By some estimates around “one out of every two people who have ever lived have died of malaria.” This just might be contributing to the medical community’s interest in malaria.
I don’t know about that… We know how to eradicate malaria—we posess the knowledge, the tools, we’ve successfully done it before. Really, the only thing that needs to happen is for the governments of the SubSaharan Africa to get their shit together. That, unfortunately, is not a medical problem.
According to this review article, titled “Short History of Malaria and Its Eradication in Italy With Short Notes on the Fight Against the Infection in the Mediterranean Basin”,
In Italy at the end of 19th Century, malaria cases amounted to 2 million with 15,000–20,000 deaths per year.
They tried free distribution of quinine, and, as you have mentioned, vector control, which involved draining marshes and spraying DDT and other insecticides:
The campaign for the eradication of malaria from the whole national territory began in 1947 and ended virtually in 1948, with the total interruption of transmission of falciparum malaria. Indoor treatment with DDT (2 g of active ingredient per m2) of houses, stables, shelters, and all other rural structures continued into the mid-1950s and even later in some hyperendemic areas. (Figure 8). The results of the first two years of the year of DDT campaign were communicated by Missiroli in the IV Congress of Tropical Medicine and Malaria in Washington in 1948 under his vice-presidency.32 On that occasion Missiroli received unconditional awards. The continuation of the vector control campaign led to a further lowering of anopheline density and kept the interruption of the transmission of malaria.33 The last endemic focus of P. vivax was reported in the province of Palermo, Sicily, in 1956, followed by sporadic cases in the same province in 1962. The World Health Organization declared Italy free from malaria on November 17, 1970. Since then, almost all reported cases have been imported.
It is curious to note a parallel with a current involvement of philantropists in fight against malaria—back in 1920s and 1930s it was Rockefeller Foundation that funded the creation of Malaria Experimental Station and Institute of Public Health in Italy.
Not only that, the entire southern US up to and including Washington, DC was a malaria zone. Southern Florida was basically not considered fit for human habitation until malaria was eradicated.
At least in Mozambique, it seems that DDT have met resistance both from the West and (parts of) local population.
This report from 2000 from BMJ (British Medical Journal) blames foreign donors, although it does not provide any references for its figures:
It is possible that DDT will be used again in Mozambique. Its use there was stopped several decades ago, because 80% of the country’s health budget came from donor funds, and donors refused to allow the use of DDT.
But environmental concerns are only a part of the whole picture, and, according to Mozambique’s chief of infectious disease control, a smaller one.
DDT is used in indoor residual spraying (IRS) which, along with insecticide treated mosquito nets and Artemisinin Combination Therapies, is one of the three main interventions promoted by World Health Organization.
But due to the fact that it has unaesthetic side effects and cannot be done everywhere, in some countries it became associated with social issues:
For IRS to be effective, at least 80% of homes and barns in an area must be sprayed,[4] and if enough residents refuse spraying, the effectiveness of the whole program can be jeopardized. Many residents resist spraying of DDT in particular. This is due to a variety of factors, including its smell[10] and the stains it leaves on the walls.[10][11][12][13] While that stain makes it easier to check whether the room has been sprayed, it causes some villagers to resist the spraying of their homes[13][14][15] or to resurface the wall, which eliminates the residual insecticidal effect.[12][15] Pyrethroid insecticides are reportedly more acceptable since they do not leave visible residues on the walls.[13]
In addition, DDT is not suitable for this type of spraying in Western-style plastered or painted walls, only traditional dwellings with unpainted walls made of mud, sticks, dung, thatch, clay, or cement.[10][15][16] As rural areas of South Africa become more prosperous, there is a shift towards Western style housing, leaving fewer homes suitable for DDT spraying, and necessitating the use of alternative insecticides.[15]
Other villagers object to DDT spraying because it does not kill cockroaches[13] or bedbugs;[12] rather, it excites such pests making them more active,[10][11][14][15] so that often the use of another insecticide is additionally required.[15] Pyrethroids such as deltamethrin and lambdacyhalothrin, on the other hand, are more acceptable to residents because they kill these nuisance insects as well as mosquitoes.[13] DDT has also been known to kill beneficial insects, such as wasps that kill caterpillars that, unchecked, destroy thatched roofs.[14]
As a result, Mozambique’s chief of infectious disease control, Avertino Barreto, says that resistance to DDT spraying is “homegrown”, not due to “pressure from environmentalists”. “They only want us to use DDT on poor, rural black people,” he says. “So whoever suggests DDT use, I say, ‘Fine, I’ll start spraying in your house first.’”[10]
Some Westerners also pattern match it to social issues, and not only environmental ones.
Other villagers object to DDT spraying because it does not kill cockroaches[13] or bedbugs;[12]
I’m not sure I believe that. At least residual DDT seems to have done a good job killing bedbugs in the States, at least until it final completely “washed out” of the system a couple of years ago.
Also wikipedia is notoriously unreliable on any vaguely political topic, probably more so then well-known explicitly political topics. The latter attract enough attention that the NPOV policy is actually applied, whereas the former wind up getting “adopted” by some mind-killed administrator with an axe to grind.
I’m basing it on the large amount of harm that malaria does in Africa and by assuming that Western pressure on Africans to not use DDT has made this harm somewhat worse.
″...the U.S. and other rich countries are siding with the mosquitoes against the world’s poor—by opposing the use of DDT...In the 1950′s, 60′s and early 70′s, DDT was used to reduce malaria around the world, even eliminating it in places like Taiwan. But then the growing recognition of the harm DDT can cause in the environment—threatening the extinction of the bald eagle, for example—led DDT to be banned in the West and stigmatized worldwide. Ever since, malaria has been on the rise...But most Western aid agencies will not pay for anti-malarial programs that use DDT, and that pretty much ensures that DDT won’t be used....”
“Greenpeace supports the Stockholm Convention on Persistent Organic Pollutants, a legally binding international agreement which aims to phase out substances such as DDT. Both the Stockholm Convention and Greenpeace allow DDT to be used for malaria control. However, according to Roger Bate, a libertarian critic of Greenpeace, the organization’s campaign to shut down the last major DDT factory in the world located in Cochin, India, would make the eradication of malaria more difficult for poorer countries. Robert Gwadz of the US National Institutes of Health said in 2007, “The ban on DDT may have killed 20 million children.”
Your second quote starts with the clear statement that there is no ban and ends with the a death toll due to this non-existent ban. This should make you suspicious that something is very wrong.
It is certainly possible that there is pressure that goes beyond treaties. And Greenpeace certainly counts as Western pressure. But my experience tracking down such examples puts low prior that there was such a plant at all, let alone a protest.
my experience tracking down such examples puts low prior that there was such a plant at all
Sigh. Wikipedia (emphasis mine):
Hindustan Insecticides Limited (HIL) is a Government of India enterprise under the Ministry of Chemicals and Fertilizers. It was incorporated in March 1954 in order to start production of DDT for the National Malaria Eradication Programme. … HIL is the world’s largest producer of DDT. The company has three manufacturing units, located at Udyogamandal, near Cochin (Southern India) and Rasayani near Mumbai(Western India) and Bathinda in Punjab (Northern India).
And here’s Greenpeace expressing a profound dislike of this particular factory.
As to Mexican DDT, more from Wikipedia:
...Mexican DDT manufacturing plant ceased production due to lack of demand
Your new quote about Mexican DDT is exactly the opposite of your prior quote. Did the factory close because of falling Mexican demand (because of cheaper alternatives, to supply the context of your quote), or because of pressure from America? Again, why do I find it so easy to find Mexican DDT today in America?
Maybe the abandonment of DDT by rich Mexicans has destroyed economies of scale and thus raised the price to Belize. But that is a completely different matter.
Your new quote about Mexican DDT is exactly the opposite of your prior quote.
No, I don’t think so. “Lack of demand” is a nice non-committal phrase. Similarly you can say that a guy driven out of business because he wouldn’t pay the mafia “closed because he didn’t buy fire insurance”. I don’t know what happened to that factory, but closing due to lack of demand is consistent with US pressure to not use DDT.
Again, why do I find it so easy to find Mexican DDT today in America?
I have no idea. Wikipedia says “India is the only country still manufacturing DDT”, but that piece of data seems to be dating back to 2009. Maybe Mexico started again—it’s not a difficult chemical to manufacture.
Yes, that short phrase is non-committal, but it is you who cut it out from the very clear context, once from wikipedia, and once after I explicitly restored it. I’m done.
Wikipedia often doesn’t have context where normal text would, since individual sentences or even words could be edited by different people than other sentences or words.
Sure, multiple authors means that it’s more likely to be incoherent or false, but there’s still context. Lumifer cut out the context and then complained that about the vagueness that he created.
In fact, the whole sentence comes from the cited source, as I checked before I restored the context.
I have looked for and never found any evidence for this. When pushed, a lot of people retreat to the unfalsifiable claim that it is secret pressure.
Africa does use lots of DDT. It used to use more, until mosquitoes developed resistance. Now it restricts it to the most useful applications in towns, especially residences and bednets.
I have looked for and never found any evidence for this.
Any? Really? Here is a result of a 10-second Google search (emphasis mine):
EPA administrator William Ruckelshaus… banned DDT.
The U.S. decision had a rapid effect in the developing sector, where the State Department made U.S. aid contingent on countries not using any pesticide that was banned in the United States. The U.S. Agency for International Development discontinued its support for DDT spraying programs, and instead increased funding for birth control programs.
Other Western nations—Sweden and Norway, for example—also pressured recipient nations to stop the use of DDT. Belize abandoned DDT in 1999, because Mexico, under pressure from the United States and NAFTA, had stopped the manufacture of DDT, which was Belize’s source. Purchases of replacement insecticides would take up nearly 90 percent of Belize’s malaria control budget. Mozambique stopped the use of DDT, “because 80 percent of the country’s health budget came from donor funds, and donors refused to allow the use of DDT,” reported the British Medical Journal (March 11, 2000).
While the statements you have linked may or may not be correct, they may require double checking, since, according to themselves (p.9) and this, “21st Century Science and Technology” magazine is published by Lyndon LaRouche, whom I know very little about, but who seems to be regarded as a controversial figure. He is also on scientific advisory board of that magazine.
Yes, I understand that and tried to not quote the parts where all kinds of bombastic statements are being made, instead focusing on what seems to be simple claims of fact. I am not treating this source as entirely credible, but it was a basic counterpoint to the statement that “I have looked for and never found any evidence for this” (emphasis in the original).
Are you saying that USAID did fund DDT spraying in the 80s and the 90s..? That large-scale efforts of the environmentalists to reduce usage of DDT had no effect at all?
I do not know in particular about USAID, though I have tracked down examples of false claim that organizations did not use DDT. It appears likely that they did use it.
I see no evidence of large-scale efforts by environmentalists to reduce usage of DDT outside of the west. I have not examined claims like the one you quoted above that environmentalists in the US affected Mexico and thus Belize, but it doesn’t seem very plausible since it is easy to get Mexican DDT in America today
Falciparum (the bad kind) only crossed into humans 5000 years ago (historical time!). But it used to be worse, before the evolution of sickle cell and other defenses (O+ Duffy negative blood, I think). Vivax crossed into humans 35 kya and was probably as bad or worse than falciparum before it evolved to be less virulent.
I think the actions of the Gates Foundation matter more than GiveWell’s when it comes to the general public impression that malaria research is important.
Prestige as viewed by students or professors doesn’t match funding provided by NIH, which focuses on diseases that affect Americans, both by mandate and because of lobbying by individuals. Other sources of funding are drug companies that don’t have much opportunity to sell to poor people, and disease-specific charities, established by rich people because of relatives who have the diseases of rich people.
Or maybe it has nothing to do with prestige, but the perk of a field trip.
One can imagine someone who hears promotion of the AMF but doesn’t grok effective altruism deciding that it means they should be researching Malaria. Even without such promotion, Malaria is a big-name disease and I wouldn’t be surprised at non-EAs ending up contributing to an oversupply of malaria researchers because they don’t realise that some disease that’s less of a big deal but has fewer people working on it might be better.
this was an unhelpful comment, removed and replaced by this comment
By some estimates around “one out of every two people who have ever lived have died of malaria.” This just might be contributing to the medical community’s interest in malaria.
I don’t know about that… We know how to eradicate malaria—we posess the knowledge, the tools, we’ve successfully done it before. Really, the only thing that needs to happen is for the governments of the SubSaharan Africa to get their shit together. That, unfortunately, is not a medical problem.
this was an unhelpful comment, removed and replaced by this comment
According to this review article, titled “Short History of Malaria and Its Eradication in Italy With Short Notes on the Fight Against the Infection in the Mediterranean Basin”,
They tried free distribution of quinine, and, as you have mentioned, vector control, which involved draining marshes and spraying DDT and other insecticides:
It is curious to note a parallel with a current involvement of philantropists in fight against malaria—back in 1920s and 1930s it was Rockefeller Foundation that funded the creation of Malaria Experimental Station and Institute of Public Health in Italy.
Wow, thanks for that!
Not only that, the entire southern US up to and including Washington, DC was a malaria zone. Southern Florida was basically not considered fit for human habitation until malaria was eradicated.
How do you propose to eradicate malaria?
The same way it was done in the US. Or even in, say, Sri Lanka—a country that was having a very long and bloody civil war in the process.
Draining swamps is contingent on geography. It is just not an option in Africa.
So, how much malaria is there in the swamps of Everglades and Okeechobee?
Besides, which geography prevents swamp draining in, say, Kenya or Tanzania?
Governments in subsaharan Africa don’t use massive amounts of DDT, not because they are incompetent but because of Western pressure.
At least in Mozambique, it seems that DDT have met resistance both from the West and (parts of) local population.
This report from 2000 from BMJ (British Medical Journal) blames foreign donors, although it does not provide any references for its figures:
But environmental concerns are only a part of the whole picture, and, according to Mozambique’s chief of infectious disease control, a smaller one.
DDT is used in indoor residual spraying (IRS) which, along with insecticide treated mosquito nets and Artemisinin Combination Therapies, is one of the three main interventions promoted by World Health Organization. But due to the fact that it has unaesthetic side effects and cannot be done everywhere, in some countries it became associated with social issues:
Some Westerners also pattern match it to social issues, and not only environmental ones.
I’m not sure I believe that. At least residual DDT seems to have done a good job killing bedbugs in the States, at least until it final completely “washed out” of the system a couple of years ago.
Also wikipedia is notoriously unreliable on any vaguely political topic, probably more so then well-known explicitly political topics. The latter attract enough attention that the NPOV policy is actually applied, whereas the former wind up getting “adopted” by some mind-killed administrator with an axe to grind.
Yes, and this is an evil comparable to the slave trade.
Can you provide any evidence that it is true?
I’m basing it on the large amount of harm that malaria does in Africa and by assuming that Western pressure on Africans to not use DDT has made this harm somewhat worse.
It is the existence of Western pressure for which I was asking for evidence.
From NYT’s Kristof
From Wikipedia
Although others claim that this isn’t true.
Your second quote starts with the clear statement that there is no ban and ends with the a death toll due to this non-existent ban. This should make you suspicious that something is very wrong.
It is certainly possible that there is pressure that goes beyond treaties. And Greenpeace certainly counts as Western pressure. But my experience tracking down such examples puts low prior that there was such a plant at all, let alone a protest.
Sigh. Wikipedia (emphasis mine):
And here’s Greenpeace expressing a profound dislike of this particular factory.
As to Mexican DDT, more from Wikipedia:
Your new quote about Mexican DDT is exactly the opposite of your prior quote. Did the factory close because of falling Mexican demand (because of cheaper alternatives, to supply the context of your quote), or because of pressure from America? Again, why do I find it so easy to find Mexican DDT today in America?
Maybe the abandonment of DDT by rich Mexicans has destroyed economies of scale and thus raised the price to Belize. But that is a completely different matter.
No, I don’t think so. “Lack of demand” is a nice non-committal phrase. Similarly you can say that a guy driven out of business because he wouldn’t pay the mafia “closed because he didn’t buy fire insurance”. I don’t know what happened to that factory, but closing due to lack of demand is consistent with US pressure to not use DDT.
I have no idea. Wikipedia says “India is the only country still manufacturing DDT”, but that piece of data seems to be dating back to 2009. Maybe Mexico started again—it’s not a difficult chemical to manufacture.
Yes, that short phrase is non-committal, but it is you who cut it out from the very clear context, once from wikipedia, and once after I explicitly restored it. I’m done.
Wikipedia often doesn’t have context where normal text would, since individual sentences or even words could be edited by different people than other sentences or words.
Sure, multiple authors means that it’s more likely to be incoherent or false, but there’s still context. Lumifer cut out the context and then complained that about the vagueness that he created.
In fact, the whole sentence comes from the cited source, as I checked before I restored the context.
Oh, good.
I have looked for and never found any evidence for this. When pushed, a lot of people retreat to the unfalsifiable claim that it is secret pressure.
Africa does use lots of DDT. It used to use more, until mosquitoes developed resistance. Now it restricts it to the most useful applications in towns, especially residences and bednets.
Any? Really? Here is a result of a 10-second Google search (emphasis mine):
(source)
While the statements you have linked may or may not be correct, they may require double checking, since, according to themselves (p.9) and this, “21st Century Science and Technology” magazine is published by Lyndon LaRouche, whom I know very little about, but who seems to be regarded as a controversial figure. He is also on scientific advisory board of that magazine.
Yes, I understand that and tried to not quote the parts where all kinds of bombastic statements are being made, instead focusing on what seems to be simple claims of fact. I am not treating this source as entirely credible, but it was a basic counterpoint to the statement that “I have looked for and never found any evidence for this” (emphasis in the original).
Yes, I have seen such assertions before, but I have tried tracking down these “bans” and as far as I can tell, they are pure fabrications.
Are you saying that USAID did fund DDT spraying in the 80s and the 90s..? That large-scale efforts of the environmentalists to reduce usage of DDT had no effect at all?
I do not know in particular about USAID, though I have tracked down examples of false claim that organizations did not use DDT. It appears likely that they did use it.
I see no evidence of large-scale efforts by environmentalists to reduce usage of DDT outside of the west. I have not examined claims like the one you quoted above that environmentalists in the US affected Mexico and thus Belize, but it doesn’t seem very plausible since it is easy to get Mexican DDT in America today
this was an unhelpful comment, removed and replaced by this comment
Falciparum (the bad kind) only crossed into humans 5000 years ago (historical time!). But it used to be worse, before the evolution of sickle cell and other defenses (O+ Duffy negative blood, I think). Vivax crossed into humans 35 kya and was probably as bad or worse than falciparum before it evolved to be less virulent.
I think the actions of the Gates Foundation matter more than GiveWell’s when it comes to the general public impression that malaria research is important.
this was an unhelpful comment, removed and replaced by the comment you are now reading
Prestige as viewed by students or professors doesn’t match funding provided by NIH, which focuses on diseases that affect Americans, both by mandate and because of lobbying by individuals. Other sources of funding are drug companies that don’t have much opportunity to sell to poor people, and disease-specific charities, established by rich people because of relatives who have the diseases of rich people.
Or maybe it has nothing to do with prestige, but the perk of a field trip.
Interesting reframe, I appreciate that
One can imagine someone who hears promotion of the AMF but doesn’t grok effective altruism deciding that it means they should be researching Malaria. Even without such promotion, Malaria is a big-name disease and I wouldn’t be surprised at non-EAs ending up contributing to an oversupply of malaria researchers because they don’t realise that some disease that’s less of a big deal but has fewer people working on it might be better.