Engineer Indur Goklany, a frequent contributor to WUWT and occasional commenter has more than a few things to say about commenter Ed Darrell’s views on Malaria posted on WUWT yesterday. There’s so much in fact, that I’ve dedicated a whole guest post to it. -Anthony
Guest Post by Indur Goklany
Ed Darrell has two sets of comments, one of which, I believe, is fundamentally flawed, and the other I would agree with, at the risk of being accused by Alexander Feht of being obsequious once again (See Alexander’s comment on September 11, 2010 at 11:28 am).
A. Ed Darrell on September 12, 2010 at 7:40 pm, responding to tarpon said:
In 1972, about two million people died from malaria, worldwide.
In 2008, about 880,000 people died from malaria, worldwide. That’s fewer than half the mortality the year the U.S. stopped DDT spraying on cotton.
If it’s cause-effect you were trying to establish, I think you missed.
RESPONSE: The flaws in Ed’s analysis are aplenty.
First, although the US banned DDT in 1972, its use continued in much of the rest of the world. [If I remember correctly, the Swedes had banned it earlier.] In fact, US production of DDT for developing country use continued into the mid-1980s. Also, it took a few years for US environmentalists to ensure that the US domestic ban was — in the best traditions of cultural imperialism and bearing the white man’s burden — exported to other countries [without their (informed) consent, mind you]. [Notably, the US ban was imposed only after malaria had been wiped out in the US for practical purposes. See Figure 13, here.] In addition, countries had stockpiles which they continued to use, and not all developed countries were initially on board with eliminating DDT use worldwide. Furthermore, by 2008 some developing countries that had stopped DDT use had resumed its use. So it is not meaningful to use either 1972 or 2008 as endpoints for developing global estimates for the efficacy (or lack of it) of DDT in dealing with malaria..
Second, while DDT is in many instances the cheapest and most cost-effective method of reducing malaria (where it works, because it doesn’t always work) the death and disease rates are also sensitive to other factors, none of which have remained stationary between 1972 and 2008. These factors include general health status, adequate food and nutrition, public health services, and so on. So, it makes little sense, without adequately accounting for these factors, to compare deaths for malaria (or death rates, which would be more correct) between 1972 and 2008 to say anything about the effectiveness of DDT.
Fortunately, though, we have results of some “policy experiments” which were undertaken inadvertently — undertaken, I note, without the consent of the subjects of these experiments, something that would not be allowed in any hospital in the US, I suspect. These “experiments” allow us to evaluate the benefit of DDT (or lack thereof). As noted here (pp. 7-8) in a paper published a decade ago by Africa Fighting Malaria, it was noted that:
“Given the higher costs and, possibly, the greater efficacy of DDT, it is not surprising that despite the theoretical availability of substitutes, malaria rebounded in many poor areas where (and when) DDT usage was discontinued (WHO 1999a; Roberts 1999, Roberts et al. 1997, Sharma 1996, Whelan 1992, Guarda et al. 1999, Bate 2000). For instance, malaria incidences in Sri Lanka (Ceylon) dropped from 2.8 million in the 1940s to less than 20 in 1963 (WHO 1999a, Whelan 1992). DDT spraying was stopped in 1964, and by 1969 the number of cases had grown to 2.5 million. Similarly, malaria was nearly eradicated in India in the early 1960s, and its resurgence coincided with shortages in DDT (Sharma 1996). The population at high- to medium risk of contracting malaria in Colombia and Peru doubled between 1996 and 1997 (Roberts et al. 2000b). Malaria has also reappeared in several other areas where it had previously been suppressed, if not eradicated (e.g., Madagascar, Swaziland, the two Koreas, Armenia, Azerbaijan, Turkmenistan; Roberts et al. 2000b, and references therein). Similarly, Roberts et al. (1997) showed that Latin American countries (e.g., Ecuador, Belize, Guyana, Bolivia, Paraguay, Brazil and Venezuela) which had discontinued or decreased spraying of DDT inside homes saw malaria rates increase. Guarda et al. (1999) also note that in 1988, when DDT use was discontinued, there were no cases of Plasmodium falciparium reported in Loreto, Peru. The number of cases increased to 140 in 1991. By 1997, there were over 54,000 cases and 85 deaths (see, also, Goklany 2000c).
“But the best argument for indoor-spraying of DDT is that in many areas where malaria experienced a resurgence, reinstating DDT use once again led to declines in malaria cases. For example, Ecuador, which had previously seen its malaria rates rebound once DDT spraying had been reduced, saw those rates decline once again by 61 percent since 1993, when DDT use was increased again (Roberts et al. 1997). The same cycle occurred in Madagascar where the malaria epidemic of 1984-86, which occurred after the suspension of DDT use, killed 100,000 people. After two annual cycles of DDT spraying, malaria incidence declined 90 percent (Roberts et al. 2000b).”
Since then, we have results of the on-again and off-again policy with regard to DDT from KwaZulu-Natal Province in South Africa:
“DDT spraying in that area started in 1946. By 1974, Anopheles funestes, the mosquito species associated with year-round prevalence of malaria in that region, had been eradicated [see Figure below.]. In the 1991/1992 malaria season, the number of malaria cases was around 600 in the Province of KwaZulu-Natal (KZN). However, in 1996, DDT was replaced by synthetic pyrethroids. In 1999 members of A. funestus were found in houses in KZN that had been sprayed. In 1999/2000, there were more than 40,000 cases in KZN. In 2000, DDT was brought back. By 2002, the number of cases had dropped to 3,500.” Source: Pre-edited version of Goklany (2007), pp.79-180.
See the Figure 1.
I have also provided additional references below, if one is interested in following up.
For a broader discussion, I recommend the chapter, “Applying the Precautionary Principle to DDT,” in The Precautionary Principle: A Critical Appraisal of Environmental Risk Assessment (Cato Institute, Washington, DC, 2001). A previous version of this chapter is available free at http://goklany.org/library/DDT%20and%20PP.PDF.
Figure 1: From Goklany (2007), based on R. Tren, “IRS & DDT in Africa — past and present successes,” 54th Annual Meeting, American Society of Tropical Medicine and Hygiene (ASTMH), Washington, DC, December 11-15, 2005.
B. Ed Darrell on September 13, 2010 at 2:19 pm said, “We may not beat malaria by 2014, but it won’t be because the Gates Foundation is on the wrong path.”
RESPONSE: I agree. For a long time, malaria control was neglected. Even the World Health Organization would not recommend DDT use indoors. It was revived, and even became (almost) chic thanks to a number of very high profile individuals including George Bush and Bill Gates, as well as lesser known people such as Don Roberts, Amir Attaran, Roger Bate and Richard Tren (all associated with Africa Fighting Malaria) . I delude myself into thinking that I played a minor role in helping ensure that DDT did not get banned outright under the Stockholm Convention.
Whatever people may think of Bill Gates stance on global warming, there is little doubt that he exhibited substantial political courage in espousing malaria control with DDT. That’s essentially why I was/am disappointed by his posting that set me off on this blog.
Perhaps I should have titled my piece, “Et tu Bill Gates!”
ADDITIONAL REFERENCES
D. R. Roberts, et al. “DDT, global strategies, and a malaria control crisis in South America,” Emerging Infectious Diseases 3 (1997): 295-301 (1997).
D.R. Roberts, et al., “A Probability Model of Vector Behavior: Effects of DDT Repellency, Irritancy, and Toxicity in Malaria Control,” Journal of Vector Control 25 (2000): 48-61.
Karen I. Barnes et al., “Effect of Artemether Lumefantrine Policy and Improved Vector Control on Malaria Burden in KwaZulu Natal, South Africa,” Public Library of Science Medicine (2005): DOI 10.1371/journal.pmed.0020330.
P. E. Duffy and T. K. Mutabingwa, “Rolling Back a Malaria Epidemic in South Africa,” Public Library of Science Medicine (2005): DOI: 10.1371/journal.pmed.0020368.
R. Tren, “IRS & DDT in Africa — past and present successes,” 54th Annual Meeting, American Society of Tropical Medicine and Hygiene (ASTMH), Washington, DC, December 11-15, 2005.
D. H. Roberts, “Policies to Stop/Prevent Indoor Residual Spraying for Malaria Control,” 54th Annual Meeting, ASTMH, Washington, DC, December 11-15, 2005.
I.M. Goklany, The Precautionary Principle: A Critical Appraisal of Environmental Risk Assessment (Cato Institute, Washington, DC, 2001). Chapter 2 deals with malaria and DDT.
Ed Darrell has two sets of comments, one of which, I believe, is fundamentally flawed, and the other I would agree with, at the risk of being accused by Alexander Feht of being obsequious once again (See Alexander’s comment on September 11, 2010 at 11:28 am).
A. Ed Darrell on September 12, 2010 at 7:40 pm, responding to tarpon said:
In 1972, about two million people died from malaria, worldwide.
In 2008, about 880,000 people died from malaria, worldwide. That’s fewer than half the mortality the year the U.S. stopped DDT spraying on cotton.
If it’s cause-effect you were trying to establish, I think you missed.
RESPONSE: The flaws in Ed’s analysis are aplenty.
First, although the US banned DDT in 1972, its use continued in much of the rest of the world. [If I remember correctly, the Swedes had banned it earlier.] In fact, US production of DDT for developing country use continued into the mid-1980s. Also, it took a few years for US environmentalists to ensure that the US domestic ban was — in the best traditions of cultural imperialism and bearing the white man’s burden — exported to other countries [without their (informed) consent, mind you]. [Notably, the US ban was imposed only after malaria had been wiped out in the US for practical purposes. See Figure 13, here.] In addition, countries had stockpiles which they continued to use, and not all developed countries were initially on board with eliminating DDT use worldwide. Furthermore, by 2008 some developing countries that had stopped DDT use had resumed its use. So it is not meaningful to use either 1972 or 2008 as endpoints for developing global estimates for the efficacy (or lack of it) of DDT in dealing with malaria..
Second, while DDT is in many instances the cheapest and most cost-effective method of reducing malaria (where it works, because it doesn’t always work) the death and disease rates are also sensitive to other factors, none of which have remained stationary between 1972 and 2008. These factors include general health status, adequate food and nutrition, public health services, and so on. So, it makes little sense, without adequately accounting for these factors, to compare deaths for malaria (or death rates, which would be more correct) between 1972 and 2008 to say anything about the effectiveness of DDT.
Fortunately, though, we have results of some “policy experiments” which were undertaken inadvertently — undertaken, I note, without the consent of the subjects of these experiments, something that would not be allowed in any hospital in the US, I suspect. These “experiments” allow us to evaluate the benefit of DDT (or lack thereof). As noted here (pp. 7-8) in a paper published a decade ago by Africa Fighting Malaria, it was noted that:
“Given the higher costs and, possibly, the greater efficacy of DDT, it is not surprising that despite the theoretical availability of substitutes, malaria rebounded in many poor areas where (and when) DDT usage was discontinued (WHO 1999a; Roberts 1999, Roberts et al. 1997, Sharma 1996, Whelan 1992, Guarda et al. 1999, Bate 2000). For instance, malaria incidences in Sri Lanka (Ceylon) dropped from 2.8 million in the 1940s to less than 20 in 1963 (WHO 1999a, Whelan 1992). DDT spraying was stopped in 1964, and by 1969 the number of cases had grown to 2.5 million. Similarly, malaria was nearly eradicated in India in the early 1960s, and its resurgence coincided with shortages in DDT (Sharma 1996). The population at high- to medium risk of contracting malaria in Colombia and Peru doubled between 1996 and 1997 (Roberts et al. 2000b). Malaria has also reappeared in several other areas where it had previously been suppressed, if not eradicated (e.g., Madagascar, Swaziland, the two Koreas, Armenia, Azerbaijan, Turkmenistan; Roberts et al. 2000b, and references therein). Similarly, Roberts et al. (1997) showed that Latin American countries (e.g., Ecuador, Belize, Guyana, Bolivia, Paraguay, Brazil and Venezuela) which had discontinued or decreased spraying of DDT inside homes saw malaria rates increase. Guarda et al. (1999) also note that in 1988, when DDT use was discontinued, there were no cases of Plasmodium falciparium reported in Loreto, Peru. The number of cases increased to 140 in 1991. By 1997, there were over 54,000 cases and 85 deaths (see, also, Goklany 2000c).
“But the best argument for indoor-spraying of DDT is that in many areas where malaria experienced a resurgence, reinstating DDT use once again led to declines in malaria cases. For example, Ecuador, which had previously seen its malaria rates rebound once DDT spraying had been reduced, saw those rates decline once again by 61 percent since 1993, when DDT use was increased again (Roberts et al. 1997). The same cycle occurred in Madagascar where the malaria epidemic of 1984-86, which occurred after the suspension of DDT use, killed 100,000 people. After two annual cycles of DDT spraying, malaria incidence declined 90 percent (Roberts et al. 2000b).”
Since then, we have results of the on-again and off-again policy with regard to DDT from KwaZulu-Natal Province in South Africa:
“DDT spraying in that area started in 1946. By 1974, Anopheles funestes, the mosquito species associated with year-round prevalence of malaria in that region, had been eradicated [see Figure below.]. In the 1991/1992 malaria season, the number of malaria cases was around 600 in the Province of KwaZulu-Natal (KZN). However, in 1996, DDT was replaced by synthetic pyrethroids. In 1999 members of A. funestus were found in houses in KZN that had been sprayed. In 1999/2000, there were more than 40,000 cases in KZN. In 2000, DDT was brought back. By 2002, the number of cases had dropped to 3,500.” Source: Pre-edited version of Goklany (2007), pp.79-180.
See the Figure 1.
I have also provided additional references below, if one is interested in following up.
For a broader discussion, I recommend the chapter, “Applying the Precautionary Principle to DDT,” in The Precautionary Principle: A Critical Appraisal of Environmental Risk Assessment (Cato Institute, Washington, DC, 2001). A previous version of this chapter is available free at http://goklany.org/library/DDT%20and%20PP.PDF.
Figure 1: From Goklany (2007), based on R. Tren, “IRS & DDT in Africa — past and present successes,” 54th Annual Meeting, American Society of Tropical Medicine and Hygiene (ASTMH), Washington, DC, December 11-15, 2005.
B. Ed Darrell on September 13, 2010 at 2:19 pm said, “We may not beat malaria by 2014, but it won’t be because the Gates Foundation is on the wrong path.”
RESPONSE: I agree. For a long time, malaria control was neglected. Even the World Health Organization would not recommend DDT use indoors. It was revived, and even became (almost) chic thanks to a number of very high profile individuals including George Bush and Bill Gates, as well as lesser known people such as Don Roberts, Amir Attaran, Roger Bate and Richard Tren (all associated with Africa Fighting Malaria) . I delude myself into thinking that I played a minor role in helping ensure that DDT did not get banned outright under the Stockholm Convention.
Whatever people may think of Bill Gates stance on global warming, there is little doubt that he exhibited substantial political courage in espousing malaria control with DDT. That’s essentially why I was/am disappointed by his posting that set me off on this blog.
Perhaps I should have titled my piece, “Et tu Bill Gates!”
ADDITIONAL REFERENCES
D. R. Roberts, et al. “DDT, global strategies, and a malaria control crisis in South America,” Emerging Infectious Diseases 3 (1997): 295-301 (1997).
D.R. Roberts, et al., “A Probability Model of Vector Behavior: Effects of DDT Repellency, Irritancy, and Toxicity in Malaria Control,” Journal of Vector Control 25 (2000): 48-61.
Karen I. Barnes et al., “Effect of Artemether Lumefantrine Policy and Improved Vector Control on Malaria Burden in KwaZulu Natal, South Africa,” Public Library of Science Medicine (2005): DOI 10.1371/journal.pmed.0020330.
P. E. Duffy and T. K. Mutabingwa, “Rolling Back a Malaria Epidemic in South Africa,” Public Library of Science Medicine (2005): DOI: 10.1371/journal.pmed.0020368.
R. Tren, “IRS & DDT in Africa — past and present successes,” 54th Annual Meeting, American Society of Tropical Medicine and Hygiene (ASTMH), Washington, DC, December 11-15, 2005.
D. H. Roberts, “Policies to Stop/Prevent Indoor Residual Spraying for Malaria Control,” 54th Annual Meeting, ASTMH, Washington, DC, December 11-15, 2005.
I.M. Goklany, The Precautionary Principle: A Critical Appraisal of Environmental Risk Assessment (Cato Institute, Washington, DC, 2001). Chapter 2 deals with malaria and DDT.
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Bethany, you are quite wrong, the cause was a closed circuit feeding system whereby spinal chords and brain stems were ground up and included in the feed, this is now banned, before the Nat Geographic went political they had some articles on this, including a study of some primitive tribe that forbade the kids meat, the women salvaged non obvious “meat” when performing funeral prep and produced the same CJD symptoms, I suspect the chemical “explanation” came later. The French had this and it continued for longer as due to the CAP they farm “traditionaly” but they failed to report it for years, the farmers called it JCB, the name of the digger/back hoe they called for when a cow went loopy, bury the evidence and carry on feeding the brain stem.
If this has already been posted, apologies. Interesting film release: “3 Million and Counting”. A snippet from the web page;
“Sure to spark outrage, Dr. Rutledge, a California physician specializing in preventative medicine, chronicles the effects of the world-wide ban on the pesticide DDT in 1972, a ban inspired by the first enviro-bestseller, Rachel Carson’s Silent Spring (1962). Rutledge’s five-year-long effort is driven by his revulsion at millions of deaths, mostly of women and young children, in Africa and South East Asia, by the mosquito-borne disease, Malaria. According to a recent World Health Organization report, Malaria kills one million people annually, a disease, Rutledge confirms, that is wholly and immediately preventable.”
http://3billionandcounting.wordpress.com/
I’d say this is pretty much on topic.
@INGSOC
Ya, and if you believe you what your told in 3 Billion and Counting, then Dr Rutledge has some amazing, life changing supplements to sell you, too:
http://askdrrutledge.com/
Anthony, I’m very confused now.
Is it fair to say you repudiate the statements that Rachel Carson is a mass murderer?
If so, I apologize for assuming you supported the position of those you cite. I can make a more forceful correction, if you provide evidence it is a correction.
But if you support the claim, it would be dishonest for me to apologize for pointing it out.
REPLY: OK you had your chance to correct your libel by saying simply: “Anthony did not call Rachel Carson a mass murderer, I’m sorry for saying he did”. I don’t need to tolerate people (in my home on the Internet, see policy page) who put words in my mouth I’ve never written or said and then refuse to retract their error given ample opportunity.
You aren’t “confused”, you are dishonest, and you are now banned, permanently. – Anthony
Alexander Feht says:
“Anton,
“Humans do own this planet (who else, harpies or fairies?), a man who is not man-centered is a man mentally ill (as any psychiatrist will tell you), and a man is a measure of all things for the simple reason that a man cannot imagine any measure that he cannot imagine.
“Before preaching to people who respect facts and logic, check your facts and your logic.”
————
That’s it? That’s your argument? And anyone who doesn’t agree is mentally ill “as any psychiatrist will tell you.”
YOU own the planet because you are a man, and you are the measure of all things because you cannot imagine any measure that you cannot imagine. How brilliant.
Best wishes.
Goodness gracious. Peter you are one very angry man, at least as portrayed in your post.
Many of humankind’s ills have been mitigated by common sense and low cost measures. Yet, some of the simplest measures have been blocked by the very countries that would be helped the most.
Western $$$??? Western leisure??? “…comfortable western benefits…”??? Wearing protective clothing, washing hands, avoiding ponded water, use of nets at night, and other low cost safety and risk mitigation measures are not my idea of high-end western ideas. Far better for third world countries to educate their citizenry on these low cost sensible measures than to depend on the vagaries of high-end, quick-fix measures.
I will repeat. Wear protective clothing, use nets, camp away from ponded water, and cover water barrels.
My point of view is I think sensible, not reactionary. Develop a hardy response to life’s risks by mitigating those risks in sensible ways. Else you become dependent on a dictatorial government (be it outside or within your country) that clearly will not have your best interests at heart.
By the way, I am anything but an environmentalist, commie, econut, terrorist, bleeding heart, or any other epitaph you might think of because I happen to like bugs. I try to lower my cost of living by using the cheapest fuel I can get my hands on, I lower my risks of injury or illness as best I can, and I clean up after myself. Not only do I like bugs, I also use bugs for a variety of purposes. Some I just like to look at, some I use to control other pests, and some I fish with. All these actions are both wise and mannerly. And I will readily join any revolution that seeks to fight against any government intent on taking away my individual rights to these beliefs and actions.
“Spoilt western brats” would not be a definition that describes me, or anyone else I know out in rural areas that like bugs.
Rutledge’s claim that Rachel Carson killed 3 billion people, blames her for more deaths than actually occured from all causes since 1972. But it’s the title of the movie, so it must be true, I guess.
REPLY: Tim, you neglected to provide a link to your post involving Mr. Goklany, so I’ll do it for you:
Indor Goklnay, DDT and Malaria
Maybe it was because you were embarrassed that you spelled both his first and last name wrong?
Of course I’ve made some spelling errors too, but I think if you are going to criticize somebody, you should at least spell their name correctly. For the record: I n d u r _ G o k l a n y
Cut and paste is also helpful in avoiding such misspellings, and his name is right there on the top of the WUWT article.
You’re welcome. – Anthony
Isn’t a Deltoid a small delta, where the debris and mud that was flowing down the river comes to rest and accumulates?
*whistles nonchalantly*
Whilst Lambert may have some potentially valid points to raise about resistance, he undermines them by a staggeringly dishonest presentation of the Sri Lanka malaria reecord.
For example; in his graph, there are two DDT “stops” and one “start”. Why has he only labelled one? What about the record prior to 1960? Why use probability of fatality, rather than the more telling number of deaths?
The likely answer to these, is if you do a bit of digging, this information strongly demonstrates the effectiveness of DDT as a tool for Malaria control. As I found out when I searched out a more complete data set (link here).
Of course, there are issues regarding resistance, and DDT should be just one of a number of tools used in combatting malaria. But when presenting the complete story, it is clear the immense value of DDT. If Lambert was really objective about this, why did he feel the need to withhold such important information?
There is a new documentary out 17 – 23 September, Quad Cinema, 34 West 13th Street, New York which proves DDT is SAFE. The trailer is here:
http://www.3billionandcounting.com/trailer.php
For those of a medical persuasion, you will find this article by Dr. Elizabeth M. Whelan, president of the American Council on Science and Health, to be very interesting. The link is here:
http://www.nationalreview.com/articles/246562/deadly-war-against-ddt-elizabeth-m-whelan
Pamela Gray says:
September 15, 2010 at 10:09 am
Western $$$??? Western leisure??? “…comfortable western benefits…”??? Wearing protective clothing, washing hands, avoiding ponded water, use of nets at night, and other low cost safety and risk mitigation measures are not my idea of high-end western ideas. Far better for third world countries to educate their citizenry on these low cost sensible measures than to depend on the vagaries of high-end, quick-fix measures.
I will repeat. Wear protective clothing, use nets, camp away from ponded water, and cover water barrels.
Pamela, for you these are low cost measures, the reality here in the Solomons is that no one can afford them.
Protective nets? Believe it or not, we were able for a while to get mosquito nets free, unfortunately, the only place to obtain them was in Honiara, which left 90% of the population unable to access them. Transportation is by foot or canoe here, the ferries and cargo boats are only for necessary trips home for weddings and funerals, unless you work for the Government.
Camp away from ponded water? This is the tropics, we have 3 – 4 metres of rain per year, mostly in the wet season from October to March, we don’t have ponded water, we have lakes.
Clean water to wash in? The people that live in Honiara, White River, Borderline, Lungga, use whatever water they can find, the ditches and small streams running through the villages are the usual source of water, and don’t talk about rain water tanks, they are beyond the reach of the local income level.
Protective clothing? All our clothing here comes from charity agencies in bales, to be sold by the various kaleko klothing shops in Honiara, the rest of the Solomons make do with hand me downs from wantok that live in Honiara or have access to the shops. I have never seen protective clothing, I know you probably mean long sleeved shirts, long trousers etc, but when it is 30+ C and 90% humidity, believe me, you don’t want to be wearing long sleeved, long legged anything.
Cover water barrels? I have the luxury of having a rain water tank, (250 gal) with a mesh screen that always has mosquito larvae in, my work crew have a stream or ditch for their water supply, which is also the garbage and sewage disposal system, as we do not have a rubbish collection, garbage collection, sewage, or reticulated water supply.
I appreciate your thoughts, but I wish a lot of well meaning people would actually get out a bit more and visit the places they are so quick to offer advice to, well meaning and all, but bearing absolutely no relevance to the actual living conditions.
I enjoy your posts, but in this case you need to get out a bit more and realise that your low cost measures are high cost measures here.
What is so amazing about this scam is that DDT is ACTUALLY SAFE!! So for you so-called enviros out there, I have a few questions I would like answered:
Why would any humanity loving person ban something which is so cheap, and so effective against malaria?
Why have I been so outrageously lied to?
What excuse do you have for allowing all of these deaths, this suffering? And don’t tell me it’s because DDT is toxic – Having seen a preview of this movie I now KNOW better than to fall for that ruse.
I’m waiting for your answers….
DDT and Malaria in Ceylon
There is apparently a lot of confusion about malaria and DDT use in Ceylon. In fact, Tim Lambert on September 15, 2010 at 11:24 am claims I’m spreading misinformation. He bases this claim on a diagram he found on a WHO website that provides a graph of malaria cases from 1960 to 2008 but is very economical with the history of DDT usage, as noted by Spence_UK on September 15, 2010 at 12:25 pm. Spence_UK has also linked to a most interesting curve, which indicates, in the words of the underlying paper at http://www.biomedcentral.com/content/pdf/1475-2875-7-140.pdf, that “relaxation of controls” (which included DDT use) after 1963 “led to rapid and dramatic resurgence” of malaria.
I would like to add to what Spence has unearthed. But, before that let me note that the information I provided in my post was identified as coming from Whelan (1992). To check that I hadn’t gotten something wrong – what the heck, I am insecure — I tried to locate the original book. I didn’t find it, but did find a book with the same name but with a publication date of 1985. No matter, in that version the data can be found on page 69. Tim, go check it out. It ought to be in your University’s library.
Now I must say that I was surprised that the WHO website provided by Tim Lambert was silent on the DDT cessation after 1963. So I thought I should verify that this actually occurred. Perhaps I had been mistaken.
However, I found a number of references to this episode. These include a report in the New York Times from February 13, 1971, headlined, “U.N. Agency Backs Indoor Use of DDT to Combat Mosquitoes”. It’s worth reading in its entirety. It’s at http://goklany.org/Misc/DDT and Ceylon Feb 13 1971.pdf. It notes that WHO “defended…the use of DDT to kill mosquitoes indoors” in a special report. [Wonder who it was being defended to, or why it needed to be defended, if no one was against its use?] It further notes:
Note that the WHO numbers quoted in the NY Times report are consistent with Whelan (1985).
The NY Times also adds:
The NY Times article goes on to report that, according to the WHO, substituting for DDT would raise costs of the program from $60 million a year to between $184 million – $510 million, depending on which substitute were used. [I interpret this to the cost of a global program, rather than a Ceylon-only program — I wonder what WHO’s budget for these activities was in 1971?]
As an aside, clearly the WHO website that Tim Lambert linked to has amnesia about the 1971 report, but that could be a genuine loss of institutional memory.
Also, I came across an abstract of an article in the Indian Journal of Malariology, from June 1993, 30(2):51-5.
Unfortunately, I don’t have access to this paper, but its story seems consistent with the Whelan (185), and the NY Times story.
Finally, I should note that, if you read my paper, it fully acknowledges the issue of DDT resistance, which is why it conditions the use of DDT to situations where it I effective. For example, in the summary posted previously, I note that “In fact, indoor spraying of DDT ought to be encouraged in countries where such spraying would diminish malaria incidence.” [Emphasis added.]
No one is advocating DDT use where, or if, it’s ineffective. But there are situations where it is not only effective, it is also the cheapest intervention available. Regardless, we should never foreclose the option that it be available for use.
Third try. The link to the NY Times article is : http://goklany.org/Misc/DDT and Ceylon Feb 13 1971.pdf.
If the link doesn’t work, copy every thing from http to pdf, and paste it in the address box.
My apologies.
Indur Goklany, The New York Times story you linked is wrong about the number of cases.
From Malaria: Principles and Practice of Malariology edited by Wernsdorfer and McGregor (1988) Chapter 45 “The recent history of malaria control and eradication.” by Gramiccia and Beales pages 1366-1367:
DDT spraying was suspended in 1964 not because of environmental concerns but because there were too few cases to justify its use. They felt that they are succeeded in eradicating malaria and the few remaining cases could be treated with drugs. This wasn’t unreasonable — that’s what had worked in temperate climates.
Actually, they are. I give you Michael Fumento:
Once upon a time DDT was the insecticide of choice for fighting malaria. But DDT resistance and new technologies like long lasting insecticide treated nets mean that these days it is not generally the cheapest or most effective means. See here.
Indur M. Goklany said on September 15, 2010 at 8:08 pm
Ah, it’s a common problem. The WordPress auto-parser just can’t handle spaces in an URL.
Refer to this chart:
http://www.december.com/html/spec/esccodes.html
It provides the “escape codes” used in URL’s that take the place of non-alphanumeric characters. In this case you’d use “percent sign-20” in place of the space. Oh, I spelled that out since some “bulletin board” programs may have “issues” where they automatically convert URL escape codes into the characters they represent, just as some do with the “ampersand” HTML codes for non-alphanumeric characters.
I’m going to test WordPress now. I’ll use your URL twice with the escape code, once by itself and once in a link that you can “right-click copy-link-location.” I’ve tested the URL in an address bar with the spaces replaced by that escape code and it worked. Using the CA Assistant Preview feature I get a working link that when I “right-click copy-link-location”
followed by a ctrl-v paste in an address bar gives me the URL with the escape codes. But until I actually post the examples I won’t know how WordPress itself will mangle them.
http://goklany.org/Misc/DDT%20and%20Ceylon%20Feb%2013%201971.pdf
Link
As you can see Indur, the links came through just fine.
As I can see, the one “wordpress” auto-correction feature I have noticed, where “WordPress” spelled with a capital-W only (as I just did in the last set of quotes) is converted into “wordpress” with both a capital-W and a capital-P, which I find highly annoying, while “wordpress” in all lowercase is ignored, which is annoying for the inconsistency, is still functioning.
DDT remains effective against the spread of malaria even after the mosquitoes have been declared resistant to DDT.
From here:
http://www.malaria.org/attarannaturemed.html
Original was in Nature Medicine, July 2000, Volume 6 Number 7, pp 729 – 731, found online behind a paywall.
Balancing risks on the backs of the poor
Amir Attaran(2), Donald R. Roberts(1), Chris F. Curtis(3) & Wenceslaus L. Kilama(4)
Excerpt:
There is confirmation. From here:
http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2915.2000.00262.x/abstract (paywall)
Originally published in Medical and Veterinary Entomology, Volume 14, Issue 4, pages 345–354, December 2000.
Cost-comparison of DDT and alternative insecticides for malaria control
K. Walker
From the abstract:
My eyes glaze over at long-winded multi-page excerpts and I usually skip over wars of dueling citations. So for those like me, here’s the quick take-home message:
Those who argue against using DDT because mosquitoes are resistant or are growing resistant, are not presenting you with the science that shows DDT is still effective against the spread of malaria.
For another reason for increased indoor spraying, over at the CIA’s World Factbook entry for Sri Lanka, under “Major Infectious Diseases” there are two listed in the “vectorborne disease” classification, dengue fever and chikungunya. From here:
There are other mosquito-transmitted diseases than malaria. Note the key phrase in both listings, “…associated with urban environments…” The word “urban” does not conjure up images of swamps that can be drained. Mosquito nets for beds, treated or not, don’t help in offices and factories. The spraying of the walls of rooms with DDT can be done for any building, protecting people from these diseases all day long while they are in them. Not doing so because of worries about resistance, and claiming bed nets are as effective, is not supported by the science.
That sounds remarkably like environmental central planning communism.
You need to understand what it was saying. “excitorepellency ” is the repellent effect, even if they are immune to a degree, they don’t like the effect it has on them. It is also referring to use in the home, which has not been banned, and is encouraged if used properly.
The difference (that many miss) is that we have developed a good therapy against malaria, artemisinin combination therapies (ACT). This prevents the spread of maleria by wiping it out efficiently in one of the hosts (us). The Gates Foundation has played a major role in getting the price of this three drug therapy down and making it available. By eliminating one of the ping pong hosts (mosquito – human – mosquito) this has dropped mortality. Distribution of bed nets and indoor spraying has contributed greatly. Attacking the Gates Foundation is fundamentally wrong. They have lead the fight in Africa, but what is scary is that resistance to artemisinin is emerging.
Re: kadaka
Indeed, from the graph I linked above you can see that quite clearly. As Tim Lambert points out, DDT was phased out for “the more expensive” malathion in 1977. Under the DDT regime, even after resistance was developed, deaths were in the single figures per year. After switching to malathion, even though total cases dropped slightly, deaths shot up to 100 per year by 1980, and stayed there. By the middle of the 1980s the total cases had returned – the “more expensive” malathion had returned to the same levels that DDT had achieved, with more deaths.
Malathion was clearly more expensive, and LESS effective and keeping deaths down than DDT, even after resistance had built up, and offered negligible improvement in total cases. Which is in keeping with the article you cite.
The only point Tim has successfully made is that perhaps the 1969 figure (on a like-for-like comparison) is probably closer to half a million than 2.5 million. (This doesn’t make the 2.5 million wrong FWIW: estimating these figures is VERY difficult and there may be more than one definition of “reporting”, i.e. diagnosis by doctor vs. blood test) But so what? Even at half a million, the point being made by Indur is still valid.
Over at deltoid people are rushing to claim a conspiracy by right wingers to attack Rachel Carson. I’m sure there are a very small number who take an extreme viewpoint, but this is not the tenor of the argument presented here. The points being made are the flaws of the precautionary principle, and that taking action to stop something when there is great uncertainty can actually increase the risk, rather than reduce it. From that perspective, there are lessons we need to learn from the DDT case and reduce such policy failures in the future.
From: stereo on September 16, 2010 at 6:11 am
I don’t think you understand what I was saying!
You better read it again. All of it. Slowly.
I know what you were saying, but what you were saying was based on a misrepresentation of what they were saying.