Doctoring malaria, badly: the global campaign to ban DDT
Malaria kills more than one million people every year, yet the United Nations Environment Programme will meet in Johannesburg next week to discuss phasing out DDT, which is still used by many countries to control the mosquitoes that spread malaria. A debate in this week's BMJ considers the merits of such a phase-out.
DDT should not be banned, argue malaria specialists Amir Attaran and Rajendra Maharaj. House spraying with DDT is an inexpensive, highly effective practice against malaria and has been approved by the World Health Organisation. The quantities used are minimal and results in little harmful release to the environment, they say.
Despite extensive scrutiny, there is still no evidence that exposure to DDT is a risk to human health, they say. Alternatives to house spraying are not always possible, particularly in African countries where the health ministry's budget may be less than £3 per person, they add. Public health benefits of DDT amply outweigh its health risks - if, indeed, such risks exist at all, say the authors. They believe that the campaign to ban DDT is not only wrong but outrageously unethical.
Richard Liroff of the World Wildlife Fund believes that the solution lies in promotion of alternative approaches to malaria control, together with a slow phasing out of DDT. Research suggests that exposure to DDT early in life might cause harmful effects, and many alternatives to DDT have already been successfully used for controlling malaria, he says.
The issue of mosquito resistance to alternative chemicals may be a dilemma for some countries, says the author, so the proposed phase-out suggests a series of challenges that must be addressed directly. These include financial and technical assistance from the developed world to enable the poorest countries to shift from DDT and investments in researching and implementing alternatives to DDT. The author believes that a properly constructed phase out of DDT can produce a "win-win" situation for environmental health - achieving protection from both malaria and DDT.
Contacts:
Amir Attaran, Center for International Development, Harvard University, Cambridge, USA
Email: amir_attaran@harvard.edu
Richard Liroff, World Wildlife Fund, Washington, USA
Email: rich.liroff@wwfus.org