Living in Europe, malaria and DDT are a distant worry. People often fail to realise how deadly the disease is and that pesticides are used as one of the most effective tools for destroying the carrier of malaria – the mosquito.

It takes one bite

Malaria was only identified as a cause of death only at the end of the 18th century. People died suddenly and very painfully not knowing what was it that was killing them. It appeared as if they were dying from fever and the only association made at the time was the connection to the “bad air” (MAL – bad, ARIA –air) as the disease hit mainly in hot and humid parts of the world.

In 1897 the link between the mosquito, the parasite that it carries, and the cycle of bite – infection was made. When a person is bitten by a mosquito he is infected with the parasite Plasmodium that finds home in the liver where it multiplies. If not treated it infects red blood cells and prohibits the transmission of blood to vital organs, causing a very painful death. All it takes is just that one bite; once infected, the parasite stays in your body forever.

No cure, only prevention

Understanding the behaviour of malaria paved the way for medical and chemical innovation and modern ways of prevention. Regrettably a cure is yet to be discovered. The most effective management of the disease is prevention; attention is focused on preventing mosquitoes the opportunity to bite humans.

The World Health Organization (WHO) recommends two main approaches for reducing the level of malaria transmission. They are called the vector control measures.

The first is the long lasting insecticide treated bed nets (LLINs) that create a protective barrier against mosquitoes. They play an important role, particularly when you are asleep as the mosquitoes- like burglars – work best at night. How does it work? You hang the net above your bed, tuck it under the mattress so there will be no way in for the mosquito to enter and have a good night sleep. Your work is done. The net is made with holes too small for mosquitoes to pass, but the real magic is an insecticide that coats the material, keeping the mosquitoes away and ensuring the long term effectiveness of the net.

The other suggested way of reducing malaria’s spread is Indoor Residual Spraying. These three letters IRS save the lives of millions. WHO approved 12 insecticides for use in IRS including DDT. Insecticides are sprayed on house walls to prevent settling of the mosquito. The substance repels the insect from a room, irritating it enough to find an alternative location for a feed. However if both of those actions fail and the mosquito is still there flying around like a superman the long-term contact with DDT should result shortly in his death. Once sprayed, DDT remains effective up to 12 months.

Better safe than sorry

The use of DDT is a controversial topic, but what is often forgotten is the fact that IRS involves spraying with very low quantities. To give you an example it’s 2 grams* of the active substance per meter square. That’s how little you need to use to make it 100% effective. The total amount of DDT used for fighting malaria is merely a fraction of what was used once in agriculture sprays.

The indiscriminate spraying of DDT posed unnecessary risk to humans and the environment. However, this mistake of the past should not cost lives today. DDT used in negligible doses saves lives and limits the spread of disease. Continued calls to ban the use of DDT are irresponsible and threaten the health and wellbeing of millions.

DDT causes minimal or close to zero possibility of contaminating the wider environment, because the substance does not escape to the wildlife. Many “green” groups in Africa have recognised that malaria and poverty are far worse than the quantities of DDT in the environment and now they are full supporters of responsible use of the substance for IRS.

Join

There are many ways that one can contribute and help in fighting malaria. You can donate a bed net, you can organise an event, there are tweets you can follow to raise awareness. There are plenty of ways to participate in this important cause. The aim is to eradicate the disease by 2015. Ambitious but not impossible!!!

http://www.malarianomore.org/

http://www.youtube.com/watch?v=pacPN6AW_Yc

http://www.fightingmalaria.org/

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*Correction: on first publication (12:49 CET 21.04.2011) this article incorrectly stated that the active ingredient of DDT is applied at 0.02g/m²

Everyone has heard of Malaria, a disease that is estimated to claim between one and three million lives every year. Young children account for 90% of the deaths, the majority of victims are in sub-Saharan Africa.

Malaria is caused by a tiny single-celled parasite called Plasmodium which is transmitted to humans through the bites of infected mosquitoes. Malaria is not necessarily deadly in every case of infection, but if not treated the disease can quickly become life threatening. There are a number of Malaria medicines available, although in some parts of the world parasites have developed resistance to them (this has been attributed to misuse of malaria drugs), and for the parts of the world most effected by malaria, drugs for treatment are not readily available, or just too expensive.
 

Prevention better than cure

According to the World Health Organisation (WHO) one of the main objectives of malaria control is to significantly reduce the rate and number of cases of both parasite infection and clinical malaria. This is achieved by controlling the malaria-bearing mosquito – basically preventing contact between infected mosquitoes and human beings.

The indoor spraying of insecticide is reported by the WHO to be the most effective means of rapidly reducing mosquito density. A practice known as ‘indoor residual spraying’ can protect a living space for three to six months. The WHO claims that the highly controversial DDT offers a longer term solution, offering up to 12 months of protection – although it’s ongoing effectiveness has been called into question.

Another favoured preventative measure is the use of long-lasting insecticidal nets (mosquito nets). Fine-mesh nets treated with insecticide offer personal or group protection and typically remain effective for three – five years.
 

A closer look at the pesticides

Yes, pesticides – because an insecticide is a type of pesticide. Let’s take a look at those most commonly used in mosquito prevention – permethrin and deltamethrin.

Permethrin is a synthetic chemical and commonly used as both insecticide and insect repellent. It’s effective because it functions as a neurotoxin (it does unpleasant things to insect nerve cells). Permethrin is a favourable deterrent to insects because it is not known to rapidly harm most mammals or birds, and is poorly absorbed by the skin. On the down-side, it is toxic to cats.  Permethrin is an effective agent in the battle against malaria, albeit one perhaps better suited to dog-lovers.

Deltamethrin is also a neurotoxin, and while it is used for insecticidal nets, it is also a widely used household insecticide for dealing with pests including bedbugs, cockroaches, ticks and fleas. Deltamethrin of one of the safest groups of pesticides, with mammalian exposure considered to be safe.

Pesticides save lives

Pesticides save lives, something you won’t read every day, but fact non-the-less. The Red Cross reports growing scientific evidence to demonstrate that combining mosquito net distribution with follow-on support and training at household level increases net usage rates and significantly reduces incidence of malaria.

It’s World Malaria Day on the 25th of April, which means I’m a little early with this post (hey, it’s the weekend… I’ve got plans) but in perfect time to share a few links if you feel like learning more about malaria, World Malaria Day, and how you can help efforts to eradicate a disease that takes a life every 30 seconds.

For your consideration

> World Malaria Day 2010 (coordinating body official site) follow @malariaday2010 on twitter

> World Health Organisation (WHO) hub for malaria

> International Medical Corps (NGO) fact sheet on malaria

> Malaria No More (NGO) follow @MalariaNoMore on twitter

> Office of the United Nations (UN) Special Envoy for Malaria follow @Malaria_Envoy on twitter

This list is not exhaustive, so please feel free to drop links and info in the comments section below.

Just watched an interesting video of Bill Gates presenting at a TED conference in America this month. He is talking about two ongoing societal challenges that he is passionate about. The first is malaria; he talks through the facts and the solutions with some interesting statistics, and the second is on education and what makes a great teacher. Worth a watch.

The cool autumn air in Brussels means that the outdoor cafes are ideal places to sit, read and watch the world go by. This is a very pleasant, civilised and thoroughly European city. As with many European cities, there are little in the way of outward reminders of Belgium’s brutal colonial history. The behaviour of Belgians in the Congo is probably something that many would prefer to forget and to move on; and perhaps they are right. However it is increasingly clear that the many European parliamentarians and Commissioners would, instead of just forgetting Europe’s dalliances in Africa, perpetuate their legacy and inflict actual harm on African economies and people through their draconian rules and regulations.

The amendments to EU Directive 91/414 are the subject of enormous debate and gnashing of teeth. Farmers are, quite rightly, outraged that EU Commissioners and Parliamentarians seem set to restrict the chemicals that they need to produce safe, high quality and low cost food, just as consumers demand. The fact that the EU is prepared to de-list these chemicals in a process that is devoid of any sound, scientific merit means that costs will be incurred without any real benefits to consumers, farmers or the environment.

But malaria scientists and public health experts are also exercised about these regulations because of the implications for disease control and have submitted a letter of petition to the EU. Insecticides for public health make up a small fraction of the total pesticides market. But it is a vital market and these products save millions of lives every year. We need insecticides to battle the mosquitoes, sand flies and other bugs that transmit deadly diseases. Although the EU is only regulating plant protection products in the EU, the public health community worries that this will lead to fewer chemicals for disease control as products are taken off the market altogether. It simply will not be feasibly to produce insecticides for public health alone once the main agricultural uses are banned.

Furthermore, strict MRLs on produce mean that EU’s regulations will be exported to any country wishing to export to the EU. The fact that the EU leads the world with these forms of regulations seems to be celebrated by activists. Pesticide Action Network’s Elliot Cannell is of the opinion that the EU must pass these regulations precisely because the rest of the world will follow. Should this happen, it will be even more difficult, if not impossible, to use these much needed insecticides to control insect-borne diseases. In some countries malaria control using DDT for indoor spraying has ground to a halt simply out of fear that tiny residues of the insecticide on produce would lead to wholesale rejection of product from the EU. If other insecticides, such as pyrethroids, are banned, malaria control could grind to an alarming halt.

The EU’s intention to regulate insecticides based solely on hazard-based assessments and to avoid any sound risk-assessment will make research and development of new products almost impossible. We need new insecticides for disease control. In some cases malaria control programs are using technologies and chemicals that are 60 or 70 years old. Resistance to insecticides is inevitable and as malaria control programs are scaled up, thanks to increased funding, the pressure on the resistant genes will only increase.

In response to my questions about the unintended consequences of the EU regulations to public health programs was dismissed by EU Commission’s Wolfgang Reinert who blithely said that public health pesticides were governed by different EU regulations. This shows a staggering lack of understanding of the market for public health insecticides and a callousness about the fact that insect-borne diseases claim millions of lives every year, inflict great human suffering and impose enormous economic costs. Though of course the proponents of these regulations would probably not want these unpleasant facts to interfere with the notion that they are attempting to make the world a safer, healthier place. They are not. These regulations are not only unscientific, they are anti-science and as such will cost lives and hamper development.

Africa Fighting Malaria is not funded by the insecticides or chemical industry. AFM’s advocacy on the EU insecticides regulations and our participation at events in Brussels and elsewhere has been funded by a grant made by the MCJ Amelior Foundation.