The world's scientific and social network for malaria professionals
Subscribe to free Newsletter | 11115 malaria professionals are enjoying the free benefits of MalariaWorld today

Two major problems with WHO Chemical Dependency Pathway to Malaria Suppression

November 11, 2014 - 21:12 -- William Jobin

Although these problems do not have much significance in the Environmental Pathway to Malaria Suppression described in my previous blog, they are two major problems for folks following the WHO Chemical Dependency Pathway. They are:

1. The Immunity Trap. If the high-maintenance costs of continuing on the Chemical Pathway - that is the annual costs of drugs and biocides (which run currently about half a billion US Dollars for the US PMI) are ever interrupted because of financial, political or technical problems, the previously protected people will have lost their immunity and will experience deadly malaria attacks. It has happened at least twice in Sudan.

2. The Resistance Treadmill. Once biocides and drugs are applied massively by programs such as the US PMI, resistance of the mosquitoes to the biocides and of the parasites to drugs becomes a major source of technical and financial problems. This is what sank the WHO GMEP in 1969. Both Pakistan and Sudan had gone through 8 major classes of insecticides before their spray programs collapsed.

Conversely, if the Environmental Pathway is followed, these problems are reduced or eliminated, since permanent measures are used instead of the ephemeral drugs, biocides and nets. Thus a failure of the program does not result in resurgence of transmission, because once a swamp is filled and turned into a cornfield, it doesn't have to be filled again. Ask the Italians who now have one of the most productive agricultural areas in what used to be the pestilential Pontine Marshes.

So why are RBM, WHO and the USPMI staying on the Chemical Pathway?

Bill, quite puzzled


Jeff Juel's picture
Submitted by Jeff Juel on

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?

Jeff Juel, PE

William Jobin's picture
Submitted by William Jobin on

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

William Jobin Director of Blue Nile Associates

Jeff Juel's picture
Submitted by Jeff Juel on

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

Jeff Juel, PE