Many Africans appreciate the involvement of US President W. Geroge Bush in the fight against Malaria. From treating mosquito nets to indoor residual spraying, all may mean well. We need to tackle Malaria beyond the ‘ US-Arusha Declaration for Africa’ against the deadly Malaria.
 What Africa needs in a ‘concrete solution’ to this epidemics and not Bush’s ‘doctor-to-patient-get- well-soon’ manipulations. Certainly we all ought to be abreast with information on Malaria in relation to mosquitoes. Many of us do not understand the behavior of mosquitoes thus rendering the fight against Malaria difficult.

Again, as we all take ourselves into the lives of mosquitoes and the disease that they transmit, it is unfortunate that we have not been able to understand our immediate neighbor, the Mosquito, who always knocks on our doors for a cup of blood at night as she pays back with Malaria.

In their book, Mosquito: A Natural History of Man’s Most Persistent and Deadly Foe’, by Andrew Speilman and Micheal D’Antonio the writers go swatting mosquitoes as the vampire-types carry some 100 nasty diseases and parasites that dispatch about one person every twelve seconds. They describe her as an “apple-seed sized creature that even harasses dinosaurs and have affected both human health and hearth than any other insect plagues combined’.

Ever since their nifty names from Aedes aegypti to the Culex pipiens and Anopheles aquasalis that sounds Lingala all have defied Kenya ’s ethnicity in the approximately 42 tribal cultures. This should then make us yearn to understand mosquitoes with their wild behavior for the sake of humanity.

Unfortunately, the Western world, including U.S.A., have become the world’s largest mosquito guardian and it is time that we re-introduced a local religious ‘great mosquito crusade’ and make malaria benign for good. As the mighty winnowers become sexually active, they suck more blood for eggs and vomit Rift Valley fever and malaria into our veins.

Ay! They do not digest blood with water (plasma) in it but suck blood, secreting the (water) from the blood in their pinkish urine. Again, like in an action packed movie, the mosquito takes away the soul this time round in a deadlier and real way.

Their prowess makes them land on walls and the average time spent before and after a blood meal is about 20 minutes on our watches. They even beat their wings more then 250 times a second and fly about 4.8 kilometers (3 miles) an hour as they protect their approximately 2,500 species in the world though most don’t suck blood. This then should be our mundane lore on deadly mosquitoes, as human deaths become the entertaining ode to the mosquito.

In another recently published book by Dr. Donald R. Roberts, an entomologist and professor of Tropical Health at the University of the Health Sciences, U.S.A, the author urges that “outbreaks of preventable diseases is as a result of inefficiency by organizations such as the U.S Environmental Protection Agency (EPA), United Nations Environmental Program (UNEP) and others that have authority and regulatory control over critical pubic health issues but lack responsibility and recognition of the public health consequences”.
Thus what ought to change, according to Dr. Donald is to “rest authority in the right hands of World Health organization (WHO) and Centers for Disease Control (CDC) that have responsibility for public health”.
  

For example, late last year (September) the WHO malaria division head Dr. Arata Kochi, announced the decision to return to science-based malaria policy and permit the use of DDT (Dichlorodiphenyl-trichloethane) for indoor spraying but which has been ignored by man counties including Kenya . Fortunately Uganda ’s President Yoweri K. Museveni and Uganda ’s Ministry of Health have allowed re-introduction of DDT’s indoor residual spraying (IRS) supporting Dr. Arata’s “courageous responsibility to this public health menace that has since overruled the 30 years of anti-DDT prejudice at WHO”.
  

As for Kenya, where over 75% of residents of North Eastern province and Kilifi regions live below the poverty line with 90% of the two populations unemployed and where the residents’ resistance to disease is concerned, lack of prevention of mosquito breeding and control mechanisms have negatively influenced the well being of such populations. Thus DDT not only has the potential to prevent malaria but also control the spread of Rift Valley fever, Dengue fever, Yellow fever among many other diseases transmitted by mosquitoes as vectors.
  

Surprisingly and fatally, the Ministry of Health, even with the consent of WHO to use DDT, chose to lax its muscle in terms of controlling breeding and mosquito movement. The consequence of flooding would be to create breeding grounds for the Mosquitoes. Moreover it is upon the MOH to come up with a disaster and management policy on health through community participation as a security issue.
 

 Even before then, disease outbreak during flooding ought to be classified as a security risk as in terrorism and which needs proper preventive medical armory.

For the Rift Valley fever bunyaviuses from animals are picked up by a biting mosquito to be readily injected into the human victim. For malaria sporozoites reach the human liver where they reproduce forming new merozites that enter the blood stream then burrow into the red blood cells causing bleeding. This happens at an interval of 48-hour cycle when new blood cells are infected and destroyed. Worse still death quickly follows when the two infections attack the brain. Other public health diseases such as cholera and typhoid only exacerbate symptoms leaving children below 5 years and pregnant mothers to approach their deathbeds sooner.

  As a matter of concern, the Ministries of Agriculture and Livestock are being over-indulged by the Ministry of Health due to poor preparedness of preventable and readily controlled public health issue. Previously the MOH had made errors including brainwashing Kenyans that the recent outbreak of disease in North Eastern province had been the deadly Ebola fever. This gave room for the infection to spread when diagnosis and treatment of Rift Valley fever were delayed. Also, the MOH lacked a reliable data collection and surveillance team to gather information about public health diseases associated with flooding. Most importantly the MOH had not ensured that there was proper infrastructure to control disease as a primary necessity. It only opted to ‘put the cart before the horse’ by treating rather than preventing spread of disease.

 Thus, the MOH ought to re-educate its pubic health staff on diagnosing; therapeutics and proper treatment in order to save innocent lives at the same time intensify its public health programs even when there are no outbreaks of diseases. Taking further grassroots research on disease patterns in relation to current climatic and environmental changes may help.

Changing climactic patterns, extensive human migration and proper screening of those leaving one geographical area to a different one apart from human and livestock vaccination that ought to be parameters to help us make decisions on health and disease. It is upon us to choose to move away from health policies on public health that propagate medical-based genocide with many preventable deaths as statistics for publication.
  
  It is unfortunate that the Ministry of Health had to spend billions of shillings to help control and manage the Rift Valley fever. Unpreparedness had been the major culprit in as far as managing disease is concerned. With the start of the rainy season there are chances that there would be outbreak of Malaria due to adverse climatic changes that exacerbate breeding grounds for vector borne insects such as Mosquitoes that transmit Malaria apart from Rift Valley fever and other diseases. As for the means of controlling the spread of Malaria the Ministry of Health ought to come out clear to create awareness about Malaria to the public before the disease kills many including children below 2 yrs and pregnant women. At the same time there have been many misconceptions about control measures and management of the public health disease. As a consequence the untimely ban on DDT (dichlorodiphenyl-trichloroethane ) in Kenya last year by the Ministry of Health was the deadliest weapon of mass warfare in the fight against global malaria. The ban was influenced by the donor community and politicians with vested interests. Towards the end of last year Kenya got Ksh. 1.2 billion ($ 16 million) for the malaria programme that included availing Artemesinin Combination Therapy (ACT) with a conditionality not to use DDT. Previously the hurly-burly ban of DDT was a result of subceived chemical warfare using insecticides. Before World War II chemical that were lethal to insects were made in laboratories at the time chemical warfare agents were developed. Thus the perceived worry built on the premise of nuclear warfare made some ethologists and conservationists initiate a cold war against medical and malaria researchers. In the book ‘Silent Spring’ by Racheal Crason, many unscientific and unresearched issues have been raised about the perceived massive toxicity of DDT on the environment and life, including human life, ad nauseum. These deceptive and false claims have allowed many lives to be lost due to the malaria epidemic in Kenya and in the African continent at large.

Fortunately, well known policy observers like Marjorie Mazel Hetch, editor of a scientific magazine, have challenged the WHO to back the use of DDT to help stop malaria. Mazel has opined the adversities of jettisoning public use of DDT. The September 29, 2006 issue of Executive Intelligence Review details the intention of the World Health Organization through its announcement on September 15 that it will back DDT spraying on the inside walls of houses to kill or repel malaria-carrying mosquitoes. Previously, the WHO’s 30 year policy against DDT had created loopholes for unscrupulous environmentalists, pharmaceutical companies and politicians to capitalize on the malaria epidemic that kills one African every 30 seconds, and debilitating 500 million people a year killing women and children in Africa . Apart from DDT being inexpensive and cost effective it kills and repels mosquitoes. DDT is estimated to cost about $5 (ksh 360) per average five-person house hold once or twice a year. Uganda has already agreed to continue with its 2007 indoor spraying program through the Health Ministry as per the Sept 20,2006 report. It went ahead to note that DDT would help reduce infant mortality from the current 88 out of 1000 births to 10. Hitherto, 800 Uganda children die a day from malaria. South Africa resumed the use of DDT in 2003 and within two 2 year the incidence of malaria in the worst-hit province of Kwa-Zulu Natal had fallen by 80% malaria cases and death dropped by 93% by 2005.

The latest WHO malaria campaign stresses that no environmental effects have been noted when small amounts of DDT are sprayed on the inside of house walls. The WHO campaign aims to ensure prompt and effective treatment of the infected through availing medication coupled with indoor residual spraying with DDT and the use of bed nets treated with a long lasting insecticide. Thus the merits and benefits of using DDT override those unscrupulous activists and environmentalist with a hidden subceived agenda for their selfish propaganda. Scientifically, DDT has been proven not to be carcinogenic, mutagenic or teratogenic to man and that it ‘does not have a deleterious effect on fish, birds, wildlife or estuarine organisms’. This is courtesy of the U.S. Environmental Protection Agency report. An example is India where $165 million (ksh11.8 billion) was extended but India was told not to use DDT. The same was done to Madagascar and Eritrea . Unfortunately 50 per cent of mortality and 60-80 per cent of morbidity in Eritrea is the result of malaria. The UNICEF funds were only for insecticide-treated nets. This lopsided international pressure to stop public use of DDT has only exacerbated death of innocent children and women of Africa yet Pharmaceutical companies are allowed to make profits out of this scourge. German chemist, Othmar Zeidler, who in 1874 produced some ‘material’ that was later named ‘DDT’ in 1939 by Switzerland ’s Nobel Peace Prize winner Dr. Paul Muller, must be the ‘saddest soul in Heaven’. Maybe his vision was that DDT saves more millions of lives than any other man-made chemical.

The WHO stated that chlorinated hydrocarbon insecticide like DDT ‘killed more insects and saved more people than any other substance’. Researchers and human volunteers have ingested as much as 35 grams (about 3 table spoonfuls) of DDT a day for two years without having adverse effects. To prove to sophists that DDT was harmless to humans a US scientist Dr.Wayland Hayes ingested a tablespoon of DDT (about 12 gms), swallowed and took a glass of water before presenting a talk about DDT lacking toxicity to vertebral animals including humans. Not only will DDT help control malaria but would help manage Rift Valley fever,typhus, yellow fever, Chaga’s disease, African sleeping sickness,
 Leishmaniasis, tick-borne bacterial and rickettsial diseases that are a threat to humans.

Selfish propagandists have made companies that produce insecticides that have a short residual action gain massive profits. Many toxic chemicals than DDT, like nicotine, have been scientifically proven to be harmful yet less receive less mentioned among these groups. Many have died of cancer respiratory and circulatory diseases but no one has died due to the use of DDT. The advantage of DDT is that it is a non-contact repellent and a contact irritant to mosquitoes and not human beings. A field study conducted in the Americas showed that DDT residues repel 95 to 97 percent of major malaria mosquitoes. Interestingly, international law specifically allows use of DDT for public health as approved by the Stockholm convention on persistent organic pollutants (‘’Pop’s Treaty’’). Despite this approval, the United Nations Environment Program (UNEP), UNICEF and the World Bank still campaign to phase out public use of DDT. The notorious World Bank gives developing countries conditions not to purchase or use DDT. This is elitist medical neo-colonialism and against the basic human right to life. 

In addition, Dr.Gilbert L.Ross of the American Council on Science and Health pointed out that ‘extensive scientific studies have not found any harm to humans, even during the massive overuse of DDT in agriculture in the 1950s and 60s’. In fact this massive use of DDT helped 36 former malarious countries totally eradicate the disease. The U.S. National Academy of Science stated in 1970 that, ‘to only a few chemicals does man owe as great debt as to DDT’. But is Africa paying dearly for the selfishness of propagandists with death caused by Malaria? Iit is time that our country Kenya took the initiative to prepare to face the Malaria epidemic that may break out soon due to the expected heavy rains and increased temperatures brought about by climactic changes. Africa as a whole should not be used as a textbook study field for Malaria statistics.
  
  Wouldn’t the availance of DDT tyo Africa, for indoor residual spraying, be the solution for Africa?
  
  
  Mundia Mundia Jnr,
  (Clinical Physiatrist)