CUBA has been in the news lately promoting a new plan to help African countries control and even eradicate malaria. The Cubans propose mosquito larvae control, which they hope will reduce mosquito populations and thereby halt the spread of the disease. The science simply does not support this approach. But with Cuba’s regime trampling the human rights of its own citizens, should we be surprised they don’t really care what might work to save lives in other countries?
Larvicide does have a place in malaria control. Indeed, SA’s world-class malaria control programme uses it in a limited way, in conjunction with other interventions. Larval control requires regular application of chemical and biological insecticides to mosquito breeding sites. But according to the World Health Organisation (WHO), “the consensus among vector control specialists, based on currently available evidence, is that in most situations, larviciding with universal coverage across large areas and populations is unlikely to be feasible”. The WHO says: “In general, larviciding should be considered for malaria control only in areas where the breeding sites are few, fixed and findable.”
The problem in much of sub-Saharan Africa is that breeding pools crop up all the time, in small puddles, river beds, hoof prints, discarded tyres etc. They come and go quickly depending on the rains, and they are all over the place. Larval control may work in urban areas but in most of Africa, malaria is a rural disease. African governments with limited budgets would do well to stick to indoor residual spraying and the use of insecticide-treated nets.
Pundits often excuse Cuba’s atrocious human rights record by explaining that it has a great healthcare system. As if a regular checkup somehow compensates for living on an island prison. They also applaud Cuba for its overseas medical assistance. But Cuban foreign aid in effect amounts to a slave trade in doctors.
Medical missions from Cuba are paid for either by the host country’s government or by donor countries that send funds to the WHO. According to the Wall Street Journal’s Mary O’Grady, “The money is supposed to go to Cuban workers’ salaries. But neither the WHO nor any host country pays Cuban workers directly. Instead, the funds are credited to the account of the dictatorship, which by all accounts keeps the lion’s share of the payment and gives the worker a stipend to live on with a promise of a bit more upon return to Cuba.”
Cuba’s medical personnel are not forced at gunpoint to go on these missions but they often have little choice. As Cuban doctor Antonio Guedes, who now lives in exile in Madrid, told German broadcaster Deutsche Welle: “Whoever does not co-operate may lose his job … or his son will not get a place at university.”
So it’s not exactly mandatory, but it’s not exactly voluntary either and with the state surveillance system, health workers dare not speak out against the regime.
Cuba is one of the world’s most repressive countries. Freedom House ranks it as one of the least free nations. In terms of economic freedom, it is ranked second last, one place ahead of North Korea, by the Heritage Foundation’s 2015 Index of Economic Freedom. Not surprisingly, the average worker in Cuba earns less than $22 (R252) a month.Africa
African nations must reject Cuba’s advances. They already have access to the tools to control malaria: insecticides, bed nets and drugs for treating patients. African countries must continue to strive towards a comprehensive malaria control programme. This requires an understanding of the science of malaria control and investment in healthcare systems. In the long run, economic development will be the major driving factor behind malaria eradication. Most African countries have become more economically free and open over the past decade, and have been rewarded with higher growth and less poverty. We already know what needs to be done and hardly need advice from Cuba’s goons.
MARCH 13 2015. BY JASSON URBACH
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