Institutional Inertia

Post date: May 25, 2009 4:14:54 AM

The World Health Organization on October 30, 1998, announced the creation of an affiliated organization, that was named, Roll Back Malaria.  The reduction of malaria in Africa by 50% within 10 years was the stated goal of this new organization.  

Dr. Donald Roberts, Ph.D, an entomologist, Professor of Tropical Public Health at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, stated, "The Roll Back Malaria program, a partnership of WHO and UN organizations, has been an abysmal failure.  Since the RBM founding in 1998, deaths from malaria have steadily increased".  This statement was taken from an article showing a graph with a projection of actual malaria deaths at 30% increase over the baseline rate just 10 years ago.

The question is why the increase instead of the projected 50% decrease in mortality over the life of this project?  Let us examine the mission statement attached to the press release announcing the inception of this program.  It starts out on the first page with the claim "simple prevention and control methods has shown startling results: in trials conducted in the Gambia, Burkina Faso, Kenya and Ghana, the use of bed nets, which are treated with pyrethroid insecticide, was shown to effectively protect sleeping children from malarial mosquitoes, resulting in dramatic reductions in deaths among children under five years of age.  Deaths were reduced by average of one fourth in these mega trials".   Perhaps the term "dramatic" in this instance is shall we say; "dramatic", in its context, this method is much ado about nothing as in ineffective. 

Let's see what other interventions, the Roll Back Malaria mission statement has for our consideration.   "Simpler and more effective means of administering medicines" and the encouragement of "new anti-malaria drugs and vaccines", it sounds like a defensive strategy.  First you hide under a net to avoid the mosquito, if that does not work; you take a pill to keep the malaria parasite from killing you. As in an American football expression goes, "the best defense resides in a good offense".  Why not deep six the little suckers and be done with it.

The reference to development of  "new anti-malaria drugs and vaccines" is a fools errand, and overlooks the incredibly  complex nature of the malaria parasite.  Some 9,000 genes. This parasite has the incredible ability to adapt to anything.  Mr. Robert Desowitz, a medical research entomologist in his book, MALARIA CAPERS says, the search for a malaria vaccine has gone on for generations, and none will ever be found, to be effective.  This research he says is for the sole purpose of getting grant money for universities, from wealthy individuals, foundations and governments.  The cause is noble, however the goal is unobtainable.  Meanwhile resources that could be applied to the elimination of this disease are wasted by academics.  Even Bill Gates is a victim of this scam, having poured untold millions into this effort.

The failure to eliminate malaria is more than a humanitarian one, it also has a dramatic impact on economic development as well.  Included in this Roll Back Malaria mission statement is a quote from Jeffrey Sachs, Professor at Harvard. and says in part "We and other groups of economist researchers are trying to determine the consequences of malaria on economic development" and "Our findings are striking.  They point to Malaria as a major impediment to economic development" enough said.  I once did an internet search and pulled up a colored graph of the poorest countries on planet earth and a corresponding colored graph of the countries with most malaria.  To my amazement they were identical.  In the arena of public health, the failure to eliminate malaria in the world is by far the greatest failure.  It is not the failure of technology; it is a failure of leadership! The West has proven the technology is available.  The Will to do something meaningful about this scourge is absent.  

Let us examine the nature of the World Health Organization, the organization that has taken the lead as "expert" to the 80 or so sister organizations known as NGO's or Non Governmental Organizations.  The WHO although it is a quasi governmental organization, is by nature a not for profit, additionally there is a kinship since they both provide public services.  Any organization is of course a simple legal instrument, so to determine the personality of an organization you have to examine the personality profiles of its leaders. 

A person known as a bureaucrat is in charge of this complex multi faceted organization, the nature of a bureaucrat is to keep steady the course of the organization.  Stifling anyone who shows creativity or initiative; otherwise how can this organization maintain its identity, if it allows any creative actions on the part of its employees or anyone else for this matter?  If any changes are made it is a committee that makes them.  Of course in the recorded history of mankind there is no record of a monument ever being erected to a committee; regrettably, only to individuals. 

An entomologist is the next personality type that needs examination.  An entomologist is a person that studies insects, usually insects that transmit diseases, the WHO in this case would employ an entomologist that knows more than a person wants to know about malaria mosquitoes, mating habits etc.  However an entomologist has no training in the art and science of killing mosquitoes only to identify them.  The problem lies in the perception in their mind that he is an expert in this endeavor.  Hence this is how you get a recommendation for the use of bed nets, an intervention that is only 25% effective.  Then you have the medical doctors, with their prescriptions pads ever at the ready, to write a prescription for whatever ails you.  In this case a prophylactic pill to keep the malaria you already have from killing you or modifying the disease in the event you get it.

The people who suffer from this misfeasance are of course, the victims of malaria here in Africa.  Additionally the non-profit organizations that depend on the ‘’sound technical guidance’’ from WHO, in their attempts to obtain value for their contribution to the welfare of fellow humans.

The Solution, eliminate the mosquito!   this is the only method that will free Africa from this scourge.  By eliminating the mosquito means to suppress the population to such a low number there will not be enough mosquitoes left to maintain the transmission cycle.  The elimination of the transmission cycle can be accomplished in about 30 days or so in Ghana.  The elimination of the parasite from the human body will take at least two years.  However there will be no more new infections in the population, perhaps only re-lapses of old infections.  The method used to obtain this goal, is what is called in the US, "space spraying".  that is the treatment of the atmosphere at night over a large area, when the malaria mosquito is out and about, flying.  However the objection to this form of treatment has been cost.  Admittedly it has been historically expensive.  However over the past 10 years, in the US there have been dramatic advances in reduction of costs through improvements of insecticide dispersal systems and application methods.  These improvements have made this process affordable for developing nations and Ghana should go in for it!

Hayford Siaw

Executive Director – VPWA Ghana (www.vpwa.org)

+233 24 3340112