September 20, 2005

GET OUT YOUR BED NETS

by Paul Driessen

Gulf Coast residents are slowly recovering from Katrina’s winds, floods, near anarchy, and incompetent local, state and federal disaster responses. Now they face yet another potential peril.

Millions of acres of brackish, polluted water could become fertile breeding grounds for billions of mosquitoes. Some fear the hordes could infect survivors with West Nile virus and encephalitis – or even malaria and yellow fever. They point out that the United States had 2,500 serious cases and 100 deaths from West Nile in 2004, and that yellow fever killed 9,000 people in New Orleans and Memphis in the summer of 1878.

However, a comparable disaster in Katrina’s wake is unlikely, say experts. US health officials have already launched C-130 aircraft capable of spraying 60,000 acres per day with Dibrom, which is safe for humans and the environment but extremely effective for mosquito control.

In 1999 three C-130s sprayed for 22 days in the wake of Hurricane Floyd. They killed 99% of all mosquitoes across 1.7 million acres in Virginia and North Carolina. This year’s program will be even more extensive. Hurricane survivors can be thankful that these officials are not controlled by the U.S. Agency for International Development (AID), World Health Organization (WHO) or World Bank (WB). Those agencies would likely tell them, Get out your bed nets and Chloroquine.

All three organizations decry the horrendous disease and death toll that malaria inflicts on African and other developing countries. Indeed, nearly 450 MILLION Africans get malaria every year – more people than in the US, Canada and Mexico combined. Up to 2 million die each year – the population of Houston, Texas. Half the victims are children.

In Kenya, malaria claims 34,000 children a year; in Uganda, up to 50,000; Ethiopia: 75,000. In the Democratic Republic of Congo, it kills 225,000 children annually!

The USAID, WHO and WB all give lip service to insecticides. But they don’t support, promote or fund the use of DDT or other insecticides, except in rare instances. Instead, they emphasize insecticide-treated nets (ITNs) and new anti-malaria drugs. This supposedly underscores their “renewed assault on malaria” and a strategy that “has moved from words to action.”

It’s empty rhetoric.

Last year, USAID spent $80 million on malaria. But 85% went to consultants and conferences, 15% helped promote bed nets, and not one dime actually bought nets, drugs or insecticides, notes Roger Bate of Africa Fighting Malaria. This year, its expanded budget emphasizes producing 55 million pediatric doses of new Artemisia-based (ACT) drugs by 2006. But with 500 million people getting malaria every year worldwide, this is woefully inadequate.

The Bank recently gave the Congo $30 million to get “at least two” ITNs in each household, saying this “could slash child deaths by as much as one-fifth.” Two nets per household is hardly enough, especially when the entire family could be protected by programs that spray walls and eaves with tiny amounts of DDT just once or twice a year, to keep 90% of mosquitoes from even entering the home, killing any that land, and irritating the rest so they don’t bite. And a 20% reduction is unconscionably low, when DDT programs get four times that.

South Africa used household DDT spraying to slash malaria rates by 80% in 18 months. It was then able to use Artemisia drugs to treat a much smaller number of patients who still got sick – and cut malaria by 93% in three years. Mozambique, Zambia and other countries have likewise achieved success this way.

But the EU tells Uganda its agricultural produce might be banned if it uses DDT, and WHO Director Lee Jong-Wook still calls nets and drugs “proven strategies” – even though malaria rates have gone up some 10% since WHO’s Roll Back Malaria campaign was launched in 1998. Moreover, with ACT drugs in short supply, many of its anti-malaria kits still contain drugs that are no longer effective against this killer disease.

USAID claims spraying won’t work because there aren’t enough trained sprayers, inadequate infrastructures prevent them from getting to villages, and “a high percentage of homes” must be treated if spraying is to be effective. Nonsense.

Spraying isn’t rocket science. Training people and getting the job done once or twice a year is easier than getting bed nets and drugs to every sick parent and child. And spraying protects every person in every house that’s treated.

Bed nets protect only those who use them, work only if they’re not torn, and are of little use when people are still working or doing homework. Further, many people simply refuse to use them.

Sleeping under a bed net is nearly impossible during torrid African nights, says Nigerian journalist Omololu Falobi. Use the net anyway, and you get heat rashes all over your face and body. Most villages have no electricity to power fans or air conditioners, and in cities like Lagos power outages are frequent. “Even if you have a generator,” he says, “you don’t want to put it on throughout the night, for fear of carbon monoxide poisoning.”

Kenyan Pauline Mwinzi’s father nevertheless insisted that his family use bed nets. But she still came down with cerebral malaria and nearly died, and her father succumbed to the disease when she was six. Today, she says, “as mother of several kids myself, I refuse to use bed nets. There’s got to be a better way of dealing with mosquitoes.”

There is. But anti-pesticide activists and bureaucrats – safe in their air-conditioned, malaria-free offices – refuse to consider them. Instead, they worry about trivial risks from pesticides – and ignore the devastation and death caused by diseases that pesticides could prevent.

Questions about which weapons to use – and where and when to use them – are life-or-death decisions. They should be made by health ministers in malaria-endemic countries. Those ministers must have the right to make decisions based on science, medicine and practicality – without fear of threats or reprisals if their decisions include DDT and other pesticides.

And they need progress NOW – not twenty or fifty years from now, when a vaccine has finally been developed, sufficient ACT drugs are available, water sanitation improves, and modern homes and hospitals (with electricity, window screens and running water) finally exist throughout the Third World. Too many will die in the meantime.

America would never tell its hurricane survivors they have to rely on bed nets and inadequate supplies of anti-malaria drugs. We have no right to tell Africans that, either. Continuing to do so violates their most basic human rights – to health, prosperity and life itself.

Paul Driessen is senior policy advisor for the Congress of Racial Equality and Committee For A Constructive Tomorrow, and author of Eco-Imperialism: Green power ? Black death (www.Eco-Imperialism.com).

© 2005 Paul K. Driessen