Malaria was on the point of being wiped out when..they banned DDT WORLDWIDE because it killed hawks in Cumbria or something.
The first example of the Green movement killing millions..
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A typically insightful Reg Commentard comment. DDT has never been banned for disease vector control (mosquitoes, to you), and is still used for that purpose today. It has been banned in most of the world for indiscriminate use as an agricultural pesticide, not least because that was resulting in resistance in mosquitoes, and so was causing the very malaria eradication programmes you supposedly support to fail as resistance spread. Where it is still effective it's still used, perfectly legally.
DDT is banned worldwide for *agricultural* use ie as a general pesticide. It is still completely legal to use against disease vectors eg mosquitos in the case of malaria.
From Wiki (usual caveats apply):
"The Stockholm Convention, which took effect in 2004, outlawed several persistent organic pollutants, and restricted DDT use to vector control. The Convention has been ratified by more than 170 countries and is endorsed by most environmental groups. Recognizing that total elimination in many malaria-prone countries is currently unfeasible because there are few affordable or effective alternatives, public health use is exempt from the ban pending acceptable alternatives. "
"Today, about 3,000 to 4,000 tonnes of DDT are produced each year for disease vector control.[16] DDT is applied to the inside walls of homes to kill or repel mosquitoes. This intervention, called indoor residual spraying (IRS), greatly reduces environmental damage. It also reduces the incidence of DDT resistance"
I've had dengue fever - which, like malaria, is carried by mosquitos, but for which there is neither cure nor preventative.
It was just as much fun as Lester's bout of malaria; except the cycle is faster. From delirium to fever to sweating buckets - I was losing a couple of kilos a day - in twenty-four hours. The bout itself kept me in bed for a week, unable to fly home (from Rio to the UK) for three weeks, and off work another two or three months.
I was not alone - that single outbreak affected about a hundred thousand people to one extent or another. The good news is that we're now all immune to that variant of the virus - but not to the remaining three variants, one of which is haemorrhagic, and often a killer.
So given that things that stop malaria tend to help reduce dengue too, I'm in this to help get malaria down. Then we can think about dengue... there are some things which should have the same status as smallpox - i.e. extinct in the wild - and malaria and dengue are two of them.
Yes Dengue is bad, and there are 4 variants, but nobody really knows why some attacks are haemorrhagic. It's probably to do with being infected with 2 different strains (1 then 4 worst risk iirc) in succession, along with some immunological factors. Children are at highest risk, probably because of some weird effect of an immature immune system (DOI: not a paediatric immunologist, but close to my work).
Dengue mossies bite during the day. Malaria mossies tend to bite at dawn/dusk. Not all interventions work equally well given the vectors are different...
And bad? Yup. Friends and patients tell me how bad it is. Really really glad I've never had it.
Wiping out malaria - I'm all for that.
As I understand it, we either destroy the parasite itself and/or the vector that it spreads by. My question is, what would happen next?
If the parasite is eradicated, how will the balance of nature shift? I've found a fair few examples of what could happen if mosquitoes themselves were wiped out, which was interesting on its own, but nothing about whether losing plasmodium falciparum would have unintended consequences.
Note - I'm _not_ invoking the precautionary principle here.
I think sickle cell disease would drop markedly, as there would be no further evolutionary benefit in having it (it's less fatal then getting malaria, it seems).
Anyone got any other theories?
Friends of mine live in Nigeria. Both are on the el-cheapo old malaria drugs, which have worked for them over the years as they've wandered the globe. Not free, but affordable for at least some of those in the developing world.
But then they had kids. And it turns out that both the kids had side-effects. As in hallucinations and waking up at 3am screaming the place down. OK, no problems. They got bunged on some of the modern shiny-new drugs that don't make you see monsters. Hooray.
Boo. Those drugs cost £70 a month for 2 kids. That definitely ain't affordable to the locals. Not even close.
Ivan 4, the WHO states that non-communicable cardiovascular diseases are the top cause of death worldwide.
Indeed. There's a list of biggest causes of death, split out to Developed/Undeveloped Countries on Wikipedia, derived from WHO figures.
Malaria is well below HIV/AIDS and various non-communicable conditions, although the list is also a bit squiffy with such groupings as "Childhood Diseases" and "Diarrhea", which can be caused by anything from diet to a range of diseases and parasites.
So it does no favours to wing round inaccuracies like "most prolific killer" and the rest, but it's certainly a shockingly awful way to go and worthy of following the Dodo and Smallpox into the choir invisible.
Happily GSK have a vaccine which has been trialled, seems to work reasonably well and is now going through regulatory approval. Better yet it's been developed in association with a non-profit and with support from the Gates foundation, and should be available reasonably cheaply for routine usage, rather than as a hugely expensive branded product. Of course you still need to nail the parasite unless you want to vaccinate in perpetuity.