DDT Revival Advocated to Fight Drug Resistant Malaria

WASHINGTON, DC, December 4, 2003 (ENS) - A body advocating the widespread use of the pesticide DDT to fight malaria flexed its muscle Tuesday at a meeting sponsored by the American Enterprise Institute. A persistent chemical which accumulates in the environment and can disperse over large distances, DDT has been shown to have damaging effects on ecological systems and wildlife, and is associated with cancer in humans.

Over 300 million cases of malaria are estimated each year, resulting in more than a million deaths, 90 percent of them in Africa. To explore how malaria can be tackled, the American Enterprise Institute (AEI), a conservative think tank, held a conference at which several speakers called for greater use of DDT.

Panelist Amir Attaran of the Royal Institute of International Affairs, a conservative think tank based in London, and AEI visiting fellow Roger Bate agreed that the reintroduction of widespread DDT use to combat malaria infected mosquitoes is key to cutting the rate of infection.

At a Ugandan health center, a nurse takes the temperature of a young child with malaria brought by his mother to the center.(Photo (c) WHO/TDR 2003)

By voluntary action, DDT is being phased out for most uses worldwide under the Stockholm Convention on Persistent Organic Pollutants, signed in May 2001, but still awaiting the ratifications of nine countries before it can enter into force.

Meanwhile, the use of DDT has been banned in 34 countries and severely restricted in 34 other countries.

"This whole movement was based on the fears of Western countries who didn't need the chemical anymore," Bate told conference delegates.

The use of DDT in the United States was banned in 1972 because of damage to wildlife, but 22 of the world’s poorest countries still rely on DDT to fight malaria because of its effectiveness, affordability and the lack of a cost effective replacement, according to the World Health Organization (WHO).

Global malaria control is being threatened "on an unprecedented scale" by rapidly growing resistance of Plasmodium falciparum, the causative agent of human malaria, to conventional drugs, WHO says. WHO is the lead agency in the Roll Back Malaria effort, a global partnership to halve the world's malaria burden by 2010.

Map shows the incidence of malaria epidemics in Africa over a six year period. (Map courtesy WHO)

Panel member Mary Ettling, malaria team leader for the U.S. Agency for International Development (USAID), said malaria has become resistant to drugs commonly used to treat it, Ettling noted, for a number of reasons, including the constant mutation of the disease, poor drug quality and lack of information on proper drug usage, and the migration and displacement of people who have the disease.

Ettling also called for a resumption of the widespread use of DDT and more adequate funding to fight the disease.

USAID, she said, is funding projects to discover and dispense new drugs such as combination therapies based on arteminisin, a wormwood derivative, which have proven to be more effective against malaria than the traditional preventative drugs chloroquine and mefloquine.

Bate went further, and in a paper published in connection with the malaria conference, took aim at the World Health Organization and USAID for purchasing drugs such as chloroquinine to distribute in malaria prone countries.

"It's bad enough that the World Health Organization, U.S. Agency for International Development, the World Bank and almost every other aid/development agency will not allow DDT to be bought with their funds to combat malarial mosquitoes," wrote Bate. "Now it appears that its not just political correctness over insecticides that these groups adhere to, but also bad drug practice: the WHO and Global Fund are supplying useless drugs to African nations. This must stop."

Defending USAID, Ettling said the agency supports the development of new policies and strategies for use of the new arteminisin based therapies, as well as the improvement of both public and private health systems.

WHO officials say that the agency distributes the drugs requested by the countries battling malaria. Dr. Allan Schapira, coordinator of WHO's Roll Back Malaria program told the British Medical Journal in November that it would be better if countries asked the Global Fund to Fight AIDS, Tuberculosis and Malaria to purchase artemisinin treatments.

But if all countries asked the fund to pay for artemisinin based combinations, on top of their requests for funding for bed nets and for control of HIV and tuberculosis, "the fund would be in trouble," Schapira said.

WHO does support the use of DDT to control malaria, but only when it is sprayed indoors which minimizes its impact on the environment.

Effective alternatives to DDT do exist but are not affordable for most poor countries, WHO says in its most recent brochure about reducing reliance on DDT. To date, alternative non-chemical methods, such as environmental management and biological control, have been effective only in limited situations, the international health agency says.

"Finding suitable alternatives to DDT will require new strategic partnerships and efforts to support research and field testing," WHO says.