William Jobin's blog

There is recent interest in the odours from human feet and how they attract blood-sucking mosquitoes.  And apparently the odours are from bacteria on the skin, not necessarily of human origin.

I am establishing this Blog in the hopes of stimulating interest in improving the WHO and PMI strategies for fighting malaria in Africa.

SEEKING
Some of us are Seekers who ask “How? We are called Scientists. Some of us are Seekers who ask “Why?” We are called Believers. Some of us are both.

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The boy and the old man sat in the shade of their favorite Neem tree during the oppressive heat of the afternoon. “Uncle, why did the Creator make mosquitoes that swarm around our heads and spread fevers?” asked the boy.

THE FIFTH LAW FOR ATTACKING MALARIA IN AFRICA

Before you attack malaria in Africa, look at what the mosquitoes did in Garki, and what the dictator did along the Blue Nile River.

GARKI

In many countries in Africa, sustained control efforts which had reduced the number of infected people in a population to near zero, were suddenly overcome by explosive epidemics. This happened in Garki Nigeria in the 1970's, and again in central Sudan in the 1980's.

The current enthusiasm for malaria control in Africa will bring us much closer to our goal if we build on the successes of the past, and avoid repeating the mistakes. The major mistake in the global Malaria Eradication Program of 1955 was to embark on an unsustainable strategy, which collapsed within a decade. We need to ensure that current strategies do not repeat this mistake.

There is great historical and practical value in looking at the successful attack on malaria in Italy during the past century, and then going ahead to plan for the attack on malaria in Africa during this century.

SECOND LAW FOR ATTACKING MALARIA IN AFRICA

If you are going to attack malaria in Africa, you don’t have to throw the kitchen sink at it, but you better use everything else.

FIRST LAW IN THE ATTACK ON MALARIA IN AFRICA
The attack on malaria will be like building a tall cathedral or a beautiful mosque, it will take generations.

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While it might appear that the call for eradication will bring out lots of enthusiasm, it is hard to see how we can mount a global program, based on fantasy.

And let's admit that the Gates and Clinton Foundations mean well but are divorced from reality, USAID and the PMI are mired in decades of bureaurocratic tangles, and the UN and WHO left the scene a long time ago, so the attack on malaria in Africa will progress as Africa progresses.

Realism will work better than fantasy.

Let's take Africa, where most malaria deaths occur. A realistic strategy would be to start in the stable, most democratic countries, and gradually develop competent national programs, employing nationals who live in the malaria zone, who can progress upward in their civil service by making progress against malaria in small and carefully measured increments.

So they would reduce malaria prev in school kids by 10% each year, at a cost within the national budget realities. That gives us a solid foundation for progress. Forget the magic bullets and fantasy. Malaria control takes careful application of proven methods - all of them - in a rational strategy that reflects budget realities as well as the ecology of malaria.

Start with the solid countries, where investments will not be wasted on some dictator and his cronies. Start with Senegal, Mali and Ghana. With Tanzania and Mozambique, Malawi, Zambia, Botswana and blessed South Africa. Grow those programs slowly and carefully. Use them as training grounds for folks around them who speak the same language. Realize that we are dealing with Arabic, English, French, Portuguese and Swahili.

Final note: I think it is the third law of for attacking malaria in Africa - The dictators are as dangerous as the mosquitoes.

Willy