There’s an important new coalition in Washington, and it’s designed not to stop the Miers nomination, but to stop malarial mosquitoes. It’s a coalition that lives by the law of the jungle: Kill them before they kill you. The "Kill Malarial Mosquitoes Now" coalition insists, "We will fight furiously for every human life now hanging in the balance as a function of current, myopic, errant and unconscionable U.S. malaria control policies."
The KMMN coalition’s story begins with big numbers, a little climatology and a bit of entomology. The numbers: Some 500 million cases of malaria occur worldwide every year, and 1 million people die, nine-tenths of them in Africa. The disease is the leading murderer of Africans under five — it kills a young child every 30 seconds — and survivors often suffer brain damage.
The climate fact is simple: Africa is a hot continent. That’s relevant here because the process of transmitting malaria begins when a mosquito bites someone already infected and ingests the malarial parasite. Over a two-week period — but one that goes faster when it’s hot — the parasite goes through a transformation called sporogony. Once it occurs, the mosquito can infect others. The curious part is that the life span of the mosquito is also two weeks, so in cool areas mosquitoes typically die just before they become infectious — but in Africa they bite first, die later.
The entomology — study of insects — explains why Africa is hit harder by malaria than, say, India. It takes two human bites in a row — one for the mosquito to ingest the parasite, the other two weeks later to infect another person — for malaria to be transmitted. In India, the predominant mosquito type prefers to bite cattle — but in Africa, mosquitoes almost always bite humans. The result is that malaria can be transmitted in Africa nine times more readily than in India.
The United States has been contributing about $200 million per year to Africa’s war on malaria. Four months ago, President Bush promised an additional $1.2 billion over five years in U.S. anti-malaria funding. But last week, a coalition of 100 doctors, scientists and activists said that anti-malaria funds up to now have been misspent.
The KMMN coalition — which includes eminent malaria experts and public health specialists, the former U.S. Navy surgeon general, the national chairman of the Congress of Racial Equality, a co-founder of Greenpeace, the president of the National Black Chamber of Commerce and the president of the Association of American Physicians and Surgeons — says most of the annual $200 million goes to advising African governments on how to combat malaria, not on actual combat.
The KMMN coalition says that none of that money goes for the most effective weapon: the insecticide DDT, which eradicated malaria in Europe and the United States more than half a century ago, but was banned in the United States in 1972 because of its supposed environmental effects. Soon, the World Health Organization and the U.S. Agency for International Development cut out DDT from its programs.
Author-physician Michael Crichton described the results of the DDT ban this way: "It has killed more people than Hitler." That’s because trying to stop every human-stinging mosquito is a dead man’s game. They will find a way in. And during the three decades since DDT disappeared from the disease-fighting weapon rack, we’ve learned that the insecticide does not thin birds’ eggshells dangerously or cause cancer among humans. Infants nursing when there’s been heavy DDT spraying may gain weight a little more slowly than others, but that’s a lot better than dying from malaria.
And that’s why the KMMN declaration arose last week. It responds to residual concerns about DDT’s environmental effects by calling for its use only for indoor spraying and not for aerial or any other form of outdoor application. But that’s the only proposed compromise: With malarial mosquitoes, it’s kill or be killed.