Malaria: Easterly vs Gates

Bill Easterly is on the warpath, accusing Bill and Melinda Gates of using "phony numbers" when they claim small victories in the war on malaria:

False victories can mislead and distract critical malaria efforts. Alas, Mr. and Mrs. Gates are repeating numbers that have already been discredited.

Gates repeated similar numbers at his TED talk:

Bed nets are a great tool. What it means is the mother and child stay under the bed net at night, so the mosquitoes that bite late at night can’t get at them. And when you use indoor spraying with DDT and those nets you can cut deaths by over 50 percent. And that’s happened now in a number of countries. It’s great to see.

So who’s right, Easterly or Gates? Is Gates deluding himself, and not being honest about the weakness of the data? I asked Bill Brieger, who runs the Malaria Matters blog, what he thought of Easterly’s allegations. And he didn’t even need to venture an opinion: he just started pointing me to pretty solid peer-reviewed research.

This paper, for instance, shows bed nets causing a 67% reduction in child malaria deaths in Rwanda, and a 62% reduction in Ethiopia, with similar reductions in infections.

In this paper, which looks at hospital admissions before and after a community-based malaria control program in rural Rwanda, there were 287 admissions due to suspected malaria before the program was introduced, of which 80.4% were confirmed by a lab to be malaria. After the intervention, the number of admissions due to suspected malaria fell to just 150 — and only 48.1% turned out to actually be malaria.

And this paper, looking at Mali, shows a highly effective cure for malaria which also "showed an additional benefit of preventing new infections".

To read Easterly’s blog, you’d think that a couple of WHO reports were all the information in existence on the success or otherwise of reducing malaria. That’s really not true. We’re talking about the poorest countries in the world, here: yes, it’s going to be difficult to pin down accurate nationwide statistics on malaria infection, although the WHO does the best it can. But just because those nationwide statistics aren’t particularly reliable doesn’t mean that anti-malaria campaigns aren’t working. In fact, looking at smaller-scale studies, they’ve been proved to work very well.