SUMMARY OF RECENT AFRICAN MALARIA DIALOGUE at BENTLEY UNIVERSITY on 21 MAY 2013
Fifteen of us attended from Bentley, BU, Yale, Harvard and MIT, and from Ghana, Sudan, Nigeria, Canada and US. Derek Willis from Columbia U also joined us via Skype.
MALARIA IN ETHIOPIA
Jim McCann reviewed the complexity of malaria and agricultural development in Ethiopia, and noted the slow pace that knowledge about malaria has followed in Ethiopia, especially regarding the ID of the An. gambiae complex (1962) and the first recognition by WHO that there were two species in Ethiopia (1976).
RESISTANCE TO PYRETHROIDS AND BENDIOCARB
Mike Reddy reported on evidence of resistance of Anophelines to pyrethroids, DDT and bendiocarb in Equatorial Guinea. The rapid development of resistance to bendiocarb was surprising, perhaps because of previous experience the mosquitoes had through agriculture. He cited the recent experience in Guinea and in Tanzania as an impelling reason to seek alternative methods for mosquito control.
HUMIDITY AND ANOPHELINES
Teresa Yamana explained the recent development of their HYDREMATS computer simulation of anopheline population dynamics as affected by relative humidity, using data from Niger in a habitat which had no surface water, and in one which was at the bottom of a streambed. Addition of humidity to temperature effects gave much better correlation with observations, but there are still gaps, perhaps due to nutrients in runoff.
GHD ONLINE DISCUSSION OF CLASSICAL AND DURABLE CONTROL METHODS
Bill Jobin reviewed the recent experience with the Global Health Delivery online discussion about durable and classical malaria control methods, noting the passionate support for bednets by the Peace Corps volunteer who was distributing bednets, and also the widespread enthusiasm for bednets among charitable groups who continue to donate large numbers of bednets for use in Africa. The passion for bednets is a new component in the fight against malaria, and should not be dismissed lightly, despite their drawbacks.
FOCUS ON CLASSICAL CONTROL METHODS
Bill also raised the larger question about where we should focus the energy of our African Malaria Dialogues, in light of the entrenched commitment to the use of insecticides, bednets and drugs by PMI, who also actively ignore the classical methods of drainage, screens and environmental management. The WHO and PMI strategies are linked with highly developed Public Relations approaches to fund-raising, which so far have been successful with the US Congress and general public, despite serious technical inconsistencies, and defiance of history.
Although it is very unsatisfying, there seems little alternative to letting the current WHO and PMI strategies run their course. Because of the difficulties and frustrations we have experienced in trying to get PMI and WHO to adopt broader strategies, our energies would probably be better focused on refining and promoting the classical methods, especially in support of the work at MIT by the eltahir group, who are exploring the adaptation of TVA strategies to reservoirs in Ethiopia. Noriko Endo is doing her doctoral thesis on this subject, in Koka Reservoir.
Of course we should continue to speak out with constructive criticism of PMI, encouraging them to broaden their approach.