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Tina at the Times anoints DDT, Arata Kochi


WHO malarial chief is dynamo, brings DDT spray back

Conservatives given credit, too. Million lives a year will be saved

Will AIDS elite also claim credit at their trial?

Having written in support of bringing back DDT to save the children of the poor world (Times on malaria: the solution is to deliver expensive drugs), we are gratified to see support today (Oct 5 Thu) in the Times for the new Bush-WHO move to bring back DDT spraying.

The Editorial Observer in the Times today is Tina Rosenberg, a prize winner enlightened on every global issue with the unfortunate exception of HIV?AIDS, writing a remarkable endorsement of the revival of DDT spraying in poor countries (indoors only) to combat malaria:

This is excellent news for the humans in Africa. DDT both repels mosquitoes and kills them. It is the cheapest, longest lasting and most effective insecticide, and it will not threaten the ecosystem. Unlike in the past, DDT will now be sprayed inside houses once or twice a year in minute amounts.

Along the way in The Revival of a Notorious Solution to a Notorious Scourge she makes the following points: more than a million die each year from the dread disease, Arata Kochi (pic), the new WHO malaria chief, is the dynamo at the center of the change, the US recently decided to pay for DDT spraying after years of selfish hostility to it by Western countries on exaggerated environmental grounds, nets haven’t worked because they weren’t free, and cheap medicine doesn’t work anymore because the disease is resistant to it.

Bald eagle eggs weighed more than babies

The most egregious aspect of the whole saga has been the elitist attitude of the US and Europe, which showed through when Rachel Carson’s “Silent Spring” turned extremism against DDT into pc environmentalism, after which the fact that DDT had proved stunningly effective at wiping out malaria here and round the world didn’t count any more against bald eagle eggs in the political calculation of William Ruckleshaus.

DDT was the most important insecticide in the eradication of malaria in the United States, and in malaria control in southern Europe, Asia and Latin America. With DDT, malaria cases in Sri Lanka, then called Ceylon, dropped from 2.8 million in 1946 to 17 in 1963.

But Rachel Carson’s 1962 book “Silent Spring” documented how DDT, sprayed over crops and over cities, built up in the ecosystem, killing birds and fish. William Ruckleshaus, the first head of the Environmental Protection Agency, banned DDT in 1972 for all but emergencies.

Tina slips in an apology from the aged Ruckleshaus in 2004, which seems as patronizing as ever:

This was the right decision — for the United States. Malaria was no longer an issue, and Washington needed to ensure that it would not be used on crops. But the decision had deadly consequences overseas. “If I were a decision maker in Sri Lanka, where the benefits from use outweigh the risks, I would decide differently,” Mr. Ruckleshaus told me in 2004. “It’s not up to us to balance risks and benefits for other people.”

Yes, except that Africa’s malaria programs are financed by donors and vetted by the world’s health establishment, which is dominated and financed by the United States and Europe, where DDT is also banned. People in rich countries felt it would be perceived as hypocritical to push a product in poor countries that they had banned at home. Even malariologists who knew DDT could be used safely dared not recommend it.

DDT wasn’t pc, so experts and conservatives arguing for it were brushed aside, and a million children a year died. A sad story, with some of the main elements of the HIV?AIDS debacle in it – pc politics trumping reality, experts brushed aside, the right judgement stained by coming from conservatives, illness and death weighing little in the balance.

Interestingly, the Time’s non partisan editorial credit goes to two conservatives in the Senate for the US funding breakthrough:

Conservatives in the Senate, led by Tom Coburn and Sam Brownback, have forced a revolution in Washington’s malaria programs. America now promotes effective malaria drugs, gives away bednets, and has brought back house spraying — including with DDT.

The AIDS pandemic’s angelic side

Ms Rosenberg even credits one more big factor for the renewed interest in the disease – the AIDS pandemic.

The AIDS pandemic has raised interest in third-world disease, and malaria financing has more than doubled in the last three years. African countries are also learning from South Africa, which doesn’t have to depend on donors. Since 2000, South Africa has been successfully beating malaria using the new medicines and house spraying with DDT

So the independence of South Africa from the need to wait upon Western donors allowed it to go ahead and save its children’s lives regardless of Western selfishness and wrong opinion. Well, well. What does that say to President Mbeki about the virtues of maintaining his own counsel in AIDS, one wonders?

Anyhow, AIDS panic has led to increased attention and money for malaria, saving more lives every year, potentially, than have been lost in the West to AIDS so far. So AIDS has in one way been a blessing.

So is AIDS a good thing after all?

The moral quandary for those who disapprove of a paradigm which has sent hundreds of thousands to their sickbeds and needless deaths is this. If AIDS has inadvertently helped to save the lives of a million children a year, is it all worth it in the scheme of things?

Can Anthony Fauci, Robert Gallo, Mark Wainberg, Robin Weiss, John Maddox, David Ho, John Moore and David Baltimore plead for leniency on this basis, when they enter their pleas as defendants in the upcoming Nuremburg Trials II of recalcitrant AIDS officials suggested by Larry Kramer, which when Kramer finally faces up to what is really going on we expect will be more properly be directed against those who have stood in the way of review of the evidently deadly paradigm, now exposed in both the highest level theoretical reviews and in the recent studies and reviews of the mainstream literature as inexplicable and rationally unsustainable in its key premises?

After all, what’s a few hundred thousand dead and a few million mismedicated compared with 44 million dead Africans, mostly babies? Surely the color of their skins cannot weigh in this balance?

Stupidity as a viable defense

But of course, the stalwarts of the HIV?AIDS paradigm guard can always plead stupidity. No one can possibly prove that any of these people had any idea that their favorite paradigm might really be wrong after all, can they? Which of them is demonstrably bright enough for such a charge to stick? Even CalTech president emeritus and Nobel prize winner David Baltimore made such an fool of himself in the Baltimore Affair trying to repress Margot O’Toole that he lost the Presidency of Rockefeller, so even he might have a good chance of copping the same plea in AIDS – except for the fact that he set a precedent for trying to repress the truth, which will be precisely the charge in the new Nuremburg Trial.

Arata Kochi, troublemaker

Of course, stupidity is not a word which is voiced much in genteel high level circles in government or science, however often it is thought.

Frankness on that front is however one of the charms of the new malarial chief at the WHO. Arata Kochi refreshingly admitted calling his new staff at the WHO that very word at times, after the previous chief was kicked out. Talking to the Times last month, Kochi made it pretty clear what he thought of the previous occupant too (W.H.O. Supports Wider Use of DDT vs. Malaria):

Dr. Kochi’s new policies and abrasive style have stirred the small world of malaria experts. Dr. Allan Schapira, a senior member of the W.H.O. malaria team who most recently oversaw its approach to insecticide spraying, resigned last week.

Reached Thursday on his cellphone, Dr. Schapira declined to comment on his reasons, except to say that they were professional. He did not return messages left Friday.

His successor, Pierre Guillet, a medical entomologist, said Dr. Schapira quit because he was uncomfortable with the new approach on insecticide spraying.

There are fierce debates among experts over when it is best to use indoor spraying or mosquito nets impregnated with insecticides that last up to five years, though most agree that both spraying and nets are important tools.

Dr. Kochi said in an interview that half the professional staff of the W.H.O.’s malaria program has left “one way or the other” since he took over in October. He described Dr. Schapira as the “main brain” behind the past approach.

“He was professionally insulted by me,” Dr. Kochi said.

In answer to a question, Dr. Kochi acknowledged that he had indeed told members of the staff in meetings that they were stupid. “They are very inward looking, and they do not communicate outside the malaria field,” he said. “It’s ridiculous.”

The Times’ Celia Dugger wrote that amusing report, which made Kochi sound a little over the top. But whatever works, works. He has helped to transform WHO and US policy and saved the lives of millions, it appears. We nominate this man for the post of chief advisor to Bill Gates and Bill Clinton on global disease matters, and for the Secretaryship of the UN when it comes up.

Few people deserve personal credit for saving a million lives a year. Maybe he’ll get the Nobel Peace Prize.

If so, this will encourage troublemakers everywhere, and truth may break out all over, even in HIV?AIDS.

W.H.O. Supports Wider Use of DDT vs. Malaria

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The New York Times

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September 16, 2006

W.H.O. Supports Wider Use of DDT vs. Malaria

By CELIA W. DUGGER

WASHINGTON, Sept. 15 — The World Health Organization on Friday forcefully endorsed wider use of the insecticide DDT across Africa to exterminate and repel the mosquitoes that cause malaria. The disease kills more than a million people a year, 800,000 of them young children in Africa.

Dr. Arata Kochi, who leads the group’s global malaria program, unequivocally declared at a news conference on Friday that DDT was the most effective insecticide against malaria and that it posed no health risk when sprayed in small amounts on the inner walls of people’s homes. Expanding its use is essential to reviving the flagging international campaign to control the disease, he said.

Dr. Kochi has powerful allies on DDT and, more broadly, on using insecticide sprays, in Congress and the Bush administration — an odd bedfellows coalition for an agency of the United Nations, which has often been at odds with the White House.

At the news conference, Adm. R. Timothy Ziemer, who leads President Bush’s $1.2 billion malaria undertaking, stood at Dr. Kochi’s side and described spraying with insecticides as a tool “that must be deployed as robustly and strategically as possible.”

The health organization’s news release quoted Senator Tom Coburn, Republican of Oklahoma.

“Finally, with the W.H.O.’s unambiguous leadership on the issue, we can put to rest the junk science and myths that have provided aid and comfort to the real enemy — mosquitoes,” said the senator, a medical doctor.

Dr. Kochi said the most substantive change in the W.H.O.’s guidelines on the use of insecticides would extend the reach of the strategy. Until now, the agency had recommended indoor spraying of insecticides in areas of seasonal or episodic transmission of malaria, but it now also advocates it where continuous, intense transmission of the disease causes the most deaths.

Dr. Kochi’s new policies and abrasive style have stirred the small world of malaria experts. Dr. Allan Schapira, a senior member of the W.H.O. malaria team who most recently oversaw its approach to insecticide spraying, resigned last week.

Reached Thursday on his cellphone, Dr. Schapira declined to comment on his reasons, except to say that they were professional. He did not return messages left Friday.

His successor, Pierre Guillet, a medical entomologist, said Dr. Schapira quit because he was uncomfortable with the new approach on insecticide spraying.

There are fierce debates among experts over when it is best to use indoor spraying or mosquito nets impregnated with insecticides that last up to five years, though most agree that both spraying and nets are important tools.

Dr. Kochi said in an interview that half the professional staff of the W.H.O.’s malaria program has left “one way or the other” since he took over in October. He described Dr. Schapira as the “main brain” behind the past approach.

“He was professionally insulted by me,” Dr. Kochi said.

In answer to a question, Dr. Kochi acknowledged that he had indeed told members of the staff in meetings that they were stupid. “They are very inward looking, and they do not communicate outside the malaria field,” he said. “It’s ridiculous.”

Dr. Kochi earlier headed the W.H.O.’s tuberculosis campaign until he was forced out after his blunt manner alienated important partner organizations.

He has brought the same in-your-face approach to malaria. In January, he demanded that 18 drug companies — all named — stop selling some forms of a new malaria drug he believed could speed up drug resistance. If they did not comply, he threatened to try to disrupt sales of their other medicines.

In April, he accused the Global Fund to Fight AIDS, Tuberculosis and Malaria, through which rich countries finance health campaigns, of ignoring W.H.O. rules that forbid treating malaria with herbal-based therapy alone — a charge that Dr. Bernard Nahlen, a senior adviser at the Global Fund, called “outlandish” on Friday.

There are now 17 African countries using at least some indoor spraying of insecticides to combat malaria. Only 10 of them use DDT — Eritrea, Madagascar, Ethiopia, Swaziland, South Africa, Mauritius, Mozambique, Zimbabwe, Namibia and Zambia — the W.H.O. said. Too many countries in Africa have shied away from DDT, Dr. Kochi said, because of the nasty environmental reputation it earned in an earlier era when it was widely sprayed on crops — dangers that do not apply when spraying small amounts indoors.

DDT has carried a special stigma since the publication in 1962 of Rachel Carson’s “Silent Spring,” which helped set off the environmental movement in America by documenting how mass spraying of DDT entered the food chain, causing cancer and genetic damage and threatening to wipe out some bird species, including bald eagles.

The nonprofit group, Beyond Pesticides, distributed news releases on Friday opposing the W.H.O.’s new policy, saying a dependence on pesticides like DDT “causes greater long-tem problems than those that are being addressed in the short-term.”

Dr. Kochi said some African countries had also been reluctant to use DDT because of fears that European countries would block food exports if crops were tainted by even minuscule amounts of DDT. In an interview, he called on leaders of the European Union to publicly encourage African countries to use DDT against malaria. Uganda, for one, has not used it because of what Dr. Kochi called “a bureaucratic standoff between the ministry of health and the ministry that oversees trade.”

A spokesman for the European Union, Alain Bloedt, said Friday that it was too late in the afternoon to get a reply.

Dr. Kochi said he himself did not worry about whether he would lose his job if he took on too many influential players. Success will require many difficult changes, he said. “I don’t want to fail.”

The Revival of a Notorious Solution to a Notorious Scourge

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The New York Times

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October 5, 2006

Editorial Observer

The Revival of a Notorious Solution to a Notorious Scourge

By TINA ROSENBERG

Of all the wars in Africa, the most deadly is between humans and mosquitoes. More than a million Africans die of malaria every year, the vast majority of them small children. Malaria shrinks the economies of countries where it is endemic by 20 percent over 15 years. One reason the mosquitoes are winning is that the world had essentially discarded its single most effective weapon, DDT.

But Washington recently resumed financing the use of DDT overseas, and the dynamic new malaria chief of the World Health Organization, Arata Kochi, has said that the W.H.O., too, endorses widespread indoor house spraying with DDT.

This is excellent news for the humans in Africa. DDT both repels mosquitoes and kills them. It is the cheapest, longest lasting and most effective insecticide, and it will not threaten the ecosystem. Unlike in the past, DDT will now be sprayed inside houses once or twice a year in minute amounts.

DDT was the most important insecticide in the eradication of malaria in the United States, and in malaria control in southern Europe, Asia and Latin America. With DDT, malaria cases in Sri Lanka, then called Ceylon, dropped from 2.8 million in 1946 to 17 in 1963.

But Rachel Carson’s 1962 book “Silent Spring” documented how DDT, sprayed over crops and over cities, built up in the ecosystem, killing birds and fish. William Ruckleshaus, the first head of the Environmental Protection Agency, banned DDT in 1972 for all but emergencies.

This was the right decision — for the United States. Malaria was no longer an issue, and Washington needed to ensure that it would not be used on crops. But the decision had deadly consequences overseas. “If I were a decision maker in Sri Lanka, where the benefits from use outweigh the risks, I would decide differently,” Mr. Ruckleshaus told me in 2004. “It’s not up to us to balance risks and benefits for other people.”

Yes, except that Africa’s malaria programs are financed by donors and vetted by the world’s health establishment, which is dominated and financed by the United States and Europe, where DDT is also banned. People in rich countries felt it would be perceived as hypocritical to push a product in poor countries that they had banned at home. Even malariologists who knew DDT could be used safely dared not recommend it.

The United States, which used DDT irresponsibly to wipe out malaria, ended up blocking much poorer and sicker countries from using it responsibly. Under American pressure, several Latin American countries that had controlled malaria stopped using DDT — and in most of them, malaria cases soared.

The other reason for DDT’s demise was donor tightfistedness. DDT has to be sprayed inside houses, an activity that needs to be carried out by governments. In most African countries, this means donors must pay. They balked, and insecticide-treated bednets became bureaucrats’ preferred solution. Donors liked the program because it was cheap and sustainable, as consumers would buy the nets — often at subsidized prices. But it has failed. The nets work — but even at $5, few can buy them. The most recent data show that only 3 percent of African children sleep under treated nets.

The eradication of malaria in rich countries turned out to be the worst thing that happened for people with malaria in poor countries. Malaria lost its constituency, and the money dried up. Throughout Africa, until recently, countries were using chloroquine to cure malaria, a medicine that cost pennies, and so could be bought by rural families. But mosquitoes had become resistant to it. And donors were unwilling to spend the money for effective medicines.

But this is changing. The AIDS pandemic has raised interest in third-world disease, and malaria financing has more than doubled in the last three years. African countries are also learning from South Africa, which doesn’t have to depend on donors. Since 2000, South Africa has been successfully beating malaria using the new medicines and house spraying with DDT.

Conservatives in the Senate, led by Tom Coburn and Sam Brownback, have forced a revolution in Washington’s malaria programs. America now promotes effective malaria drugs, gives away bednets, and has brought back house spraying — including with DDT.

Malaria soared because the forces allied against it quit the battlefield. Now the humans are back.

3 Responses to “Tina at the Times anoints DDT, Arata Kochi”

  1. Truthseeker Says:

    Communication from Pharma Bawd, prevented from Commenting directly by unknown software glitch (Firefox works best on this software, possibly other browsers may not, according to Powerblogs Support).
    =====================================================

    Fri Oct 6

    Jeeze TS,

    You really do fall for a good conspiracy story don’t you?

    DDT has never been banned for controlling malaria. They stopped using indoor spraying in Africa because it was too difficult to acheive adequate, over 80% of households, coverage and because of emerging resistance in mosquitoes to DDT.

    Consider the case of Sri Lanka discussed here: DDT

    Tim Lambert keeps on top of this pretty well. I’d suggest you do some reading there before you go handing out any Nobel Peace Prizes.

    Deltoid

    Regards,

    PhB

    PS: I don’t seem to be able to comment at newaidsreview.com. Tried the password reset, didn’t work. And by the way, I didn’t delete your comment at momentofscience, it’s still there.

  2. Truthseeker Says:

    Thanks Pharma Bawd, though we weren’t talking about any conspiracy, just a policy attitude on the part of the higher echelons here in the US who we believe until recently had no great interest in one million Africans, mostly babies, dying from malaria annually, and dispensed funding according to PC environmental guidelines inappropriate to recipient countries. The fact that there may not have been an official ban would make no difference to the outcome. DDT was effectively knocked out, and not just because it inevitably provokes resistance on the part of the mosquito larvae or whatever.

    Nor by the way are we talking about any conspiracy in HIV∫AIDS, but rather a public policy of repressing review and media coverage of review of the paradigm, which according to the literature would all be convincingly negative.

    The blog entry you refer to carried by Tim Lambert and Deltoid (if we have skimmed it correctly) makes the point that mounting a spraying campaign in darkest Africa is rather demanding logistically and that mosquito nets which are portable possessions for the afflicted would be more effective.

    Maybe. Maybe both approaches should be adopted according to whether one or the other is best in a particular region. Whatever the outcome, the fact remains that funding for malaria is abysmal as long as one million are dying from it annually.

  3. Martel Says:

    Thank goodness that clearer heads have prevailed for a change in the WHO and the US Congress. As TS correctly notes, it has been the attitudes of misguided, self-righteous Westerners (who think they know all) that have deprived so many millions in tropical countries of life itself. Who cares if it was a ban or simply a refusal to fund and deliver the needed pesticide? The result was simple: most people who needed an effective pesticide couldn’t get one.

    I might remind NAR, though, on the occasion of another admiring mention of President Clinton, that said personage made precious little movement towards relieving suffering in Africa and elsewhere by making DDT available when he was in office. In fact, if I’m not mistaken, it is Clinton’s own former VP who has distinguished himself as one of the biggest purveyors of junk-science environmentalism in our time. Not that he’s wrong on everything. But when a guy claims that cigarette smoking is a cause of global warming…

    If DDT actually ends up in widespread use, saving lives again as it should have been permitted to do for these past several decades, I hope that some people will notice that those politicians who have pushed for this–putting actual science over do-gooder pc emotion and also placing some value on non-Western human life–are some of the same politicians who are accused every day and from all scientific quarters of politicizing science and defunding research.

    It wasn’t Clinton who helped bring DDT to the people who need it…it was Republicans in Congress. And if anyone is able to look critically at the HIV-AIDS funding machine, it won’t be Clinton’s political allies (who call for NIH budget-doubling every five years with or without results or even any real science). It will be those who do not swallow everything a “scientist” tells them on pure faith…politicians who think for themselves rather than triangulating, taking polls, and trying to be all things to all people.

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