Africans aren’t helpless animals–they know what works against malaria. Unfortunately, what works against malaria is DDT. But any country that proposes a program of household DDT application faces starvation at the hands of European bureaucrats and consumers. The nets are an unnecessarily expensive and epidemiologically phony sauve-qui-peut measure, a work-around for what could be described as the greatest ongoing mass murder ever perpetrated. Reilly’s appeal (or Ted Turner’s appeal, rewritten by Reilly) isn’t calculated to save lives–he’s essentially urging Americans to underwrite the costs of environmental “consciousness” in the developed world. You might just as well FedEx a box of cookies to Stuttgart: it’ll have the same net effect, no pun intended.
Matt McIntosh corrects Cosh, but in my opinion is too kind to him:
I think I’m probably breaking some rule of blogger etiquitte by performing the dreaded fact-check manoeuver on Colby Cosh just after he linked to my other blog. But it always makes me wince when people I respect stake out strong positions where they’re demonstrably wrong on the facts, so I’m afraid I cannot let this pass:
The fact is that nets work and save lives. If someone is persuaded by Cosh that nets don’t work and chooses not to donate, more people will die of malaria. It is irresponsible of Cosh to make the claims that he did without proper fact checking.
Just published April 24 in Malaria Journal:
Malaria is a huge public health problem in Africa that is responsible for more than one million deaths annually. In line with the Roll Back Malaria initiative and the Abuja Declaration, Eritrea and other African countries have intensified their fight against malaria. This study examines the impact of Eritrea’s Roll Back Malaria Programme: 2000-2004 and the effects and possible interactions between the public health interventions in use.
This study employed cross-sectional survey to collect data from households, community and health facilities on coverage and usage of Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), larvicidal activities and malaria case management. Comparative data was obtained from a similar survey carried out in 2001. Data from the Health Management Information System (HMIS) and reports of the annual assessments by the National Malaria Control Programme was used to assess impact. Time series model (ARIMA) was used to assess association.
In the period 2000-2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0-5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (SZ=-0.125, p<0.005) and the amount (kg) of DDT and Malathion used for IRS (SZ =-2.352, p<0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant.
Eritrea has within 5 years attained key Roll Back Malaria targets. ITNs and IRS contributed most to reducing malaria morbidity.