AFRO-NETS> Advocates Push for DDT Use to Fight Drug-resistant Malaria

[Claudio Schuftan <aviva@netnam.vn>]

Advocates Push for DDT Use to Fight Drug-resistant Malaria
----------------------------------------------------------
 
[By the way, this is not to support the advocacy of DDT use, per 
se, but rather to underscore the real cost of not having some ef-
fective way of dealing with the mortality and morbidity effects 
of malarial evolution. And global climate change is making the 
patterns of malaria transmission more wide-spread. I've not come 
across any good (ecological) assessment of alternatives and op-
tions in this matter.]
 
http://www.ens-newswire.com/ens/dec2003/2003-12-04-01.asp
 
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 envi-
ronment 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, re-
sulting in more than a million deaths, 90 percent of them in Af-
rica. To explore how malaria can be tackled, the American Enter-
prise Institute (AEI), a conservative think tank, held a confer-
ence at which several speakers called for greater use of DDT.
 
Panelist Amir Attaran of the Royal Institute of International Af-
fairs, a conservative think tank based in London, and AEI visit-
ing fellow Roger Bate agreed that the reintroduction of wide-
spread DDT use to combat malaria infected mosquitoes is key to 
cutting the rate of infection.
 
Illustration omitted: 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)
 
They said that although a measure to ban the use of DDT, citing 
links to cancer and birth defects, at the Stockholm Persistent 
Organic Pollutants conference in 1994 did not pass, use of the 
pesticide declined in subsequent years.
 
By voluntary action, DDT is being phased out for most uses world-
wide under the Stockholm Convention on Persistent Organic Pollut-
ants, 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 se-
verely 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 dele-
gates.
 
The use of DDT in the United States was banned in 1972 because of 
damage to wildlife, but 22 of the worldUs poorest countries still 
rely on DDT to fight malaria because of its effectiveness, af-
fordability and the lack of a cost effective replacement, accord-
ing 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.
 
Illustration omitted: Map shows the incidence of malaria epidem-
ics in Africa over a six year period. (Map courtesy WHO)
 
Multi-drug resistant falciparum malaria is widely prevalent in 
Southeast Asia and South America, according to the international 
health agency. Now Africa, the continent with highest burden of 
malaria is also being seriously affected by drug resistance.
 
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 worm-
wood 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 distrib-
ute 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, coordina-
tor 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 pur-
chase 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 environ-
ment.
 
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 meth-
ods, 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.

--
To send a message to AFRO-NETS, write to: afro-nets@healthnet.org
To subscribe or unsubscribe, write to: majordomo@healthnet.org
in the body of the message type: subscribe afro-nets OR unsubscribe afro-nets
To contact a person, send a message to: afro-nets-help@healthnet.org
Information and archives: http://www.afronets.org