Everything sooner or later is linked to climate change. It is not an unexpected tactic when the goal is to raise public awareness or alarm — depending on you position.
The malaria climate connection however raises important ethical questions. Malaria is too often framed as a “climate disease” by NGOs, regulatory agencies, media and some scientists. (See here and here.) This carefully constructed message implies the control of malaria requires that we control carbon dioxide emissions. This message is untrue, unethical and immoral.
Malaria is a preventable and treatable disease that we allow, by our inaction, to kill one million people and infect another 250 million to 350 million each year. (See this report from the World Health Organization.) These are not modeled deaths. Nor are they possible deaths related to some future carbon scenario. These dead had names, were loved, and are mourned. And nearly 80% of these dead are African children under the age of five.
We could eradicate malaria worldwide in less than two decades and drastically cut malaria’s death toll in less than one. But first malaria must stop being used as a weapon by ideological combatants on all sides of the climate change wars, as well as the much older pesticide wars.
Malaria is not a tropical disease. Ague and marsh fever, malaria’s older names, ravaged England in the 16th to 19th centuries. North America was not spared the plight of malaria either. In fact, 30% of Al Gore’s home state of Tennessee was infected by the disease in 1933.
Greenpeace and others have implied the mosquito vector (Anopheles) for malaria requires a mean winter temperature above 60 degrees F to survive. In reality, 10 million Russians were reported in a New York Times dispatch to be debilitated by the disease in 1920.
Also consider that in the late 18th century, 5% of Finland’s population was infected by malaria, according to research by Lena Huldén at the University of Helsinki. Moreover, the coldest temperatures ever recorded in the northern hemisphere were in Yukutia Russia: -76.2C in 1926 and -67.7C in 1933. At that time, according to Huldén, malaria infected 4% of the population.
In reality, the Anopholes mosquito which carries malaria lives on every continent with the exception of Antarctica and its range extends to the polar regions, according to the CDC.
Malaria was not the only mosquito born illness feared by U.S. citizens. Yellow Fever, the other “tropical disease”, killed 5,000 of Philadelphia’s 45,000 inhabitants in 1793 and caused 17,000 survivors to evacuate the city.
I do not care what side journalists take with respect to climate change. I simply request that malaria be left out of it. I ask journalists to question and challenge EPA, IPCC, and any scientist who attempts to frame malaria as a climate disease. The response to any malaria infection model for some future warmer world is simple. Malaria should not exist in any future — warm or cold!
Malaria was not eliminated in the United States until 1949. Through the efforts of the Centers for Disease Control (ostensibly formed to combat malaria), breeding areas were drained, and the interiors of 4.5 million homes, neighborhoods and prime mosquito breeding grounds were sprayed with DDT. So successful was CDC’s malaria eradication effort that the dread of this disease was purged from our collective memories and DDT repackaged as man’s most evil chemical in less than two decades.
There are potential risks with DDT just as there are with every survival dilemma. DDT is no longer a magic bullet for malaria eradication (that time has passed). But it remains an essential tool within a larger toolbox. However the ability to use DDT where needed is often blocked or impeded by groups that oppose the use of DDT for any purpose. For example, that has been the case in Mozambique.
Peer reviewed science is used to show DDT may effect in-utero thyroid levels, or it may be associated with decreased attention levels in children or some statistical association with an increased possibility of developmental problems. But here’s what the World Health Organization found: “While a wide range of effects were reported in laboratory animals, epidemiological data did not support these ﬁndings in humans.”
Despite the failure to show “human findings” one may assume the precautionary principle should apply. However let’s reframe the risk. One out of four survivors of cerebral malaria are inflicted with long-term cognitive impairment. These are not theoretical or laboratory risks; these risks have names. Children don’t die theoretical malarial deaths.
There is no replacement for DDT in areas where mosquitoes have developed resistance to non-DDT alternatives. (It is correct that in some locations mosquitoes have acquired DDT resistance and not to other pesticides and why a toolbox approach is so important. There are also additional complicating issues that are beyond this post.) Bottom line: Western fears or bias should not trump Third World reality.
The World Health Organization’s 2007 Report, “The Use of DDT in Malaria Vector Control,” highlighted the dangers of eliminating DDT from its tool box: “For instance, in South Africa the switch from DDT to pyrethroids in 1997 soon resulted in the reappearance of Anopheles funestus, a major malaria vector, eliminated from the country for decades and found to be resistant to pyrethroids.” Severe malaria outbreaks followed, resulting in the reintroduction of DDT in 2000. The report further stated that “DDT is still needed today because investment to develop alternatives over the past 30 years has been grossly inadequate.”
The WHO report concluded:
“DDT is still needed and used for disease vector control simply because there is no alternative of both equivalent efﬁcacy and operational feasibility, especially for high-transmission areas.”
If NGOs wish to ban the production and use of DDT then I challenge them to first buy mosquito nets for all the potential victims of this policy, insure sufficient monies are allocated to develop a replacement for DDT, and allow DDT to save lives until such time as a replacement is found. Basically, eradicate malaria and we can all agree no more DDT. Seems fair.
Total global spending over the last decade for malaria research, treatment and control has averaged little more than several hundred million dollars per year. (Recent funding initiatives outlined in the above WHO report give hope that this may be slowly changing)
One of the malaria control tools, insecticide treated nets (ITNs), has demonstrated the ability to reduce child mortality from all causes by 17%. For every 1,000 sleeping nets distributed and used, 6 children are given the gift of life. ITNs decrease malaria infection by 50%, reduce problematic low birth rate by 23%, and produce a 33% reduction in miscarriage, among other benefits. The cost?: $1.05 per person per year, according to the WHO.
Please promote “interim solutions,” such as ITNs, that can alleviate human suffering between now and some more perfect future.
Joseph Stalin would say malaria’s million dead each year are a statistic. I ask journalists to make it a tragedy.
Patrick Moffitt built a full service environmental company (CFM Inc) that provided engineering, laboratory and impact studies, and the contract operation of water and wastewater facilities. He later formed a joint venture named U.S. Water that was responsible for privatized North American water, wastewater and remediation projects. Since retirement, he has developed new fishing methods that reduce bycatch, including sea birds and sea turtles. “I take no money from any organization or group and have no clients,” he says. “I’m simply a person concerned that serious environmental issues have fallen through the cracks.