Malaria Talk

Unicef and Japan to save the children of Ghana?

noreply@blogger.com (Malaria Talk) — Tue, 30 Oct 2007 14:07:00 +0000

Unicef, in a news item on its website, praises the support it has received over the last 3 years from the Japanese government in combating malaria in Ghana. In 2007 the Japanese government has apparently provided US$ 1,000,000 for the purchase of long-lasting mosquito bednets (LLINs), which will be distributed to young children and women in November.

While one must support any initiative to help control malaria in Africa, one can't help wondering about the ultimate motivation of all these "generous" donors. It has become common practice in articles and news pieces to state any conflict of interest of the authors of any such article or news item. Of course one must assume that UN agencies (such as Unicef) and governments consider themselves above these niceties.

So it is that in the news item a woman can clearly be seen holding an Olyset LLIN. For those of you that do not know, Olyset is a LLIN produced by Sumitomo Chemical, a Japanese company. So, as with much aid supplied by the rich OECD countries (there are exceptions), the aid is often tied to the purchase of commodities from the donor country, or the use of organizations and consultants from those donor countries to run the funded aid program. It would have been nice to see this conflict mentioned somewhere in the Unicef news item. Of course, given the shocking performance of the Japanese economy since the early '90s, one can possibly forgive them for thinking their industrialists need all the help they can get.

But it could have been so much better, for Japanese industrialists and the people of Ghana. In a recent publication in the Bulletin of the World Health Organization, the global resources needed to control malaria were estimated (and please see the "Competing interests" at the end of the article). In a companion Technical working paper, the methodology and numbers behind the publication were elucidated. We find that there are 3,853,411 pregnant woman and children under 5 in Ghana - the presumed target of the Japanese/Unicef largesse. The US$ 1,000,00 is said to be able to protect 400,00 woman and children in Ghana (At US$ 6.00 per Olyset net it means that 166,000 will be distributed, and that 2,4 people will be protected by each net distributed). But this is a measly 10,4% of the target population.

Surely by now Unicef is aware of the fact that at coverage levels of 85% one can get community protection from the use of LLINs. Surely that is a target worth pursuing! For that target we would need 1,364,749 Olyset nets at a cost of US$ 8,188,494. Not a figure that will break the Bank of Japan. And think how happy that would make Sumitomo!

Come on Unicef - get serious about making a difference. We might even forgive the Japanese for their blatant promotion of their own commercial interests if this was achieved. And let's not forget the pawns in this game of aid ping-pong (it's not really chess - that game might be too hard for Unicef to play) - the people of Ghana. Think how happy they would be!

ACT drugs in Uganda

noreply@blogger.com (Malaria Talk) — Thu, 11 Oct 2007 06:07:00 +0000

A recent article on News You Should Know tells the story of the opening of a new factory in Uganda for the production of ACTs and ARVs. The joint venture between the local company and Cipla of India apparently involves an investment of US$ 40 million, half of which has been put up by the Indian company. The half put up by Quality Chemicals has apparently been secured by loans from local banks, and implicitly guaranteed by the Ugandan Government, i.e. a very soft loan.

The Ugandan Government has also apparently given assurances to Quality Chemicals that it will source all its requirements for ACTs and ARVs from the factory for the next 8 years. The question is, does this mean that there will be no competitive tendering for these drugs in Uganda for the forseeable future? Where does this leave the donors of funding for HIV and malaria interventions in Uganda, such as the Global Fund? Do they not prefer that money they provide be used in a transparent manner?

It remains to be seen whether the price of these drugs will decrease in Uganda as claimed by Quality Chemicals if no competitive bidding takes place.

More DDT controversy

noreply@blogger.com (Malaria Talk) — Wed, 10 Oct 2007 11:33:00 +0000

It seems as though the controversy surrounding the use of DDT for the control of malaria vectors (female Anopheles mosquitoes) will never end. Recent research has shown that exposure to DDT used for malaria spraying negatively impacts semen quality in young men.

http://andrologyjournal.org/cgi/reprint/27/1/16
http://andrologyjournal.org/cgi/content/abstract/28/3/423

In all the hype and bluster surrounding the DDT "story" these findings seem to be generally ignored or disparaged by the pro-DDT lobby. What should be of even more concern is that these studies were done on men with non-occupational exposure. What is happening with the men actually applying DDT week in and week out in South Africa and other African countries?

While it is obvious that DDT still has a role to play in malaria control, especially in Africa, it seems as though the argumentation from the pro-DDT lobby is as one-sided and biased as they accuse the anti-DDT lobby of being. Even worse, those arguing against the use of DDT are often accused of being "child-killers" due to the deaths of children not being protected by indoor residual spraying with DDT. Will the pro-DDT faction one day be categorized as killers of unborn children?