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Article
24 April 2001Printer-friendly versionEmail a friend

Without DDT, malaria bites back

by Roger Bate

Malaria is on the increase in all tropical regions of the planet - especially in Africa. In 2000, the disease killed more than one million people and made 300million seriously ill.

According to Professor Wen Kilama of the African Malaria Vaccine Testing Network in Tanzania, 'Malaria is equivalent to crashing seven jumbo jets filled with children every day'.

Malaria halts economic development, places huge burdens on a country's health resources, and causes massive productivity losses. It also scares away investors from developing countries, who are not keen on having their workforce suddenly become ill and unable to work. Professor Jeffrey Sachs of the Harvard Centre for International Development reckons that the disease destroys around one percent of Africa's wealth every year.

Given the devastating humanitarian and economic costs of malaria, you might expect the international community to be fighting the disease with all its might. But instead, the world's politicians are trying to force developing countries to abandon their best weapon in the fight against malaria - the pesticide dichlorodiphenyltrichloroethane (DDT). The United Nations (UN) is even promoting a treaty that might completely ban the use of DDT across the globe.

Today malaria is a tropical disease, but until the 1920s it was endemic all over Europe and America. Oliver Cromwell died of malaria, and the disease was mentioned (as 'the ague') in eight of Shakespeare's plays. It was a British army major, Dr Ronald Ross, serving in Madras, India, who in 1898 found that the female anopheles mosquito was the disease vector. Ross's discovery led to new, more effective methods to control malaria.

After the Second World War, Europe and North America used DDT to eradicate malaria. The pesticide saved millions of lives by killing the malarial mosquito - but it never had complete success in the world's poorer countries. Then, following complaints from environmentalists in the 1970s, DDT was removed from the malaria control programme in many developing countries - but it continued to be used in more than 20 countries, most of them in Africa.

According to Dr Donald Roberts, professor of medical entomology at the Uniformed Services Hospital of the Health Sciences in Maryland, USA, the huge drop in houses sprayed with DDT has resulted in an average annual increase of 4.8 malaria cases per 1000 of the population in Latin America, from the mid-1980s to the mid-90s.

For the whole of Latin America, a minimum of 1.8million additional cases of malaria were occurring each year up to 1996. Case rates have continued to grow since 1996, and according to Dr Roberts, 'we can reasonably expect that the number of excess cases is now much greater than in 1996'. Only Ecuador, which has continued to use DDT, has seen a reduction in the number of malaria cases in recent years.

Other mosquito-borne diseases are also on the rise. Until the 1970s, DDT was used to eradicate the aedes aegypti mosquito from most tropical regions of the Americas. The reinvasion of aedes aegypti since then has brought devastating outbreaks of dengue fever, dengue hemorrhagic fever, and a renewed threat of urban yellow fever.

Dr Donald Roberts is livid at the 'high pressure tactics of international activist organisations who have forced developing countries to abandon public health uses of DDT', which has caused a colossal public health disaster in Latin America. 'There are annually more than 250,000 cases of dengue fever - a disease which had been eradicated', says Roberts. Worse still is the appearance of a more aggressive strain - dengue hemorrhagic fever - which literally makes its sufferers bleed to death. There were 9129 cases of this disease in 1995 alone.

So given all the human suffering, why is DDT to be banned?

DDT is the totemic baddy of the green movement
DDT is the totemic baddy of the green movement. Suspicions about it caused the first green crusade, inspired by Rachel Carson's Silent Spring nearly 40 years ago. When it was used in vast quantities in agriculture, DDT probably harmed reproduction in birds of prey - but this harm subsequently proved reversible.

After 50 years of study there is not one replicated study that shows any harm to humans at all. And DDT is now only used for vector control, and is only sprayed inside houses. Dr Amir Attaran from Harvard University estimates that the amount of DDT used to spray a few acres of cotton in the USA in the early 1960s would spray all the homes in Guyana of those at risk of malaria - and that such indoor spraying will have 'negligible impacts on the environment'.

Despite the evidence, Greenpeace militants have been protesting to close down DDT's only major production facility in the world, in Cochin, India. The Indian government has given its assurance to Greenpeace that production will cease from 2005. But fortunately, India's National Anti-Malaria Programme has objected to this commitment, because it has used DDT to control vectors since it began its operations in 1953. The government may make an embarrassing but essential U-turn.

In South Africa the government stopped using DDT in 1996 - and since then malaria rates have risen by around 1000 percent, because mosquitoes are becoming resistant to the new generation of pesticides. The parasite that causes malaria is also becoming resistant to drug treatments - and out of sheer desperation, South Africa has returned to using DDT.

As a result, the South African government faced hostility from the United Nations Environment Programme (UNEP), which met in December 2000 in Johannesburg. The country delegates to the Persistent Organic Pollutants Legal Instrument Negotiations (POPs) decided to restrict the use of DDT, and agreed a text which will be discussed again in Stockholm on 22 May 2001, before a final version is agreed and signed.

So it is still possible that the greens will have their ban on DDT. But the case for using DDT for malaria control is overwhelming and will hopefully be maintained by the country delegates whose citizens so desperately need it.

Yet even if a ban is not agreed, the reported restrictions demanded under the existing draft will be onerous for the poorest countries - some of which have health budgets of less than five dollars per person per year. And many countries have been put under pressure from international health and environmental agencies to give up DDT or face losing aid grants. Belize and Bolivia have admitted that they stopped using DDT after giving in to pressure from the US Agency for International Development (USAID).

The result of this is that although more than 20 countries around the world currently use DDT to control malaria, at the last count only 17 asked for an exemption for use under the POPs treaty. No doubt other countries will either not use DDT or use it without reporting it to the UNEP.

Since DDT was reintroduced in South Africa in April 2000, the number of mosquitoes is down. The locals are optimistic that things will now improve. They were not aware of the reason for the removal of DDT, nor are they aware of the debate around whether or not to ban it outright. They are simply a few of the countless millions who are victims of the thoughtless politicking of an environmentalist elite.

It seems outrageous that the Western world can even contemplate imposing a ban on the use of this life-saving pesticide - but that is what may happen, either directly under POPs, or indirectly by donors withdrawing funding from DDT projects.

Dr Roger Bate is a director of the South African NGO Africa Fighting Malaria. His co-authored paper When Politics Kills is published here. An updated version will be available at an Institute of Economic Affairs lecture in London on 21 May 2001. To reserve a place at the lecture, phone +44 (0)20 7799 8900.


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