“Wait, wait, wait!” I told myself,“You are not going to drive out your readership by talking about malaria, of all things, are you? Write on things you know well, like the bathroom habits of boozed-out businessmen and sober socialites. Write on how bad other doctors are, compared to you. Etcetera.”
A recent paper published in the World Journal of Surgery interested me. First of all, the author’s name was familiar. In fact, I had written a blog post on one of his publications and scoffed at his pretentiousness.
This time, however, I wondered what his beef was. What was a surgeon trying to do by publishing an edit piece in the World Journal of Surgery on a very old medical disease like malaria?
My twisted mind told me that this was no scholarly treatise on the disease. Rather, underneath the medical jargon, there was a scathing indictment of Governments and world bodies like the WHO, and a hot story involving money, politics, global warming, the environment, and sex. Okay, not the last, but I thought I should raise your hopes a bit before I proceed.
A global perspective on malaria reveals that:
* It affects around 40% of the world’s population.
* Around 500 million cases of malaria occur every year (about 10 cases per second).
* 1 to 3 million children die of this disease annually. One could translate that to a death of one child every 30 seconds. Most deaths occur among young children in tropical Africa.
The author, perhaps, felt a need to justify writing on this topic:
……why do Third World surgeons and internists care so much for what, after all, is another ‘‘bug’’ for which cures have been discovered and Nobel Prizes long conferred? The question is answered by looking from the past to the future of malaria.
Malaria has defied all the predictions and plans of organizations such as the World Health Organization (WHO) by staging a massive comeback from the brink of extinction during the 1960s and 1970s. According to many public health experts, environmentalists must bear a significant burden of guilt for this owing to their campaign against the pesticide DDT. This agent removed malaria from endemic areas such as the United States (in 1951) before its use was almost banned a decade later for suspected (though unproven) damage to animals and humans. The use of DDT led to massive drops in the number of malaria cases, and the end of its use led to a massive resurgence.
Damn, damn, damn! Someone was actually attacking environmentalists?! WTF?
Actually, DDT was banned after Rachel Carson, in Silent Spring (1962), accused it of a range of dangers to human health (notably cancer), to the ecosystem and to thinning the eggshells of bald eagles. Ted Lapkin claims that “no scientific peer-reviewed study has ever replicated any case of negative human health impacts from DDT”.
He asserts that of all Carson’s charges “the only contention that has been scientifically proved is the thinning effect DDT has on the eggshells of predatory birds”. Several others have trashed Carson’s contention.
Bjorn Lomborg (The Skeptical Environmentalist):
Our intake of coffee is about 50 times more carcinogenic than our intake of DDT before it was banned…the cancer risk for DDT is about 0.00008 per cent.
Ted Lapkin:
(DDT is) still widely regarded as the single most powerful weapon at our disposal in the war against malaria and its disuse has been a scandal of public policy.
Author Michael Crichton:
Banning DDT is one of the most disgraceful episodes in the 20th century history of America.
It has even been speculated that the DDT ban (with the resultant deaths from resurgence of malaria) has been a Western ploy to control the population growth of the developing countries.
The environmentalists scoff disdainfully at the opposition, arguing that there are better alternatives to DDT, and that resistance of the malaria parasite to DDT was the main reason the world chose to ban DDT.
Crichton indicts the West, and especially the environmentalists. Take this quote from an article:
For Crichton, the most imperative of contemporary challenges is to retrieve responsible environmentalism from the clutches of those zealots for whom it has become a substitute faith….
“I am thoroughly sick of politicised so-called facts that simply aren’t true. It isn’t that these ‘facts’ are exaggerations of an underlying truth. Nor is it that certain organisations are spinning their case… in the strongest way. Not at all — what more and more groups are doing is putting out lies, pure and simple. Falsehoods that they know to be false. This trend began with the DDT campaign and persists to this day.”
Crichton estimates that between 10 and 30 million poor people of Asia and Africa have died because of aggressive environmentalism.
According to the WJS article, the return of malaria stems from several issues that, in turn, stem from interventionist Government business policies. Weak drug patency laws in Asian (including China, Thailand, and Cambodia) and African countries led to spurious chloroquine (the curative drug for malaria at the time) flooding the markets. The malaria parasite quickly became resistant to the drug. In spite of this, for long years, the WHO continued to push the drug as the main weapon against the bug.
So how much money is needed to fight malaria? The Bill Gates Foundation is at it, as is the WHO with its Roll Back Malaria program.
According to the WHO, around $2 billion per year is
required to halve the disease burden by 2010.
The WJS article quotes studies that trash the premise of this assessment:
Critics assert that public health spending and injection of foreign capital do not result in desired results. Filmer and Pritchett (1999) showed that although mortality in very young children could be massively reduced in the poorest countries by spending only $10 per child, the actual amount spent by governments to spare one child death is an incredible US $50,000 to $100,000. Among the several reasons for this, a couple are worth mentioning.
Public health agencies are inefficient and corrupt, with only a fraction (30–70%) of funds ending up in the community, and aid-financed drugs are sold in the black market. In addition, the presence of free public health
services drives out the private sector, resulting in a slothful monopoly in the health services, a fact known to the people of Africa and Asia.
So, if pouring tax money on malaria prevention and control is not going to work, what is?
The article ends off lamely by saying:
Malaria, a disease that has survived a million years,
cannot be eliminated unless humankind eradicates what the
American playwright Eugene O’Neill called ‘‘the most
deadly and prevalent of all diseases’’—poverty.
There are very cogent arguments in scholarly studies that espouse a free market society as the ultimate solution to curb the ravage of malaria. The most wretchedly poor and socialist countries are the ones most affected by malaria.
Capitalism (as the most successful wealth-creating system) as malaria vaccine. Some concept, isn’t it?
