Who is failing Africa on malaria?
Malaria is a big problem for Africa. It kills millions of people each year and weakens countless others. It imparts on the ability of families to support themselves and damages Africa's economic progress. It seems right, then, that the World Health Organisation (WHO) should be taking the problem seriously. Back in 1998, it kicked off its ambitious 'Poll Back Malaria' programme, with the lofty goal of halving malaria incidence by 2010, it hoped to achieve this by a combination of judicious drug use and the distribution of insecticide treated bed-nets.
Millions of dollars and over half a decade later, it is clear that malaria is stubbornly refusing to be rolled back. 'In fact, it is positively on the march. Some studies Estimate that malaria has actually increased by some 12 per cent since the launch of Roll Back Malaria and an external evaluation set up by the WHO says "most of those involved" believe "malaria has got somewhat worse during this period."
The Lancet's latest editorial is harsher: "in the seven years since its inception, malaria rates have increased and the organisation has accumulated an expansive list of missed opportunities and dismal failures," says the authoritative medical journal.
Even more worryingly, scientists from the University of Oxford recently claimed that improved measuring shows that more than half a billion people -- nearly double previous estimates -- were infected by the deadliest form of malaria in 2002.
Clearly, something is going seriously wrong in the WHO high command. because it is failing spectacularly to get a grip an malaria. But the real tragedy is that malaria could be far less of a problem today if the WHO had adopted a different strategy from the start.
Central to any malaria control plan should be spraying the inside walls of residential buildings with the insecticide DDT. This helps prevent mosquitoes from entering dwellings and it repels or kills those insects, that do make it inside, Because it minimises the chances of humans being bitten, it effectively prevents the transmission or the malarial parasite, making it an excellent tool for preventing the spread of the disease. In the years following the Second world War, the WHO put DDT at the centre of its malaria eradication plan, saving an estimated So to 100 million lives through, prevention alone.
Over the last few decades, however, the WHO has deliberately discouraged the use of DDT in member states, egged or? by environmentalists who overstate the negative impact of DDT on human and animal health, Today, Western aid agencies make virtually no money available for indoor spraying programmes, and the WHO provides little financial assistance to those governments that wish to go down this route.
Worse, there is the threat of sanctions against those that do use DDT: when Uganda determined this April to start using DDT, The chief of the EU mission in Uganda, Sigurd, Illing, said there could be dire consequences for the country's exports to Europe -- which account for more than 30 percent of Uganda's total exports -- if DDT was detected in export commodities such as horticultural produce.
This is a betrayal of those Africans who are suffering and dying from malaria. There are plenty of instance of countries that have tamed malaria through indoor insecticide spraying. India, for example, started a nationwide programme of indoor DDT spraying in the 1950s, which it has continued to this day. Despite the fact that its population has mushroomed to over a billion in this period, deaths from malaria have decreased to a few thousand each year.
In Africa, Namibia, Botswana, Mozambique and South Africa have replicated this success by carefully using DDT and other pesticides in controlled, alternating, programmes. Uganda is determined to start using it, health minister Dr. Alex Kamugisha said in April 200S. By contrast, those countries that have phased out the use of insecticides have witnessed a resurgence of malaria.
So if the WHO is not spraying houses and killing mosquitoes, what is it doing to fight malaria? The answer, it seems, is nurturing its fixation on insecticide treated bed-nets. The WHO has bet its shirt on these bed-nets, arguing that they provide the most effective means of vector control. It funds bed-nets almost to the exclusion of other preventative measures.
Whilst it is true that bed-nets have a role in preventing transmission of malaria, they are far from perfect, particularly in the poorest areas where they are most needed. Mosquitoes tend to be most active in the hottest parts of the year, and few people relish the thought of covering themselves in a net during these hot nights. People can also misuse them.