Please help us end malaria's global reign of terror (2)
> A principal reason is that far too many global "health" organi-
> zations refuse to fund or even permit or support the use of
> pesticides, especially DDT.
DDT may be used for public health purposes (although importing
nations may refuse to accept goods with DDT residues) and it may
not be appropriate to include WHO and the Roll Back Malaria cam-
paign in your list of 'offending' organizations. Below are two
newspaper stories from South Africa (courtesy of Andy Gray and
the DrugInfo forum).
WHO to push DDT use in new malaria fight
CAPE TOWN * The World Health Organisation (WHO) Roll Back Ma-
laria Programme will unveil a new malaria control strategy on
Sunday clearly endorsing the use of DDT to control mosquitoes,
which carry the often deadly disease.
The organisation said last week it hoped the unequivocal state-
ment would help more African countries to use the pesticide,
which is opposed by environmentalists concerned about its eco-
Between 350-million and 500-million people in more than 100
countries catch malaria each year, according to the WHO and the
United Nations Children's Fund in their World Malaria Report
Although the 2004 Stockholm Convention on Persistent Organic
Pollutants bans agricultural use of DDT worldwide because of its
harmful effects on the environment, it grants exemptions for
public health purposes such as killing malaria-carrying mosqui-
SA, Swaziland and Mozambique are among the countries which use
the chemical, but other African countries have encountered dif-
ficulties when they announced plans to introduce similar pro-
Uganda, for example, ran into opposition from the European Un-
ion, which threatened to ban some agricultural imports if the
country began using DDT to control malaria.
Roll Back Malaria's executive secretary Awa Marie Coll-Seck said
partner organisations such as the World Bank and the Global Fund
to Fight AIDS, Tuberculosis and Malaria supported the use of
"What is clear is that DDT can be used for public purposes, but
this needs to be clarified for countries that want to use it,"
Prof Wen Kilama, African Malaria Network Trust's Managing Trus-
tee, said: "Environmentalists have to remember that we spray
very minimal amounts of DDT on the inside walls of buildings."
Let DDT take care of malaria scourge
Philip Coticelli & Richard Tren
THIS week, the Southern African Development Community commemo-
rates malaria week and, coincidentally, the US congress is de-
bating appropriations for malaria control to be spent by the US
Agency for International Development (USAID). Unless congress
insists on wide-ranging changes to the way malaria control is
conducted, most of the money appropriated will be wasted and Af-
ricans will continue to mourn their children, mothers and fa-
thers for years to come.
USAID has become a magnate of malaria control by virtue of its
deep pockets but has little to show for the millions it spends.
According to the World Health Organisation's Roll Back Malaria
Partnership (RBM), malaria in Africa has increased or remained
the same since 1998. Malaria has risen sharply in several Afri-
can countries despite endless technical advice from USAID, RBM
and other donors.
This is because these organisations single-mindedly focus on
mosquito nets as a prevention strategy. USAID claimed, for exam-
ple, that the distribution of insecticide-impregnated mosquito
nets in Togo and Zambia effectively protected 90% of the recipi-
ent population (a few thousand children). This figure is a prod-
uct of many convenient assumptions: that people stay under the
nets from dusk until dawn; that nets are never torn or misused;
that the nets are annually re-impregnated with insecticide by
their owners, etc. However, only one net per household was given
and USAID admits (in a footnote) that only 56% of those were be-
Mosquito nets alone are insufficient. DDT, a chemical insecti-
cide which kills mosquitoes, was used to eradicate malaria from
the US and western Europe by the mid-20th century, saving untold
numbers of human lives. In 1971, the US banned DDT based largely
on unsound science and scaremongering. Largely for this reason,
DDT is absent from USAID control strategies despite its proven
success. Where DDT was used in Zambia to target malarial mosqui-
toes, reported cases of the disease plummeted 75% in two years.
In SA, DDT was removed from national malaria control strategies
in 1996 to appease environmental interest groups. Cases had in-
creased tenfold by 2000, when the government promptly reintro-
duced the chemical and watched the malaria burden drop nearly
Yet DDT continues to be demonised. Its use in public health pro-
grammes is limited to spraying tiny amounts of the chemical in-
side houses not aerial spraying of agricultural fields as oppo-
nents would have you believe. Spraying it on the inside walls
once a year is sufficient not only to destroy mosquitoes coming
into contact with the chemical, but also to stop mosquitoes from
entering the house. Moreover, DDT has not been linked to a sin-
gle case of human cancer in five decades of use. Perhaps DDT's
adversaries would relent if they, like many African children,
were bitten every night by deadly insects.
DDT remains the cheapest and most effective means of combating
malaria. The US has the money to buy DDT and the political might
to rebrand its image. This is why a coalition of public health
experts and political leaders has signed a declaration to "Kill
Malarial Mosquitoes NOW!", demanding that 66% of the house for-
eign appropriations funding for malaria control be used to buy
DDT. The declaration is being actively circulated, and has so
far been signed by Archbishop Desmond Tutu, a former US Navy
surgeon general, the Congress of Racial Equality chairman, a co-
founder of Greenpeace and the Association of American Physicians
and Surgeons president among others.
If the coalition has its way and USAID reforms itself, many
lives will be saved. The fact is Africa desperately needs DDT.
USAID should buy it.
Coticelli is a researcher and Tren is a director of the health
advocacy group Africa Fighting Malaria.