MdM Talks: Richard Howe on malaria

As with all MdM talks, content should be recognised as the thoughts and opinions of the person with whom I am holding a conversation. Richard Howe first approached me while I was interning at the then World Health Organization (WHO) funded Roll Back Malaria Partnership Secretariat, based in Geneva. MattersduMonde plays host to our interview, and addresses Howe’s view that action to fight malaria has represented ‘a failure of the imagination’.

Richard is the Managing Director of Application Dynamics which he founded some five decades ago. Starting out as an apprentice agricultural pilot (‘crop duster’), Richard moved up through the ranks and aircraft, finally converting nine craft into adult mosquito control spray planes. His company’s control programmes are primarily centred in Florida with existent contracts with Palm Beach County. Having already treated over 42 million hectares, Richard plans to pass on his experience, aerial application methodology and approach to a new generation of pilots who, he hopes, will explore the limits of this technology in conjunction with the application of natural insecticide compounds.

 

Richard, based on your 60 years experience working in this sector, what are the determinants or contributing factors that have most impacted global activity to combat mosquito-borne diseases?

An attempt to eliminate malaria, dengue and lymphatic filariasis, all mosquito vector borne diseases over the past 60 years in developing countries has, by all accounts, been a dismal failure. The reason is, in my opinion, due to a lack of leadership in the Non Governmental Organisation (NGO) community and from WHO.

 

How do you view the latest publication from the Roll Back Malaria Partnership – Action and Investment to Defeat Malaria, 2016-2030 with its adoption of a multi-sectoral approach?

To eliminate these diseases, the WHO recommends a defensive, not an offensive strategy. A study promoted by the WHO at the inception of the Roll Back Malaria campaign on the effectiveness of mosquito nets produced a 25% reduction in infections. Indoor residual spraying was not tested to my knowledge, however, 50% of the biting occurs outdoors, so this method is only 50% effective overall, provided indoor residual spraying is 100% effective, which I seriously doubt.

 

How would you propose amplifying these tools, or what would an offensive strategy comprise?

At this time I would like to propose a new concept: large area aerial application of mosquito control insecticide. Why not go on the offensive and eliminate the cause of these diseases; mosquitoes. The technology to accomplish this [exists], and is used in Florida, USA. It is called a High Pressure Aerosol Generator that operates at 3000 psi (pounds/square inch) and produces an eight micron droplet. This is the ideal droplet size for control of mosquitoes based on operational and laboratory research that goes back to 1944. This technology does not require the use of a large aircraft due to the efficiency of this method. For example, a US $50,000 Cessna aircraft with a 500 pound payload can treat up to one million acres or [approximately] 1500 square miles in one night.

Reproduced with permission from Richard Howe.

Reproduced with permission from Richard Howe.

What about the development of vector resistance, that has been a well-documented [click here for Hemingway, Kelly-Hope & Ranson 2008 study] threat to such strategies?

Another concept available to offset the growing resistance to existing chemical concoctions currently used would be plant based insecticides. There are about 2000 plant species with insecticidal properties. Extracting the active ingredient of the more promising ones could be an answer to the problem of resistance. Some of the compounds have a molecular structure so complex the mosquito will never develop resistance.

 

Why do you think that wide area aerial application technology in conjunction with alternative natural insecticides has only been employed to a limited extent in mosquito vector control programmes?

It has to do with institutional inertia. As a rule, the larger an organisation the more resistant it is to change. These institutions are so lethargic, they eventually become irrelevant. The problem: the nature of WHO leadership. Bureaucrats, medical doctors and academics take the lead in an operational matter. The NGO community is treating the symptoms while ignoring the problem, the mosquito. It is going to take leadership that lives where the rubber meets the road to solve this problem.

 

To make such change at the policy level, there needs to be benefit estimations that will contribute to a decrease in the global burden of disease. Will figures be enough?

I would like to discuss body counts and how accurate they are. The WHO takes great pride in announcing [that] the number of deaths from malaria have been cut in half. I take issue with this statement. It is pretty well established there is no accurate accounting of deaths from malaria in Africa, so how can this estimate be verified. It can’t!

Reproduced with permission from Richard Howe.

Reproduced with permission from Richard Howe.

Any final comments?

In conclusion, [malaria] should have been eliminated years ago for a fraction of the billions of dollars wasted on this effort to date. However, from my perspective, it looks like amateur hour all over again after doing the same thing for 60 years with no success. [So] perhaps it is time to reassess, strategise and start thinking outside the organisational box, to eliminate the problem once and for all time.

Thank you to Richard for his time and contribution. Interview dated October 2015.

 

Image Credit: Chuck Simmins, Flickr.

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