Just continue spending on ritual LLINs and IRS, or invest limited budget in more effective ways?
We have been distributing untreated mosquito nets in Guinea and Guinea-Bissau for several years, though the number of nets is very few, but we could observe reduction of malaria incidence and death.
Cochrane reported that ITNs reduced the incidence of uncomplicated malarial episodes by 50 % compared to no nets, and 39% compared to untreated nets, which can be interpreted as untreated nets are more effective than no nets as well. Untreated nets can be physical barrier although no function of repelling and killing. In addition, it is obvious that we don’t have to care about adverse effect by pesticides.
Last year, WHO published Global Plan for IRM, in which they discussed merely resistance management, that is, to introduce new combination of insecticides or methods of usage, with asking for advices from dominant chemical companies. They seemed to overlook a fundamental problem: why the current drug-dependant strategy does not work well. In regard to this IRM plan, I roughly counted the number of contributors: 66 of experts and health workers, 33 WHO, 4 B&M, 14 PMI, 10 others, and 15 from chemical companies. 9 out of 15, they are from Sumitomo, Olyset Net maker. It seemed that Sumitomo people gathered with all their efforts.
Almost all of insecticides used in LLINs and IRS act as endocrine disruptors as I wrote in another blog, and some of them are prohibited to use in EU. For example, permethrin, pesticide used in Olyset net, lost its registration in 2000 in EU, http://ec.europa.eu/food/plant/protection/evaluation/existactive/list1-23_en.pdf and fenitrothion as well.
Malaria elimination is a good reason and good chance for chemical companies to expand their markets due to shrinking market in advanced countries.
According to Water Aid, an international NGO, approximately 2.5 billion people still do not have access to toilets, and the majority of those live in sub-Saharan Africa or Asia. Needless to say, it’s the region where malaria prevails. In such insanitary places, why do they cause more severe contamination by distributing LLINs and spraying insecticides? Sanitation and nutrition should take priorities. We should keep in mind that children and pregnant women (fetus) are most vulnerable people and also susceptible to chemicals.
Malaria world people should steer in another way for the purpose of saving children from malaria not eliminating malaria.