TIM LAMBERT, DISSEMINATOR OF MISINFORMATION (PART 2)
With nine DDT posts since January at his new site and 31 during 2005 at the old, Lambert has, to put it mildly, a "thing" about DDT. Sure, I've posted a fair bit on DDT but nowhere near as much as Lambert. With the sheer volume of material he's posted and the maze of internal links he's created it's very difficult to ferret through his DDT posts.
So, what say we do something different and play one of Lambert's favourite games, DDT ban myth bingo – http://timlambert.org/2005/12/ddt-ban-myth-bingo/. Rather than put up the link to each square on the card the squares will be addressed left to right, top to bottom – go to the copy and paste link above if you want to access the links on the bingo card.
The upper left myth on the bingo card is "Sri Lanka banned DDT in 1964". Lambert probably has this basically correct in that Sri Lanka stopped using DDT for anti-malaria spraying but it's agricultural use continued. This square to Lambert.
Next is "The world Bank doesn't fund DDT spraying". Lambert says the World Bank funds DDT use in India, Madagascar and the Solomon Islands. The World Bank does fund DDT use in India but since the Indian government produces it's own DDT through Hindustan Insecticides Ltd. the World Bank has to accept India's use of DDT or cut off support funds. And anyway, the World Bank would prefer India find an alternative. The link Lambert provides for the Solomon Islands only covers up to 1999 and says nothing about recent World Bank funding for DDT. The Madagascar link is dated 2000; it says that the World Bank and the national government agreed in 1998 to seek alternatives to DDT. On balance Lambert has failed to make his case so he loses this square.
Next is "USAID doesn’t support DDT spraying". On the one hand USAID claims it's supportive of DDT spraying programs but no examples are given and the GAO investigation of the US's anti-malaria efforts finds fault with past funding – $0 has been spent by USAID for DDT purchase. Lambert loses this square.
Next is "Rachel Carson killed more people than Hitler". This isn't worth arguing about. Lambert wins this square.
The second row starts with "Alternative insecticides cost four times as much". Even though there are some doubts about the efficacy of deltamethrin, Lambert can have this square.
Next is "DDT could eradicate malaria". There is no attribution for this claim and the link doesn't really address eradication. Lambert loses this square.
Next is "We have to choose between saving wildlife from DDT and people from malaria". The only anti-malaria use of DDT suggested by anyone with any sense is indoor residual spraying (IRS). IRS poses no threat to wildlife. Lambert loses this square.
Next is "The EU threatens trade sanctions on countries that use DDT". Not only does the UN threaten trade sanctions, the EU threatens sanctions by consumer organisations. Lambert loses this square.
The third row begins with "No mention that mosquitoes evolve resistance to DDT". Mosquitoes develop resistance to all chemical insecticides. Lambert loses this square.
Next is "Fake Wurster quote: 'People are the main cause of our problems…We need to get rid of some of them and this is as good a way as anything'". It is a fake quote. Lambert wins this one.
Next is "Astroturf group Africa Fighting Malaria cited". Lambert can call AFM anything he chooses but that doesn't mean they're wrong any more often than he is. As he doesn't discredit AFM, Lambert loses this square.
Next is "The World Health Organization does not support DDT spraying". The WHO doesn't support DDT spraying. Lambert loses this square.
The bottom row starts with "Bed nets don’t work". Sure they work but a Lambert provided link says they don't work all that well unless coupled with DDT IRS. Lambert loses this square.
Next is "Reinstating DDT in South Africa caused a 95% decrease in deaths". Lambert's link is to one of his typically pathetic, obsessive, anti-Tim Blair rants. Lambert loses this square.
Next is "The article proposes DDT spraying where the mosquitoes are resistant to DDT". DDT is very effective at keeping mosquitoes out of sprayed dwellings even if the mosquitoes are resistant. Lambert loses this square.
Finally there's "DDT is banned." Lambert hasn't won enough squares to win the game so he can have this square uncontested.
Gee, Lambert can't even win when he's playing with himself. Now if Lambert or any of his toadies would like to prove me wrong...
Update: A non-bingo playing reader points out that he can't figure out what I'm trying to do in this post. A bingo game is won when a player wins all of the squares in line vertically, horizontally or diagonally. A win can also be achieved by winning the four corner squares. Lambert's bingo is a version of the game that isn't really meant to be won: it's meant to be a creative take on bingo to be used to find the supposed errors in DDT related written material. You're meant to use each "myth" square on Lambert's board to test the validity of this written material. (According to Lambert, the "myths" that describe each square are frequently occurring.)
In my post I look at the "myth" described by each square – if Lambert has the myth right he wins the sqaure; if he gets it wrong he loses the square. Mostly Lambert gets it wrong; if the game is played as traditional bingo he loses.
To be continued...
So, what say we do something different and play one of Lambert's favourite games, DDT ban myth bingo – http://timlambert.org/2005/12/ddt-ban-myth-bingo/. Rather than put up the link to each square on the card the squares will be addressed left to right, top to bottom – go to the copy and paste link above if you want to access the links on the bingo card.
The upper left myth on the bingo card is "Sri Lanka banned DDT in 1964". Lambert probably has this basically correct in that Sri Lanka stopped using DDT for anti-malaria spraying but it's agricultural use continued. This square to Lambert.
Next is "The world Bank doesn't fund DDT spraying". Lambert says the World Bank funds DDT use in India, Madagascar and the Solomon Islands. The World Bank does fund DDT use in India but since the Indian government produces it's own DDT through Hindustan Insecticides Ltd. the World Bank has to accept India's use of DDT or cut off support funds. And anyway, the World Bank would prefer India find an alternative. The link Lambert provides for the Solomon Islands only covers up to 1999 and says nothing about recent World Bank funding for DDT. The Madagascar link is dated 2000; it says that the World Bank and the national government agreed in 1998 to seek alternatives to DDT. On balance Lambert has failed to make his case so he loses this square.
Next is "USAID doesn’t support DDT spraying". On the one hand USAID claims it's supportive of DDT spraying programs but no examples are given and the GAO investigation of the US's anti-malaria efforts finds fault with past funding – $0 has been spent by USAID for DDT purchase. Lambert loses this square.
Next is "Rachel Carson killed more people than Hitler". This isn't worth arguing about. Lambert wins this square.
The second row starts with "Alternative insecticides cost four times as much". Even though there are some doubts about the efficacy of deltamethrin, Lambert can have this square.
Next is "DDT could eradicate malaria". There is no attribution for this claim and the link doesn't really address eradication. Lambert loses this square.
Next is "We have to choose between saving wildlife from DDT and people from malaria". The only anti-malaria use of DDT suggested by anyone with any sense is indoor residual spraying (IRS). IRS poses no threat to wildlife. Lambert loses this square.
Next is "The EU threatens trade sanctions on countries that use DDT". Not only does the UN threaten trade sanctions, the EU threatens sanctions by consumer organisations. Lambert loses this square.
The third row begins with "No mention that mosquitoes evolve resistance to DDT". Mosquitoes develop resistance to all chemical insecticides. Lambert loses this square.
Next is "Fake Wurster quote: 'People are the main cause of our problems…We need to get rid of some of them and this is as good a way as anything'". It is a fake quote. Lambert wins this one.
Next is "Astroturf group Africa Fighting Malaria cited". Lambert can call AFM anything he chooses but that doesn't mean they're wrong any more often than he is. As he doesn't discredit AFM, Lambert loses this square.
Next is "The World Health Organization does not support DDT spraying". The WHO doesn't support DDT spraying. Lambert loses this square.
The bottom row starts with "Bed nets don’t work". Sure they work but a Lambert provided link says they don't work all that well unless coupled with DDT IRS. Lambert loses this square.
Next is "Reinstating DDT in South Africa caused a 95% decrease in deaths". Lambert's link is to one of his typically pathetic, obsessive, anti-Tim Blair rants. Lambert loses this square.
Next is "The article proposes DDT spraying where the mosquitoes are resistant to DDT". DDT is very effective at keeping mosquitoes out of sprayed dwellings even if the mosquitoes are resistant. Lambert loses this square.
Finally there's "DDT is banned." Lambert hasn't won enough squares to win the game so he can have this square uncontested.
Gee, Lambert can't even win when he's playing with himself. Now if Lambert or any of his toadies would like to prove me wrong...
Update: A non-bingo playing reader points out that he can't figure out what I'm trying to do in this post. A bingo game is won when a player wins all of the squares in line vertically, horizontally or diagonally. A win can also be achieved by winning the four corner squares. Lambert's bingo is a version of the game that isn't really meant to be won: it's meant to be a creative take on bingo to be used to find the supposed errors in DDT related written material. You're meant to use each "myth" square on Lambert's board to test the validity of this written material. (According to Lambert, the "myths" that describe each square are frequently occurring.)
In my post I look at the "myth" described by each square – if Lambert has the myth right he wins the sqaure; if he gets it wrong he loses the square. Mostly Lambert gets it wrong; if the game is played as traditional bingo he loses.
To be continued...
posted by J F Beck at 8:44 PM
5 Comments:
Ill repost this and clean up my typos. This will increase the chance it will get peoples attention
There are at two substantial issues I have taken up with TIM Lambert but failed to get any indication on his part of any interest in the downsides of opposing DDT.
Taken together, the two issues I document blprove anti-DDT activism has killed people and caused a large amount of disease, numbersing many thousands of cases. Nature Medicine 6, 729 - 731 (2000)
Balancing risks on the backs of the poor
Amir Attaran2, Donald R. Roberts1, Chris F. Curtis3 & Wenceslaus L. Kilama4
Department of Preventive Medicine and Biometrics Uniformed Services University of the Health Sciences Bethesda, Maryland 20814, USA
droberts@usuhs.mil
Center for International Development Kennedy School of Government Harvard University Cambridge Massachussetts 02138, USA
amir_attaran@harvard.edu
London School of Hygiene & Tropical Medicine London WC1E 7HT, UK
Chairman, Malaria Foundation International; also Chairman-Coordinator, African Malaria Vaccine Testing Network C26/27 Tanzania Commission for Science and Technology Building, Ali Hassan Mwinyi Road, P.O. Box 33207 Dar Es Salaam, Tanzania
Malaria kills over one million people, mainly children, in the tropics each year, and DDT remains one of the few affordable, effective tools against the mosquitoes that transmit the disease. Attaran et al. explain that the scientific literature on the need to withdraw DDT is unpersuasive, and the benefits of DDT in saving lives from malaria are well worth the risks.
KEY QUOTES
Until now, developed countries have grudgingly tolerated the use of DDT against malaria in poor tropical countries; at least 23 countries do so1. However, this may now be ending. Led by the United Nations Environment Programme, more than 110 countries are negotiating a treaty to "reduce and/or eliminate...the emissions and discharges" of 12 persistent organic pollutants, citing their "unreasonable and otherwise unmanageable risks to human health and the environment."2 If it becomes law, the treaty will likely end DDT manufacture, or at least make the supply scarce and unaffordable to tropical countries.
This, in our view and that of nearly 400 colleagues who have signed an open letter to the diplomats negotiating the treaty, is simply dangerous3. The scientific literature is unpersuasive of the need to withdraw DDT; on the contrary, it is clear that doing so risks making malaria control ineffective, unaffordable, or both.
...
In contrast, DDT spraying for malaria control is less intensive, less frequent and far more contained. The current practice is to spray the interior surfaces only of houses at risk, leaving a residue of DDT at a concentration of 2 g/m 2 on the walls, ceiling and eaves, once or twice a year. Half a kilogram can treat a large house and protect all its inhabitants. Doubtless some fraction of this escapes to the outdoors, but even assuming it all did, the environmental effect is just 0.04% of the effect of spraying the cotton field. Guyana's entire high-risk population for malaria can be protected with the DDT that might otherwise be sprayed on 0.4 km2 of cotton in a season5. Compared with its agriculture uses, public health uses of DDT are too trivial to merit banning with any urgency.
Tonic...or toxin?
Environment aside, health considerations arise, and with them the dilemma that one man's benefit is another man's risk. Environmentalists in rich, developed countries gain nothing from DDT, and thus small risks felt at home loom larger than health benefits for the poor tropics. More than 200 environmental groups, including Greenpeace, Physicians for Social Responsibility and the World Wildlife Fund, actively condemn DDT for being "a current source of significant injury to...humans."6 But five decades of experience with DDT shows that it is highly effective and safe when deployed in house spraying7.
...
But despite 'resistance' in itself, DDT still works to alleviate mortality and morbidity. Resistance tests work by measuring whether mosquitoes survive a normally toxic dose of DDT. The tests wholly overlook two non-toxic actions of DDT: contact-mediated irritancy9, which drives mosquitoes off sprayed walls and out of doors before they bite, and volatile repellency10, 11, which deters their entry in the first place. Both actions disrupt human−mosquito contact and disease transmission.
Data from the Pan-American Health Organization show a strong inverse correlation between malaria cases and rates of spraying houses (1959−1992) in South America, even after DDT resistance became widespread in the 1960s ( Fig. 1). Here, 'cumulative cases' represent the population-adjusted, 'running' total of cases that exceed or fall short of the average annual number of cases from 1959 to 1979 (years in which World Health Organization strategy emphasized house spraying12). Cumulative cases increase considerably in later years, coincident with a sharp decrease in rates of spraying houses.
This body of evidence is so indisputable that even environmental groups such as Physicians for Social Responsibility concede that DDT is "highly effective" in malaria control15. Campaigning for a DDT ban given this benefit would seem politically difficult unless one alleged even greater health risks associated with its use, which is precisely what environmentalists do. Recent bulletins from Physicians for Social Responsibility and the World Wildlife Fund cite animal studies indicating involvement of DDT in neurological and immune deficits, and epidemiological studies linking DDT to human cancers and endocrine-disrupting effects, such as reduced lactation15, 16.
In this kind of 'balance of risks' paradigm, the evidence must be scrupulously weighed. Although the International Agency for Research on Cancer rates DDT as a possible human carcinogen (along with, notably, several pharmaceutical drugs), not one case-control study of DDT's human carcinogenicity has been affirmatively replicated. Breast cancer furnishes the clearest example: the first study to correlate DDT exposure with statistically elevated risk17 has now failed to be replicated at least 8 times18, 19, 20, 21, 22, 23, 24, 25, and of these later studies, some found exposure to significantly reduce risk24, 25. Much the same can be said of studies indicating involvement of DDT in multiple myeloma, hepatic cancer and non-Hodgkin lymphoma26, 27.
That DDT interferes with maternal lactation is also questionable. The leading study to correlate DDT metabolites in breast milk with unexplained, premature weaning28 does not reach statistical significance unless the data are first 'adjusted' for potential confounders, but the authors did not disclose how their adjustment was done, and other labs have yet to confirm the result28. Lactation's many social, nutritional and cultural influences make inferences difficult, but even if DDT really abridges lactation, the authors found a "lack of any detectable effect on children's health."28
With such weak evidence of harm to human health, one must decide whether to set policy as a precaution and ban DDT based on animal studies. Ordinarily, this makes sense (given the alternative of experimenting on humans with toxins), but not for the spraying of houses with DDT. Acting with precaution because there are risks in animals, and thus denying people the known health benefits of malaria control, is very unethical: house spraying exposes millions of people to DDT, any of whose health can be studied, making extrapolations from animal studies unnecessary. Proper case-control studies should be done before policy is cast in treaty law.
Indeed, if precaution is relevant, it favors spraying houses with DDT, because it is affordable or effective where other interventions may not be. Cost data from India show that, even using DDT alone, the entire national malaria-control budget is sufficient to protect only 65% of high-risk persons. Switching to malathion, the next-cheapest alternative, reduces that coverage to 21%, which leaves 71 million more persons unprotected29. House spraying also has the advantage that it protects whole families, which is sometimes overlooked in comparing it with insecticide-treated bed-nets, which protect only one or two people at a time30. Simply put, there are too few economic studies to determine with certainty whether bed-nets are more or less cost-effective than DDT house spraying31. However, the fact that spraying houses with DDT can lower the prevalence of malaria parasitemia in highly endemic African communities to levels below that achieved by bed-nets (less than 5%) indicates that it is careless to treat them interchangeably8.
Patience in all things
How then to reconcile DDT's 'Janus-faced' character? Its benefit in alleviating the suffering of malaria, at a reasonable cost, outweighs any reasonable speculation of its health risks. Living with this may not be easy; changing it is harder still.
Above all, rich countries must allow, and even facilitate, poor tropical countries to make choices about DDT freely, and with informed consent. African countries in particular lack the resources to dispatch health experts to the treaty negotiations, and although it provides financial assistance, the United Nations Environment Programme has declined to assist with this, or even to provide a translator when French- and English-speaking diplomats meet to discuss DDT. The resulting lack of knowledge suffocates debate. At worst, threats are used, as Belize learned when the US Agency for International Development demanded that it stop using DDT.
Such arm-twisting is as lamentable as it is effective. Highly indebted poor countries must of necessity rank poverty reduction over environmental orthodoxy, and stimulating growth and foreign investment will require nearly eliminating malaria from economically productive zones. This is essential for development in sub-Saharan Africa, where malaria subtracts more than one percentage point off the gross domestic product growth rate, for a compounded loss (since 1965) now reaching up to $100 billion a year in foregone income32.
Seen in this way, the insistence to do without DDT is 'eco-colonialism' that can impoverish no less than the imperial colonialism of the past did. Sub-Saharan Africa, which never experienced much spraying of houses with DDT, should consider starting this. South Africa, Swaziland and Madagascar, among others, run successful DDT-spraying programs and prove it can be done1, 33.
At present, the United Nations Environment Programme mandate to "reduce and/or eliminate" DDT probably cannot be accomplished safely, without causing extra disease. As 'preachers of precaution', environmental groups and rich country governments should start by committing at least $1 billion annually to roll back malaria in Africa.
THE British Medical Journal has an open access article discussing effort to ban DDT- a ban Lambert repeatedly claimed was never attempted or implemented.
Doctoring malaria, badly: the global campaign to ban DDT
http://bmj.bmjjournals.com/cgi/content/full/321/7273/1403
DDT for malaria control should not be banned
BMJ 2000;321:1403-1405 ( 2 December )
Amir Attaran, director, international health research, a Rajendra Maharaj, deputy director, vector-borne diseases. b
a Center for International Development, Harvard University, Cambridge, MA 02138, USA, b South Africa Department of Health, Communicable Disease Control, Private Bag X828, Pretoria 0001, South Africa
The treaty on persistent organic pollutants---POPs---will be finalised at the United Nations Environment Programme meeting in Johannesburg, 4-9 December. One proposal is to ban DDT, still used by many countries for controlling the mosquitoes that spread malaria. It should not be banned, argue Amir Attaran and Rajendra Maharaj, specialists in malariology and also international development and law---there's no evidence that spraying with DDT harms anyone. The issue is not straightforward, says Richard Liroff, director of the World Wildlife Fund's alternatives to DDT project; the treaty raises a series of equity challenges.
KEY QUOTE FROM THIS PAPER
South Africa illustrates these limitations in practice. Facing pressure from environmentalists, the national malaria control programme abandoned DDT in favour of more expensive pyrethroid insecticides in 1996. Within three years, pyrethroid resistant A funestus mosquitoes invaded KwaZulu-Natal province, where they had not been seen since DDT spraying began in the 1940s. Malaria cases then promptly soared, from just 4117 cases in 1995 to 27 238 cases in 1999 (or possibly 120 000 cases, judging by pharmacy records). Other provinces experienced similar catastrophes, and South Africa was forced to return to DDT spraying this year. It had little alternative: no other insecticide, at any price, was known to be equally effective.
This experience raises a challenging question: if the wealthiest, most scientifically advanced, and least malarious major country of sub-Saharan Africa cannot make do without DDT, how can superendemic and impoverished countries like Tanzania, Congo, or Mozambique do so? Should they be asked to?
We conclude that the public health benefits of DDT amply outweigh its health risks---if, indeed, such risks exist at all. For doctors or their banner groups such as Physicians for Social Responsibility to campaign otherwise is not only wrong but outrageously unethical. Risk-benefit trade-offs are part of public health and medicine, and we would be swift to condemn the malpractice of doctors who would from ideology deny their patients cyclosporin, tamoxifen, chlorambucil, azathioprine, or any other lifesaving drug known to be a human carcinogen.12 The situation with DDT and malaria is hardly different. The public health malpractice of its avoidance must stop.
The second substantive issue that Lambert avoided in discussions with me is the epidemic of malaria that occured after DDT was banned in South Africa in the leadup to the Joberg 200 conference. When DDT was eventually reintroduced the epidemic was bought under control:
S Afr Med J. 2005 Nov;95(11):871-4
Impact of DDT re-introduction on malaria transmission in KwaZulu-Natal.
Maharaj R, Mthembu DJ, Sharp BL.
Malaria Research Programme, Medical Research Council, Durban, South Africa. rajendra.maharaj@mrc.ac.za
OBJECTIVES: To determine whether the re-introduction of DDT in KwaZulu-Natal had any effects on malaria transmission in the province. DESIGN, SETTING AND SUBJECTS: The 2000 malaria epidemic in KwaZulu-Natal has been attributed to pyrethroid-resistant anopheles mosquitoes in the area. Previous studies have shown that these mosquitoes are still susceptible to DDT. To determine whether DDT re-introduction had any impact on malaria transmission in KwaZulu-Natal, the following variables (pre- and post-epidemic) were investigated: (i) the number of reported cases; and (ii) the distribution of Anopheles funestus in relation to the insecticides sprayed. OUTCOME MEASURES: The notified malaria cases and the distribution of A. funestus were measured to determine the effects of DDT re-introduction on malaria transmission. RESULTS AND CONCLUSION: After DDT re-introduction, the number of malaria cases decreased to levels lower than those recorded before the epidemic. A. funestus appears to have been eradicated from the province. The combination of an effective insecticide and effective antimalarial drugs in KwaZulu-Natal has resulted in a 91% decline in the malaria incidence rate. Unfortunately the continued exclusive use of DDT within the malarious areas of the province is threatened by the emergence of insecticide resistance.
Dear Deathbeast,
Perhaps because I do not play bingo, I do not understand what you were doing in this post.
If you would like to write a more straightforward listing of Lamberet's errors and omissions, I would be glad to put it up on Greenie Watch
Cheers
John Ray
jonjayray@hotmail.com
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