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  • Reply to: Injectable artesunate: cure or killer?   3 days 14 hours ago

    Anemia similar to that noted in recent reports on imported malaria in Europe after IV artesunate treatment is also reported in France (M Danis et al., Bull Acad Nat Méd 3, 699-716, 2013). Artesunate is not licensed in Europe but has been available in France since May 2011 through patient program controlled by the French Agency for Drug Safety [ANSM]. The first 99 patients treated with artesunate up to September 2012 experienced satisfactory efficacy and tolerability. Delayed, sometimes persistent anemia was observed in 29% of the patients . This unexpected adverse effect requires further investigation. IV artesunate is now recommended as the first-line treatment for severe falciparum malaria in France.

    This is close to the figure of 23 % reported for Belgium and Netherlands (A Kreeftmeijer et al., Malaria Journal, 2012, 11 :102) and to the average figure reported for Europe : 6 patients out of 25 travelers treated at 7 centers in Europe ( T. Zoller et al., Emerging Infectuous Diseases, 17, 5, 2011).

    Who is going to stop this disaster !

  • Reply to: Two major problems with WHO Chemical Dependency Pathway to Malaria Suppression   6 days 13 hours ago

    Hi Bill,

    I am not a descendant of dike builders, however my four kids are Cajuns from their mother's side. The Canjuns (slang for "Acadians") of Louisiana originated in French Acadia which is present day Nova Scotia & New Brunswick Canada on the Bay of Fundy.

    The Acadians began their colony a decade before the Pilgrims landed at Plymouth Rock. The Acadian settlers floundered for many years before they began diking and draining the marshes. By 1755, (when they were expelled by the British) there were 15,000 Acadians and they were very prosperous.

    The dikes in Holland are major engineering works. What I have in mind for African estuaries and river valleys is more like what was done in Acadia in the 17th and 18th centuries. The Acadian dikes and "Aboiteaux" - what they called their unique tide gates - were obviously constructed without heavy equipment.

    The Acadian diking projects brought people together and made strong prosperous communities that survived the Great Upheaval (or Le Grand Dérangement) of 1755.

    Economic development is vitally important for the eradication of malaria. In the right places, flood control and diking and drainage for agriculture will spark spectacular economic development as it did in Acadia, In Holland, in Egypt 6,000 years ago, in Mesopotamia before that.

    If done with innovation, diking and draining marshes and flood plains will reduce mosquito populations, produce food, and improve people's standards of living.

    It is completely counter-intuitive, however I believe that diking and draining can be done while preserving important wetland habitats. I have a photo of the salt marsh vegetation upstream from one of my tide gates at Edison Slough in Washington State. It's gorgeous! (I'll e-mail it to you.)

    It's low-tech and it's not particularly flashy, but I believe that diking and draining is how the battle against malaria will be won on many fronts.

    Jeff, father of half-Cajuns

  • Reply to: Two major problems with WHO Chemical Dependency Pathway to Malaria Suppression   6 days 17 hours ago

    Thanks Jeff,

    But as a descendant of one Willie Kieft from Groningen, I must remind you of the way Holland has reclaimed its coast from the North Sea, and managed to grow enough tulips for all of us.

    Also see Alvaro Pemartin's recent column on northern Europe and how Finland and Holland controlled malaria.

    Bill, grandson of Willie Kieft the Dutchman

  • Reply to: Two major problems with WHO Chemical Dependency Pathway to Malaria Suppression   1 week 1 day ago

    This is a vitally important question, however I would not expect RBM, WHO, and/or the USPMI to volunteer an answer.

    My speculation, from least devious to most devious:

    1) Ignorance - They simply are ignorant of the history of past malaria eradication success stories.
    2) Hope - They are wishing for a magic bullet.
    3) Ego - To change course now would be an admission that their efforts to date have been a dead end.
    4) Arrogance - They think they're smarter and more capable than William Gorgas, Israel Kligler, Arthur E. Morgan or other-like-minded leaders and drainage engineers who lived 100 years ago.
    5) Sloth - Significant effort is required to design, construct, operate & maintain flood control and drainage infrastructure.
    6) Greed - The directors of these organizations hold stock in Dow Chemical, Union Carbide, and all of the big chemical companies. (I jest.)
    7) Bureaucracy - Bureaucracies are unaccountable behemoths. They are accessories to mass-murder by neglect and there is no consequence for this.

    (My Seven Deadly Malarial Sins.)

    Turning marshes into farms via diking and draining should be profitable. Lack of money is not a valid excuse.

    Diking and draining a portion of a floodplains for agriculture results in a remarkably constructive geometric progression: If one person can construct, say 400 feet of dikes, he will surround 100 x 100 SF. If he works with his neighbor, they will construct 800 feet and surround 200 x 200 SF. FOUR TIMES THE AREA!!! Their combined farm has twice the area per person compared to the one-man dike.

    This is absolutely amazing:

    If 100 people in a region all collaborate to construct a single very large square dike, the enclosed farm will have 100 times the area PER PERSON. This is a remarkable geometric progression.

    You can demonstrate the above with two or more people and a box of toothpicks. Even a five years-old will see the light: Give each person four toothpicks and have them make a square. Now compare the size of the 2, 3, 4... 1 x 1 squares to a single large square made up of all the toothpicks. If you have ten or more people it is impressive.

    I believe that this is why the Egyptians were able to mobilize sufficient manpower to build the pyramids. The Nile has a large flood plain and geometric progressions are astounding.

    Mosquitoes propagate geometrically and the Plasmodium parasite also propagates geometrically. It seems reasonable that winning this war will require a geometric progression working to OUR advantage.

    The icing on the cake is FOOD - and COMMUNITIES COOPERATING - and JOBS - and PROSPERITY.

    Let's do this shall we? Who's in?

  • Reply to: Tea against ACT: David against Goliath   1 week 2 days ago

    China Is Testing An Unproven Malaria Drug On An Entire African Nation ?!

    By George Dvorsky

    Malaria is a serious problem for Comoros, where in some districts upwards of 90% of people carry the parasite. But as CBS News reports, a team of Chinese scientists, in partnership with the Comoran government, have apparently wiped the disease off the islands with a new, Chinese-made drug called Artequick. The unproven drug was given to everyone on the island across three waves of treatments — all 700,000 inhabitants — despite it not being approved for use in humans by any international health body.
    And they're not making any apologies for their approach, saying that the ultimate plan is to "contribute to the elimination of malaria in the world."
    The Comoran government says the massive drug experiment is bringing free medicine to its people, saving it $11 million each year in health care costs.
    Artequick is a new medicine that has not been studied a lot and it is not widely available. For example, Artemisinin — an active ingredient in the drug — has been shown to be toxic to early stage embryos in animal studies, but there is no data available on use in pregnant women during the first trimester.
    The World Health Organization is not disputing the claim from the Chinese scientists and the Comoran government that malaria has all but vanished on the islands since the Artequick "mass drug administration." But the howls of outrage have begun. As CBS reports:
    [Andrea] Bosman, of the WHO's Global Malaria Program, is critical of how the Chinese experiment's managers are handling reported side effects from Artequick.
    In Bosman's view, it is also a missed opportunity to learn lessons from the project that might have helped other countries in the fight against malaria…

    My comments
    - It is not true that Artequick has not been tested previously. Many clinical trials have been run in many countries and can easily be found on internet
    - It is in use in China since 10 years and in on the way of eradicating malaria in this country (Quian Zhang et al, Malaria Journal 2014, 13:419)
    - The clinical trials have shown that Artequick is more effective and better tolerated than Coarsucam
    - Artequick (via piperaquine) has a preventive, prophylactic effect and a prolonged therapeutic effect, decreasing the rate of recurrence and reinfection . Coartem and Coarsucam have no prophylactic effect (AR Hasugian, RN Price et al., Clin Infect Dis 2007, 44, 1067-1074)
    - The reaction of WHO is understandable: they receive a royalty for every pill of Coartem sold in Africa. Shameless.