[Stoves] Off-topic: Bednets and stoves, without the blinders (Re: Andrew, Ron, Roger)
Traveller
miata98 at gmail.com
Sat Dec 17 12:50:28 CST 2016
Andrew: (What remains of you after gnats and midges; hey, my "anger and
scorn" are just humor to me)
(I am adding Ajay Pillarisetti on cc list because Ron brought him in for a
tirade on me yesterday. My response to Ron was off-list, because I don't
think it's worth bickering on this List. Ajay can skewer me online or
offline; I am always happy to be shown up as an ignoramus. "One authority
versus another" is a matter for the courts of law; at least in US,
groupthink is not necessarily law.)
I agree with you "In no way does this detract from the need for cleaner
stoves." I might substitute "cleaner, healthier environments", but that is
a quibble.
The main point is that research like the Malawi/Nepal studies are
irrelevant, GACC's search for "Evidence Base" is smog. Inane quantification
that is devoid of "context" - and happens to be based on dubious data and
methods - is a red herring.
Crispin thinks, "Being 'obvious' might be good enough for some."
But that would threaten the new Lords and Ladies of Poverty - the Academic
Bureaucratic Complex in search of "results" without a theory of change. In
econometrics, it's called Specification Error. There are multiple other
errors in assertions of causality all around.
It's good that customers know what they want, experts be damned.
****************
I may have mentioned treated mosquito nets a long while back because the
basic idea of Disease Control Priority Project - the origin of DALY concept
- was to compare $/aDALY computations. DCPP is now in its third phase
<http://dcp-3.org/>.
I happen to have been peripherally involved with "results based budgeting"
across sectors, including health. While DCPP objectives are laudable, it is
primarily a research enterprise with a lot of questions about data quality,
methods, and usability of results. I forget now when the lingo developed -
I think GBD concept first came in 1990 from Chris Murray and Alan Lopez,
and DCPP may have arisen from it, publishing "Comparative Risk Assessment"
(CRA), which is the basis for DALY computations. Dean Jamieson - then of
the World Bank - advanced the idea of $/aDALY budgeting in World
Development Report 1993
<https://openknowledge.worldbank.org/handle/10986/5976>. My thinking is
Jamieson then went to University of Washington, and ran DCPP. CRA is
probably better characterized as that part of the GBD exercise that seeks
to allocate computed DALYs to various "risk factors".
Those who haven't already might want to read my 25 October 2016 post on
this List - The story of GBD 2010: a “super-human” effort, "a way of life";
still getting away with murder? (Ron: Aren't IHME researchers the ultimate
authority on what they do? Why pick on Crispin and me?)
I read portions of various CRAs. Murray and Lopez edited a volume The
Global Burden of Disease: A Comprehensive assessment of mortality and
disability from diseases, injuries and risk factors in 1990 and projected
to 2020
<http://apps.who.int/iris/bitstream/10665/41864/1/0965546608_eng.pdf>.
Projections for 2020 were pure poppycock. (Webster says the term comes from
Dutch and meant "soft dung". Biomass believers love it.)
I looked into the potential for employing $/aDALY justification for
"stoves" - indeed, LPG cylinders and burners as studied under the Malawi
exercise we have been talking about - back in 2000/1 and dismissed the idea
once I realized the pitfalls of the concept and incredible assumptions
required to defend it.
Ron Larson and I had a series of arguments on the Shell Foundation
Household Energy and Health online dialog in 2001. Unfortunately, I had
done some homework.
Nothing in the last 15+ years has required a change in my view. Unlike the
faithful, who persist in the faith. The search for Holy Grail goes on
forever.
Credulousness is a chronic disease. Just like skepticism.
Back around 2000, de Hollander, et al. wrote:
"The relatively very high disease burden we attributed long term exposure
to particulates was based on the results of only two American cohort
studies, which were not without controversies. Fortunately, a Dutch study
recently confirmed these results. One challenge consists certainly in where
to place the threshold of considering the evidence as too weak as a basis
for burden of disease estimates."
I think the problem persists. The "Integrated Exposure Response" model used
in computing "risk factors" is still, in my view, poppycock if applied to
contexts beyond assumptions.
Yes, Cecil; "context" means everything. EPA/BAMG "box paradigm" is ok only
so long as researchers stay in the box and suffer the smoke inside the box.
It has zero relevance to policy-making. But then, GACC and its funders knew
that; their continued search for "Evidence Base" is an excuse to waste time
and money. Same with ISO/IWA protocols.
Glittering, glitzy razzle dazzle is not necessarily science.
Just because something gets published in Lancet - or by the World Bank Global
Burden of Disease and Risk Factors (2006)
<https://openknowledge.worldbank.org/bitstream/handle/10986/7039/364010PAPER0Gl101OFFICIAL0USE0ONLY1.pdf>
- doesn't mean it's worth attention; the $/aDALY business is - like, um,
tinkering with biomass stoves - a cottage industry, using fuel of
indeterminate quality on open fire in a place closed to experts.
I leave it Gates Foundation to fund research on the intellectual health
consequences of inevitable intellectual smoke generated by WHO/EPA.
I have no shame in saying this because serious science demands more than
just a thick skin. It demands steely eyes and razor tongue; I just happen
to do it in public.
***********
I have written policy notes in support of clean cooking - subsidies for
LPG, electricity, "better stoves" using any fuel, including coal. So my
sympathies with Paul, Ron, Crispin.
I have no gripe with GACC and IHME per se, except for this "stoves and
health" bandwagon of quantifying health benefits in terms of aDALYs.
Ron may remember my aversion to "stand alone" research back 15 years ago.
The Malawi study is indeed an "intervention based research" that I
advocated at the time. Just that it is too late and irrelevant. The
professoriat is doing nothing useful, whether based in Liverpool or
Atlanta.
As far as I can tell, no budgeting of health expenditures (about $8
trillion a year was my guess in early 2014) is yet done on $/aDALY basis.
There is a Malawi Disease Control Priority
<http://dcp-3.org/resources/malawi-dcp2-case-study> exercise, but it
doesn't mean actual budgeting will be done on the basis of it.
The reality is, "even EPI (Expanded Program on Immunization) will suffer *if
the vaccines can be procured but yet there is no money for fuel to
distribute them to health centres o*r for supportive supervision."
Enough said. I have suffered great disillusionment with "results-based
financing" for the health sector in an African country.
Those who think DCPP is the Holy Grail will be disillusioned.
A stove is not a pill. Randomized Controlled Tests to verify health
benefits of "improved stoves" is an inanity. (Will post on the 2012 report
of MIT-Harvard trio separately).
Roger mentions Lords of Poverty
<https://grahamhancock.com/lords-of-poverty/>. It was diatribe of an
ill-informed hack. Hancock ought to have researched the history of US
legislation and budgeting for development aid.
Now we have another set of Lords of Poverty -- in charity foundations that
are opportunities for retired or failed politicians and businessmen (the
Clintons and the Gateses, Tim Wirth, Michael Milliken). A whole industry of
"Results Evaluation" has sprung in the 30-odd years after Hancock ranted
against the finance ministers of the world.
The Malawi-type "stoves and health" studies that do not do stoves and fuels
characterization are epidemiologists' junkets.
---------
> Message: 1
> Date: Mon, 12 Dec 2016 19:12:00 +0000
> From: Andrew Heggie <aj.heggie at gmail.com>
> To: Discussion of biomass cooking stoves
> <stoves at lists.bioenergylists.org>
> Subject: Re: [Stoves] report with disappointing results from cleaner
> cookstoves
> Message-ID:
> <CAPSaZeb=_Fb4p_teY_duzPgMqZpfTi-GfizLLipGb7cBV7A+2Q at mail.gm
> ail.com>
> Content-Type: text/plain; charset=UTF-8
>
> On 12 December 2016 at 17:43, Crispin Pemberton-Pigott
> <crispinpigott at outlook.com> wrote:
> > Dear Friends
> >
> >
> > And Nikhil asks if you are interested in helping the public, who about
> developing and giving out malaria vaccines? Or treated nets which are very
> effective.
>
> I must have missed that in Nikhil's post but yes I was aware that malaria
> is a major problem and I would have no hesitation in sleeping under a net
> treated with DDT if I were at risk and certainly wouldn't want others to do
> without.
>
> However that is not a stoves subject
>
> Andrew
>
>
>
> ------------------------------
>
> Message: 2
> Date: Mon, 12 Dec 2016 13:11:52 -0700
> From: "Ronal W. Larson" <rongretlarson at comcast.net>
> To: Discussion of biomass <stoves at lists.bioenergylists.org>, Andrew
> Heggie <ajheggie at gmail.com>
> Subject: Re: [Stoves] report with disappointing results from cleaner
> cookstoves
> Message-ID: <5B8858E4-0FEF-4AC4-8BA0-C7447CCA0AC0 at comcast.net>
> Content-Type: text/plain; charset="utf-8"
>
> Andrew:
>
> Agreed. But I feel a need to modify your statement a bit - and
> say that not all stove subjects should be on this list - as our charter
> specifically uses the word biomass (in fact the list address is
> ?Discussion of biomass?). The intro material also identifies cookstoves,
> with exceptions (grudgingly?) for biomass heating stoves (and I can?t
> remember when we had any discussion on those). There must be a web site
> for coal burning stoves? There are plenty of places to talk about biomass
> heating stoves.
>
> Since I have introduced the word ?coal?, I apologize - but maybe
> can make amends by showing why we chose twenty years ago to limit the stove
> list to biomass (bringing in a witness - Marshall Ramsey (and Donald
> Trump?) - who puts coal in less than the most positive light):
>
>
>
>
> Ron
> >
> ------------------------------
>
> Message: 3
> Date: Mon, 12 Dec 2016 21:48:57 +0000 (UTC)
> From: Roger Samson <rogerenroute at yahoo.ca>
> To: Discussion of biomass cooking stoves
> <stoves at lists.bioenergylists.org>
> Subject: Re: [Stoves] report with disappointing results from cleaner
> cookstoves
> Message-ID: <49273179.1568959.1481579337745 at mail.yahoo.com>
> Content-Type: text/plain; charset=UTF-8
>
> So 30% malaria thats tragic. That's the reality of being a child born in
> the bottom economic rank of a bottom country. If its that bad you might
> want a smokey stove in the house to drive out mosquitoes and save lives.
>
> If you really want to get angry about any agency exploiting funds its WHO,
> they just keep messing up whether its Ebola in West Africa (the Cubans save
> the day on that one) or more recently Cholera in Congo or in malaria
> control globally. On the malaria front I have been informally working on
> whole plant medicines in West Africa as so many people are resistant to
> anti-malaria drugs in Gambia. WHO only recommends western medicines. Mostly
> they recommend ACT-Arteminisin combination therapy which is having major
> resistance issues. Arteminsin is derived from Artemesia which is bought by
> the pharmaceutical companies from farmers for a pittance. The companies
> extract the arteminsin and sell it back to African's for real money and at
> least until recently WHO was getting a perecentage of ACT sales from the
> pharmaceutical industry. Now it turns out that the Artemesia plant has
> about 60 chemicals that may improve success in acheiving a malaria control
> (some stimulate the immune system to help the recovery). Now it turns out
> it works better than the ACT's that WHO recommends. Check it out here:
> https://malariaworld.org/blog/breaking-news-clinical-trials-
> artemisia-plants
>
> You can just pound or grind up the whole Artemesia plant you can get
> better control for next to nothing and limited potential for resistance as
> so many chemcials are involved. You can also use it with lemongrass tea.
> For tough cases of resistance I use vodka extracts of papaya leaves to
> improve eradication. Anyone working overseas on stoves should consider
> taking artemesia tea as a prophylactic where malaria is present.
>
> In any event what I know is that general rule is that the bigger the
> organization, the less resource efficient they are with funds and the less
> they care about the poor. This is true with UN agencies and NGO's.
>
> It was working in South Sudan that I realized how fully broken the whole
> international development field is with the big money being controlled and
> wasted by the big agencies. It was the most stressful experience ever, not
> the poverty but seeing the agencies eat the money that was destined for the
> South Sudanese ex-combattants desperate to recover from the 30 year war
> with the north.
>
> Its like the old song of Leonard Cohen: Everybody Knows.
> https://www.youtube.com/watch?v=Lin-a2lTelg
> The poor stay poor ...and the rich get rich
>
> A really good read for everyone:
> Lords of Poverty: Power, Prestige and Corruption in International
> Development
> https://www.amazon.ca/Lords-Poverty-Prestige-Corruption-Inte
> rnational/dp/0871134691
>
> ... and the poor stay poor...that's how it goes......everybody knows
> You will find the Lords of Poverty hanging out at the Imperial Hotels of
> the world .... eating the money destined for the poor.
>
> regards
> Roger
>
> ------------------------------
>
> Message: 4
> Date: Mon, 12 Dec 2016 21:53:35 +0000
> From: Crispin Pemberton-Pigott <crispinpigott at outlook.com>
> To: Discussion of biomass cooking stoves
> <stoves at lists.bioenergylists.org>
> Subject: Re: [Stoves] report with disappointing results from cleaner
> cookstoves
> Message-ID:
> <YTOPR01MB02354E7AEC85E3DB30E7CFCDB1980 at YTOPR01MB0235.CANPRD
> 01.PROD.OUTLOOK.COM>
>
> Content-Type: text/plain; charset="us-ascii"
>
> Dear Andrew
>
> >I must have missed that in Nikhil's post but yes I was aware that malaria
> is a major problem and I would have no hesitation in sleeping under a net
> treated with DDT if I were at risk and certainly wouldn't want others to do
> without.
>
> They are not treated with DDT. They are treated with pyrethroids, which
> are natural and grown in Uganda, among other places. This is why I think
> that:
>
> "These nets are dip-treated using a synthetic pyrethroid insecticide such
> as deltamethrin or permethrin which will double the protection over a
> non-treated net by killing and repelling mosquitoes. For maximum
> effectiveness, ITNs should be re-impregnated with insecticide every six
> months. This process poses a significant logistical problem in rural areas.
> Newer, long-lasting insecticidal nets (LLINs) have now replaced ITNs in
> most countries."
>
> For stovers to argue that they provide more health benefit compared with
> nets or pneumonia inoculations they have to come up with provable claims.
>
> Regards
> Crispin
>
>
>
>
>
>
> ------------------------------
>
> Message: 6
> Date: Tue, 13 Dec 2016 12:27:00 +0000
> From: ajheggie at gmail.com
> To: Discussion of biomass cooking stoves
> <stoves at lists.bioenergylists.org>
> Subject: Re: [Stoves] report with disappointing results from cleaner
> cookstoves
> Message-ID: <5qpv4c9lr3eibjmnfkr9em62ja1umbak20 at 4ax.com>
> Content-Type: text/plain; charset=us-ascii
>
> [Default] On Mon, 12 Dec 2016 21:53:35 +0000,Crispin Pemberton-Pigott
> <crispinpigott at outlook.com> wrote:
>
> >They are not treated with DDT. They are treated with pyrethroids, which
> are natural and grown in Uganda, among other places. This is why I think
> that:
>
> My point was I'd rather risk the long term effects of targeted application
> of DDT than increase the risk of malaria, I'd happily use a safer natural
> treatment were it effective and available.
>
> In fact I am old enough to have witnessed and experienced blanket fogging
> of DDT to reduce insect populations and presumably still retain the
> chemical in my fat (unfortunately gnats and midges still like to eat me).
>
> >
> >For stovers to argue that they provide more health benefit compared with
> nets or pneumonia inoculations they have to come up with provable claims.
>
> I don't believe anyone is arguing that, we know cleaner stoves should lead
> to better indoor air quality but the conjecture in this case is that other
> factors are more significant in causing the respiratory problems that they
> overwhelm any contribution cleaner stoves can make.
>
> In no way does this detract from the need for cleaner stoves.
>
> Andrew
>
>
>
> ------------------------------
>
> Message: 7
> Date: Tue, 13 Dec 2016 13:21:32 +0000
> From: Crispin Pemberton-Pigott <crispinpigott at outlook.com>
> To: "ajheggie at gmail.com" <stoves at lists.bioenergylists.org>
> Subject: Re: [Stoves] report with disappointing results from cleaner
> cookstoves
> Message-ID:
> <YTOPR01MB02357C56C02D5C8952F790B1B19B0 at YTOPR01MB0235.CANPRD
> 01.PROD.OUTLOOK.COM>
>
> Content-Type: text/plain; charset="utf-8"
>
> Dear Andrew
>
> I agree with you. Now, how do we substantiate our claims for having an
> impact? Being 'obvious' might be good enough for some.?
>
> The benefit of saving fuel is pretty easy to demonstrate, provided the
> testing context is realistic and the calculation is done properly. The CDM
> funding is only available when the fuel supply is being cut
> 'unsustainably', as defined. There is no (official) interest in saving fuel
> in places with an excessive supply of it.?
>
> So the question arises, what happens if efforts are made to increase the
> supply around Lusaka and the charcoal market is expanded? It would be easy
> to supply that sustainably, it just isn't being done. ?Will that be
> rewarded or penalized?
>
> The Dutch government group DGIS used to have a great concept for selecting
> projects called 'access to modern energy'. If the stove was more 'modern',
> it was supported. That places the user and their perception front and
> centre, instead of an outsider pushing the agenda they happen to have
> funding for. Darfur is a good example. Some families ended up with half a
> dozen different 'improved stoves' or more.
>
> We need a discussion about needs and wants and what a desirable, holistic
> solution would look like.?
>
> Regards?
> Crispin?
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