Well, for one thing, we know how to build durable electric power supplies.
When 17 hydroelectric dams were built on the Tennessee River in the southern USA after the Second World War, malaria disappeared from the region within a few years, and never returned. This was before DDT and chloroquine. Why? Because the availability of adequate water and affordable electricity resulted in increased income for the people, better housing with screens, and electric fans that made sleeping indoors comfortable in the hot, humid malaria season.
Well, for one thing, we know how to build durable electric power supplies.
Epidemiological nugget three;
At MalariaWorld we aim to serve you - it's the very reason we exist.
But every year in December, during the festive season, we ask you for a small favour in return. A small gift in return for a full year of weekly newsletters that we drop in your mailbox, and a website full of information on malaria that you all receive for free.
This year we are not asking anything for MalariaWorld itself. Instead we have another cause for which we ask your support...
Malaria World has become a broad and wonderful forum for exchanging information on malaria, with about 7,000 members, coming into 2013. And lately there have been many items relevant to the big fight against malaria in Africa. These items have come from all over the world; the latest exciting one being the contribution by the people from Southern Africa who are showing us the way.
But there are important groups who are noticeable for their absence.
There is too little appreciation in current vector-borne disease paradigms for the intervention characteristics that are appropriate for stop-gap emergencies vs. those that are vital for the end-game: elimination. Regardless of whether you think elimination of any vector-borne disease is possible, it will not be accomplished without this.
Epidemiological Nugget Number Two........Many malaria programs are slowly converting to better diagnostic methods for reporting the prevalence of malaria. However the numbers have to be carefully analyzed, because of the artifacts caused by changes in False Positivity of the better diagnostic tests. The most common diagnostic method used in Africa - and reported through WHO - is called Clinical Diagnosis. This method, relying on the clinical judgement of the health care worker, has a False Positivity Rate of about 80%.
Epidemiological Nugget Number One: Bednets are avoided by adults, especially during the hot and humid malaria season.......However infants cannot escape their mothers protective care, thus infants usually sleep under bednets, even though no one else in the family does.........Now - what happens when groups like PMI report their success in terms of reduced Infant Mortality, or prevalence of malaria among infants?..........It is no surprise that Infant Mortality drops because the infants are sleeping under bednets.
Last week showed unambiguously that unless the world pulls up its sleeves, the hard-won gains of the last decade may go up in smoke. 'The world' in the previous sentence is you, us, all of us engaged as professionals in the field of malaria. MalariaWorld has put out warning signals over the last three years, about the problems with drug resistance, about artemisinin resistance in SE Asia and the risk of it escaping to other parts of the world, about impregnated bednets being shipped to parts of Africa where full-blown resistance against pyrethroids occurs, about counterfeit drugs undermining curative treatment and increasing the risk of resistance popping up, about the difficulties of vivax elimination, about the problems with zoonotic malaria, about...the list is endless I'm afraid...
Water, Engineers and Malaria..............
We are all sure in - our hearts - that suppression of malaria in Africa will improve the rate of economic development. Recently this hope was formalized in an African Futures Brief by Moyer and Emde at the Pardee Center of the University of Denver in their Brief #5 published in November. Their projections indicated that driving the malaria prevalence down to zero in Africa by 2025 would by 2050 result in an increase in income of $30 per year per person, compared to the current average for Africa in 2010 of only $1.25.
This contribution was posted as a comment by Dr. Bill Jobin, Director of Blue Nile Associates in response to the meeting report of the WHO Malaria Policy Advisory Committee that was held in September 2012.
It is ironic that a WHO policy meeting in September will ignore the terrible truth outlined by the WHO Director General Margaret Chan in December - that the malaria program is going to crash..... With due respect to Rob Newman and Margaret Chan in Geneva, I would like to suggest 6 steps to save their Global Malaria Program. My suggestions are simple applications of rational approaches to a problem, the same things we would do with any other problem in life. It does not take a Rocket Scientist to figure this out. Simply put, I suggest that they Narrow their Focus, Expand their Base, add 2 more Components to their Strategy, establish a valid Monitoring and Evaluation system, and set Realistic Goals against which they can Measure their Progress ......
The BBC published an article on the myths of mosquito repellers based on ultrasounds following articles on MalariaWorld. Amazingly, in spite of the massive evidence that is there to show that ultrasounds do nothing to repel mosquitoes, the electronics giant LG has started to market an air conditioner in Nigeria that incorporates ultrasound. The company published a news release titled 'LG fights malaria in Nigeria with hi-tech air conditioner'...
Every year in December, the global malaria community eagerly awaits the World Malaria Report published by the World Health Organization. Every year countries around the world report their status of the disease, and year after year over the last decade the World Malaria Report was like a Christmas gift. Our collective efforts were paying off, both mortality and morbidity was on the decline, and scaling up of the tools yielded what we expected: A massive reduction in malaria. But this year’s end is different…
This expert blog was contributed by Dr. Merlin Willcox, Honorary Secretary of the Research Initiative on Traditional Antimalarial Methods (RITAM), in response to the outcome of a poll on MalariaWorld and recent contributions regarding the use of Artemisia tea as a remedy for malaria.
Yesterday, BBC's William Kremer published an excellent article about the myths surrounding ultrasounds as repellents against mosquitoes. We both talked many times about these myths and he researched the matter thoroughly. Nothing but praise for this piece of great journalism. But for us here at MalariaWorld the story isn't over yet, because the Cannes Lions Festival is simply waiting for the media storm to blow over and then move on with business as usual...
And how can we help engineers fight malaria in new African water projects?.....
The guest blog below was provided by Dr. Pierre Lutgen.
The guest blog below was contributed by Prof. Matt Thomas, of Penn State University. Read more about Professor Thomas here.
It is said that predictions are very difficult – especially when they concern the future. No doubt Scott O’neil and his Eliminate Dengue team never would have expected to be where they are now 10 years ago. In contrast, those who dreamt of releasing malaria-refractory transgenic mosquitoes two decades ago in the Tucson desert would have been surprised too.
This week I was contacted by Dr. Dana Dalrymple with a very unusual offer. He wishes to provide all MalariaWorld subscribers free access to his book 'Artemisia annua, Artemisinin, ACTs & Malaria Control in Africa' published just seven months ago. This is truly remarkable and we highly appreciate this gesture!
In July I was approached by a Dutch radio station that brought a most interesting YouTube video to my attention. It features an award winning idea by Go Outside magazine (based in Brazil), this being the 'Repellent radio'. It was created by the Sao Paulo-based advertising agency Talent, and it won the Radio Grand Prix award 2012 at the Cannes Lions International Festival of Creativity. Take a look...
The article below was published in Index on Censorship on 30 August 2012. Click here for the online version.
For most of us, it’s entirely logical that medical practitioners should be familiar with the latest scientific knowledge and evidence-based practices in order to treat ailments. This forms our fundamental basis of trust in medical professionals. If your doctor suggests a CT scan or drug X, you follow that advice on the basis of trust. So how would you feel if your doctor confesses that he lacks the latest scientific information about your condition?
The article below was contributed by journalist Ntaryike Divine Jr. (Douala, Cameroon) as part of the SjCOOP project in collaboration with MalariaWorld.
I am not sure if at all you are familiar with TED, which stands for Technology, Entertainment, and Design, with its motto 'Ideas worth spreading'. I love to watch these talks, they inspire me, provide energy, and are often fun to watch.
Yesterday I watched the talk by Margaret Heffernan with the title 'Dare to disagree'. This is a very interesting talk and it made me think of the world of malaria. First, have a look at what she has to say...
People tend to do quick cost-benefit comparisons of bednets vs metallic screens, and make some large mistakes. Bednets are temporary, protect only against anopheline mosquitoes which bite at night, and are used only about one-third of the time. One of the reasons for their misuse is that they are suffocating to sleep under.
Seldom does so much news appear so suddenly that it grabs me by the ears and says, “You MUST write a blog. Now!” Following are the highlights of recent publications that reflect the maturing potential for genetic control to affect malaria and dengue transmission. If you’re interested in a quick summary of recent news and views, here it is.
Last week I was in Geneva, trying to understand the WHO fight against malaria, when - to my delight - the folks at CERN announced that they had found the Higgs Boson! In fact we were driving out near Geneva Airport, right over the Super Hadron Collider, when they made the announcement. But it made me wonder about WHO. Why was it easier for CERN to find the Boson than for WHO to suppress malaria?
The editorial below was written by Manuel F. LLuberas, MS IDHA, Public Health Entomologist
More than a decade after implementation, the global malaria control strategy has proven woefully inadequate. It has reported expenditures exceeding several billion dollars and relies heavily on passive methods like mosquito nets but has been unable to meet its goals of reducing an annual morbidity rate that continues to hover around half billion and a mortality rate equivalent to six Jumbo jetliners crashing daily. The time has come to get serious about this problem. Malaria vector control programs around the world need to be placed under trained public health entomologists who can implement comprehensive mosquito population suppression methods and deploy truly integrated vector control systems. Continuing in the current path is unacceptable and wastes quickly dwindling, limited resources.
Whenever I teach on the history of malaria, I talk about the different time periods when certain ideas were fashionable and implemented, and then disappeared, and sometimes came back much later.
Take the 'chloroquine era'. Discovered by Bayer scientists in the early 1930s and saved millions of lives around the globe, followed by resistance popping up in SE Asia and Colombia in the late 1950s. Resistance spreading to Africa in the late 1970s, and its use now largely reduced. End of the 'chloroquine era'.