gave a presentation at the World Malaria Day Celebration, '1.3% of Ghana’s GPD is spent on malaria annually’.

Mr Siaw described this figure as "staggering" for a country that wants to achieve Middle Income Status by 2015. He said that in spite of the massive spending by donor agencies and government of Ghana, a WHO report on malaria in Ghana states: 'There was no evidence of a reduction in malaria cases between 2001-2007, and reported deaths have increased in 2007'.

The same report records that a sum close to $100 million from government, the Global Fund, the World Bank and bilateral donors, was spent on malaria control in Ghana alone between 2006-2007.

Mr Siaw is challenging the Ghanaian Government to change the name of the National Malaria Control Programme to the 'National Malaria Eradication Programme' ’in a belief that this will help attract more sponsorship from corporate Ghana to take the issue more seriously. Malaria affects the majority of the workforce in Ghana and causes a negative output, which has an adverse effect on corporate Ghana.

Mr Kwaku Appau, Board Chairman of VPWA, said: "The question Ghanaians and the donor communities should be asking themselves is why are there all these investments into malaria control and yet the death rate continues to rise? It is simple; expenditure is going into areas that do not stop the malaria vector from breeding so there is a continuous multiplication."

The KICK OUT MALARIA project will run for four weeks between August to September 2009. A team of local and international volunteers will travel across Ghana, Nigeria, Benin, Togo and Cote D'Ivoire raising awareness of some of the simple activities people can do in their home environment to eradicate mosquito breeding grounds.

Kirsty Osei-Bempong – PR/Communications for VPWA


PRESS SECTION- VPWA

Eradication of Malaria in the US (1947-1952)

Eradication of Malaria in the US (1947-1952)

BY Courtney Peterson

The National Malaria Society considers malaria to no longer be an epidemic “when no primary indigenous has occurred in the area for three years.”
Between 1949 and 1951, the National Malaria Eradication Program successfully eradicated malaria from the United States. This program was a collaboration of the 13 Southeastern states and the Communicable Disease Center of the US Public Health Service.

The strategy was to apply DDT to the entire interior of homes in rural areas, or to an entire area where malaria was considered an issue. This operation began on July 1, 1947, and by the beginning of 1950, almost 5 million homes had been treated with DDT. By 1952, CDC withdrew the actions, because the eradication attempt had proved to be a success.

In addition to spraying, other successful control efforts conducted by the local departments were adequate drainage to prevent standing water and the removal of mosquito breeding sites.

Campaign that Drastically Drops the Price of Malaria Drugs

A New Campaign that Drastically Drops the Price of Malaria Drugs

By Courtney Peterson

April 23, 2009

International health agencies and the European governments have announced their campaign to drive down the cost of malaria medication to 20 cents. The initial budget will be $225 million and will be run by the Affordable Medicines Facility for Malaria (AMFM).

Malaria continues to kill over 1 million people each year, the majority of those people being children. Awa-Marie Coll-Seck, executive director of the Roll Back Malaria partnership describes this new campaign as a “triumph of international cooperation.”

The United States is the world’s most substantial donor to the fight against malaria, but they have yet to sign up for this project. Dr. Bernard Nahlen, deputy coordinator of the President's Malaria Initiative, has said that he wants more studies proving that subsidies would work before investing hundreds of millions of dollars.

America-based drug companies have resisted lower their wholesale price from $4 per unit to $1 per unit price. If the prices can be lowered to a single dollar, donor funds would cover 95 cents of the cost. African and Asian villages would only pay 5 cents for the drug, and their mark up price should not exceed 20 cents. That would lower the cost for the average patient from $8 to the 20 cent price. This will be a huge savings for the poorer regions of African and Asia, the areas where the disease tends to flourish.

The money for this program was raised by slightly raising airline ticket fees. It was a collaborative effort by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Roll Back Malaria partnership, the British, Norway, and Netherlands governments and the Unitaid partnership of 30 different countries.

Within the regions where malaria is an issue, drugs are normally handed out at public health clinics. However, since cerebral malaria can be fatal to children within 24 hours of onset, these drugs must be sold within walking distance of every village. The lower prices predicted by this campaign will make wide drug placement a more plausible goal.