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FIFTH LAW - Before you attack malaria in Africa....

June 10, 2010 - 12:48 -- William Jobin

THE FIFTH LAW FOR ATTACKING MALARIA IN AFRICA

Before you attack malaria in Africa, look at what the mosquitoes did in Garki, and what the dictator did along the Blue Nile River.

GARKI
An intensive well-documented attack on malaria was made in Garki, Nigeria by WHO experts with three effective methods, house spraying, drugs, and larviciding. After three years of success, they stopped to see what would happen. To their dismay, the malaria parasite prevalences jumped right back up to where they were before the attack started.

They did some calculations which showed why they failed. The person-biting rate before control was 42 bites per night in the project population. Their computer modeling showed that 0.1 person-bites per night was all that was needed to maintain transmission!

That meant that if their attack methods were 90% effective, they would still have 4.2 bites. And if it were 99% effective, they would still have 0.42 bites! Four times the amount necessary to maintain transmission. What control method can be 99% effective? So the lesson was that you have to maintain control continuously.

BLUE NILE
This has to do with perfidy of dictators. The Blue Nile Health Project had a 10 year plan with a solid exit strategy, for attacking malaria in the 2 million people living in the irrigated areas along the river. The attack was successful for 9 years, but in the 10th year a military dictator took over, and walked away with the hard currency that was to be used for the drainage system - the exit strategy. So the worst malaria epidemic in history hit the area, as described in Blue Nile Monograph One. That lesson was: we should first attack malaria in stable countries with democratic governments.

THE SUM OF IT ALL
We have to be in this for the long haul, and don't mess with dictators. Mussolini learned that in World War Two with Adolf Hitler.

But we CAN do it, as long as we pay attention to the FIVE LAWS.

Bill

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