A recent peer-reviewed scientific paper in Malaria Journal by Yukich, Lengeler, Tediosi, Brown, Mulligan, Chavasse, Stevens, Justino, Conteh, Maharaj, Erskine, Mueller, Wiseman, Ghebremeskel, Zerom, Goodman, McGuire, Urrutia, Sakho, Hanson and Sharp compared several large vector control programs to prevent malaria, including both insecticide-treated nets (ITN) and indoor residual spraying (IRS). The results:
|Method||cost per child death averted|
Even using IRS, DDT was not the most cost effective insecticide, which was deltamethrin. Yukich et al conclude:
These findings confirm that large-scale delivery of ITNs and IRS in sub-Saharan Africa is feasible and highly cost-effective using a range of strategies. Delivery of LLINs through campaigns provides a highly cost-effective and achievable method for rapidly improving ITN coverage. However, many other options exist for ITN programming, some well suited to maintain coverage levels after campaigns. IRS, or a combination of ITNs and IRS, remain attractive and viable options in some settings. Given that sustainable high-level funding appears to be available in the long-term through new global financing mechanisms, every malaria endemic country should aim to upscale their vector control programmes as rapidly and sustainably as possible.
Western, developed countries don’t have to do very much thanks to the bed-net campaigns: just spend a fiver on a net and you can possibly ‘save a poor person’.
Yes, Dingle is opposed to bednets because they are an inexpensive way to prevent malaria.
Under the bed-net initiatives, ‘preventing malaria’ means taking small, very low-tech steps which involve no development whatsoever, thus helping to maintain the status quo.
But the huge economic cost of malaria is a major factor in preventing development in Africa. If Worldwrite’s anti-ITN campaign is successful, not only will they kill African children, they will also hinder economic development there.
Written into the bed-net campaign is a deep hostility towards modern, chemicalised methods of destroying malaria.
Apparently Dingle thinks that they treat the nets with insecticide because of hostility to using chemicals.
The demon DDT, a non-herbal, non-traditional, Western invention, was used to great effect to wipe out malaria in the West, until it was banned on environmental grounds in 1972, despite court hearings which found it to be harmless.
It took until 2005 for the World Health Organisation to admit to DDT’s harmlessness.
This is not true. The World Health Organization has never stopped promoting the use of DDT.
Wondering, as Jessica Mudditt puts it in the WORLDwrite film, ‘whether the next mosquito bite is going to kill you’ is a terrible state of affairs for people in malarial areas. Never mind staying up late or going out at night, simply a rip, a tear, a tangle in your bed-net, or a trip to a pit latrine in the middle of the night, might be a killer moment. And all of this because Western campaigners hate the amazing chemicals we have created that can wipe out the pests.
ITNs are not 100% effective at preventing mosquito bites, but neither is IRS with DDT. But the scientific evidence shows that ITNs are more cost effective. And again, the nets are treated with insecticide, which seems inconsistent with the claim that their proponents hate chemicals. And we have no chemicals that can wipe out mosquitoes. The point of both ITNs and IRS is to stop the mosquitoes from biting people.