Bringing Back DDT

In February of this year, Microsoft creator Bill Gates opened a jar of mosquitoes during the Technology, Entertainment and Design Conference. He did this to demonstrate how much of a concern malaria is for several regions of the world.

Bill Gates and many others support the idea of reintroducing DDT as an effected tool to fight against malaria. Him and other scientists believe that spending mere cents on spraying houses would be more cost effective than supplying $10 dollar mosquito nets to everyone in an area impacted by malaria. They also believe that killing the insect using DDT is better than just preventing them from biting by using a net.

The stigma around the use of DDT dates back to the 1950’s. Dichlorodiphenyltrichloroethane (DDT) was discovered during World War II by the Swiss chemist Paul Hermann Müller of Geigy Pharmaceutical. He awarded the Nobel Prize in Physiology or Medicine in 1948 for his discovery of the high efficiency of DDT as a contact poison against insects.

During WWII, DDT was used to control the spread of Typhus. In the 1945, it began to be used to fight against the spread of malaria. In 1955, the World Health Organization initiated a program to eradicate malaria worldwide, its main weapon being DDT. The attempt was semi-successful. It eradicated malaria 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 and dramatically reducing mortality in Sri Lanka and India.

Soon after this program started, scientists began to notice certain side-effects of DDT. Birth defects and cancer-related cases began to steadily rise in the regions of the world where the drug was being heavily used. It was discovered that the pesticide was leaching into water supplies, remaining in the ecosystem for long periods of time.

In the 1970’s DDT was banned from being used in almost every region of the world. In the areas where malaria was suppressed but not successfully eradicated, the mosquito population and impact of the disease has returned with a vengeance.

DDT is without a question the most successful tool used to date in the attempt to eradicate malaria from the planet. Bill Gates and other supporters encourage the return of DDT, because they are convinced that if spraying is done in small amount in and around the home, water supplies will stand low risk of contamination and millions of lives will be saved as a result.

This data was compiled using data found at www.who.org and www.cnn.com

Space Spraying: Thermal Fog vs. Cold Fog

Space spraying can be accomplished using one of two forms of fog; thermal fog and cold fog.

Thermal Fog

The insecticide used in thermal fogs is diluted in an oil-based transporting fluid. Hot gas heats this fluid, causing the oil to become vaporized. When the hot vapor exits the machine distributing the pesticide, it hits cooler air, creating a visible, white, dense fog.

There are several advantages to using a thermal fog. The reaction with the cooler air creates a visible cloud, allowing the operator of the machine to ensure thorough placement of the spray. Because the transporting fluid is oil based and not water based, less active ingredient is needed during the treatment, allowing for a lower concentration of exposure for humans dwelling in the region being treated.

However, there are several disadvantages to this treatment. Thermal fog operations are very expensive. An oil-based transporter in very pricey and can also be a fire hazard in the areas in which it is sprayed. Oil can also cause staining and leave heavy odors. It can leave roadways slick and cause possible traffic casualties.

Cold Fog

A cold fog is just another term for a diluted insecticide. There is no transporter fluid used other than the formula used to create the insecticide. There is no heat involved, and spraying is accomplished by using a high pressure nozzle.

The main advantages to cold fogs are that they are cost effective and pose little to know fire hazard. The water-base keeps roadways from becoming slick and is virtually odorless.
There are issues with cold fogs as well. The fact that they are nearly invisible makes them nearly impossible to observe, impacting the homogeny of dispersion. Without an oil-based matrix, the chemical can often evaporate or deactivate before it treats the area thoroughly.

Which to use?

Thermal fogs would be more appropriately used in areas where the pest being treated was a severe endemic. Areas with few roadways would be ideal. It is also a choice to use when the budget for treatment is larger.

Cold fogs are more appropriate in areas where the pest is not an issue that has grown out of control. It is better for areas with high traffic and heavier populations. It is also the better choice when the budget for treatment is small.

Ideally, in areas where there are both rural and urban populations, both treatments should be used together, breaking up the region into a mosaic of treatment types.

This information was collected from data posted by http://www.who.org/.

Space Spraying

Space spraying is a method used to quickly kill a pest population with little to no residual effect. However, this treatment cannot be used in isolation. It is important that the removal of the target population be a collaborative effort between space spraying and other forms of defenses. Populations that can be fought against using this method include houseflies, sand flies and mosquitoes. Space spraying is ideal for use in emergency epidemic situations, and could be a very effective method for helping to eradicate malaria from areas where the disease is endemic such as Ghana, South Africa, and Mexico.

Space spraying is effective at not only killing a disease-transmitting population of insects, but it is also effective at interrupting the transmission cycle of the actual disease. The process consists of a cloud of insecticide droplets that are dispersed over the impacted region. The idea is that the insects will encounter these droplets during flight and die. In order for this method to be effective, the behavior pattern of the specific target insect must be well studied and understood. The right toxins will be needed to shut down the biological system of the insect without posing a great health risk to the human population.

Space spraying is technically a form of fog. The defense is only effective while the droplets are airborne, so it is important that the spray is released during the prime time of flight for the target population. The spray comes in two forms, thermal fog and cold fog. The difference between these two types, the costs, and the effectiveness of each method is what will be addressed in the next report to come.

This information was compiled from data released by the World Health Organization at www.who.org

AN APOLLO PROGRAM FOR ACCRA

On July 16, 1969 Commander Neil Armstrong was the first man to set foot on the moon. At that time he made the statement "one small step for man, one giant leap for mankind"

On May 25, 1961 President John F. Kennedy of United States announced his support for the Apollo program with the goal of landing men on the moon by the end of 1969. This objective was met with 6 months to spare.

This seemingly impossible feat was accomplished only because the leader of the Country made it a matter of priority, the landing of a man on the moon. At the time it seemed that President Kennedy had taken leave of his senses. In spite of the nay sayers this goal was met within the allotted time frame of eight years.

What I would like to propose at this time is establishing the goal of eliminating malaria in Ghana within 3 years. This is a more achievable objective than sending a man to the moon. The reason, it has already been done in the United States, the Country that sent Commander Neil Armstrong to the moon. Perhaps we should take a page out of their play book on this one. First of all, the Americans did not waste any time or national treasure treating the symptoms. They attacked the cause. The cause of malaria is not the malaria parasite, it is the mosquito. Removing the mosquito from the environment will eliminate malaria. When you break the transmission cycle, the malaria parasite present in the human population will be expelled from the body within about two years. The method used by the Americans to eliminate malaria was a massive aerial application program. This method achieved the objective of dramatically decimating the mosquito population as to destroy its ability to maintain the transmission cycle. It has been some 60 years now since the United States was declared malaria free and it continues to be malaria free until this day.

At present here in Ghana and most African countries, there is a policy of treating the symptoms of malaria, with prophylactic pills, bed nets and indoor residual spraying. The marginal effect of this reactive policy only institutionalizes failure. Meanwhile, our country continues to sacrifice its most precious resource on the altar of malaria, its children and young mothers. In developed countries disease and death affects the old and consumes perhaps 90% of the national medical resources, treating it's citizens with expensive medications and operations for the last 10% of their life span. However the average life span is twice as long as in the developing nations.

In Ghana the death rates are much higher in the young, than the old. This is neither a natural nor an acceptable outcome. This is the reason for an average life expectancy of only 40 or 50 years.

The annual expenditure of 100 million dollars now dedicated to treating the symptoms of malaria in Ghana is perhaps 10 times more than is necessary to eradicate this disease. However over the past several years the problem only gets worse, in spite of grand statements to the contrary. One definition of insanity is the expectation of a different outcome, each time you perform the same act. I can only conclude that the institutions charged with dealing with this problem are certifiably NUTS!

What I would like to propose is a pilot program to eliminate malaria from the City of Accra, with the goal of making Accra the first malaria free City in Sub Saharan Africa, employing the same methods used to achieve success in the United States some 60 years ago. A successful outcome of such a program will have a more far reaching impact than the Apollo program, in that it will serve a humanitarian objective of saving lives, the most precious lives, that of the young.

With this thought in mind, if Ghana government or corporate Ghana will not come together to fund such a project, perhaps the funding source should logically be the PMI or Presidents Malaria Initiative that has dedicated some 17.3 million dollars for malaria in Ghana this year alone. All that would be necessary is 3 million dollars to eliminate malaria for one year in the City of Accra, a City that contains 10% of our population. They can use the rest of the funding to satisfy their bed nets spree.

At this time I would like to ask anyone that has an opportunity to gain the ear of President Obama on his trip to Ghana this coming July to make mention of this proposal for 3 million dollars for this pilot program. If you live in Accra like me, you will be doing yourself a favor.

Hayford Siaw

Executive Director, Volunteer Partnerships for West Africa (VPWA)

Tel : 00233 21 928245

00233 24 3340112

www.vpwa.org

info@vpwa.org

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