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Copyright 2001, National Review, Inc
May 14, 2001, Vol. LIII, No. 9
ROGER BATE

A Case of the DDTs: The war against the war against malaria

MILITANTS from Greenpeace have been mounting protests in an effort to close down the only major DDT production facility in the world, located in Cochin, India. The protesters won't be getting any support from Jocchonia Gumede, a domestic servant in Johannesburg, South Africa: In the past two years, six of Jocchonia's close relatives have died from malaria. His family lives in northern KwaZulu Natal, where malaria has always been endemic—Jocchonia himself contracted it twice while growing up—and DDT is simply the cheapest and most effective way to combat this dread disease. 

Malaria is now on the increase, not just in Africa but in all tropical regions of the planet. It afflicted well over 300 million people last year, and killed over 1 million. Prof. Wen Kilama of the African Malaria Vaccine Testing Network in Tanzania characterizes the death toll as "equivalent to crashing seven jumbo jets filled with children every day" 

That's a devastating human cost. And it has far-reaching consequences, beyond even the sad plight of the sufferers and the huge burden the disease imposes on health resources. In many countries, the disease is also clouding the long-term economic future: When people are unable to work effectively because of illness, productivity suffers-and this, in turn, scares away investors. Professor Jeffrey Sachs of the Harvard Center for International Development estimates that every year, malaria destroys around 1 percent of the wealth—not just income, but total wealth—of Africa.

Given such devastating human and economic costs, one might expect the "international community" to be fighting malaria with all its might. But the chief effort of the world's politicians has been to try to force developing countries to abandon their best weapon in the fight against malaria—the pesticide dichlorodiphenyltrichloroethane, known commonly as DDT The United Nations is actually promoting a treaty that might ban the use of DDT globally—and on April 18, President Bush agreed to sign the treaty.

This is absurd, because DDT is the proven solution to malaria. Today malaria is a tropical disease, but until the 1920s it was endemic all over Europe and America. Epidemics were found as far north as Archangel in the Russian Arctic Circle, and occurred regularly in Holland and England. After World War II, Europe and North America eradicated it with DDT. The pesticide saved countless millions of lives by killing the malarial mosquito, but it never had complete success in some of the world's poorer countries, because their governments lacked the capacity to implement the necessary spraying programs and removal of mosquito breeding areas; without the appropriate medical and organizational ability, even the best sprays won't be effective in eradicating a disease. Then, in the late 1960s, environmentalists started to complain about DDT, and it was removed from the malaria-control program in many countries; some 20 countries-most in Africa-continued to use it. 

According to Donald Roberts, a professor of tropical public health at the Uniformed Services University of the Health Sciences, the huge drop in the number of houses sprayed with DDT has had severe consequences: From the mid 1980s to the mid 1990s, Latin America experienced an annual increase of more than 1.8 million malaria cases (more than 4.8 per 1,000 people)-and the rate has continued to grow since 1996. Ecuador, however, continued to use DDT, and its malaria rate fell over the period 1988-97. 

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. A new invasion of Aedes aegypti has since brought devastating outbreaks of dengue fever and a renewed threat of urban yellow fever. Roberts says the international anti-DDT groups, with what he calls their "high-pressure tactics," bear some responsibility for this public-health disaster. 

About 40 years ago, suspicions about DDT—inspired by Rachel Carson's book Silent Spring—sparked the first green crusade. When it was used in vast quantities in agriculture, DDT probably did harm reproduction in birds of prey. (This harm subsequently proved reversible.) But after decades of research, there is not one replicated study that shows any harm to human beings at all. Furthermore, DDT is now only sprayed inside houses. Dr. Amir Attaran, a researcher at Harvard's Center for International Development, estimates that the amount of DDT used to spray a few acres of cotton in America in the early 1960s would be enough to spray all the homes in Guyana of those at risk of malaria. Such indoor spraying, he concludes, would have "negligible impacts on the environment." Even Green presidential nominee Ralph Nader has come out in favor of DDT use. 

Undeterred, Greenpeace continues to try to shut down the Indian DDT factory-and, in effect, to prevent some of the world's poorest countries from using the least expensive method of eradicating malaria. A few months ago, the Indian government gave an assurance to Greenpeace that production would cease in 2005-but officials of that country's anti-malaria program, which has used DDT since 1953, objected to this commitment; the government may make an embarrassing but felicitous U-turn. (There is precedent for such a switch. In 1996, South Africa stopped using DDT, and the death rate from malaria rose by around 1,000 percent. In desperation, the country has returned to using the pesticide.) 

There are other pesticides that work against malaria, but they are at least twice-and sometimes up to 20 times as expensive, and none is as effective a repellent. These substitutes are less persistent than DDT-they don't linger in the environment as long-and this is what makes them so attractive to the greens. But when you are using pesticides indoors, a persistent material is better: It means you might have to spray only once a year-and to a poor country, this kind of cost consideration could make all the difference. 

Despite these basic facts of science and economics, international-pesticide treaty negotiators decided last December to restrict the use of DDT Their decision is not final; they will meet again in Sweden in May, when environmental ministers are expected to sign a final text. It may get worse between now and then; the negotiators may yet decide to replace the restrictions with an outright ban. But even the restrictions demanded under the existing draft will be onerous for the poorest countries, some of which have health budgets of less than $5 per person per year (rich countries spend well over 400 times this amount on health care). Even worse, many countries have been coming under pressure from international health and environment agencies to give up DDT or face losing aid grants: Belize and Bolivia are on record admitting they gave in to pressure on this issue from the US. Agency for International Development. 

South Africa has asked for an exemption from the DDT restrictions. Jocchonia Gumede reports that the number of mosquitoes is down since DDT was reintroduced in February 2000. He is cautiously optimistic that the situation will improve, but his quick smile belies the anguish that he feels. Jocchonia was not aware of the reason for the removal of DDT, nor is he aware of the debate surrounding whether to ban the substance outright. He is simply one of countless millions around the world whose health and prosperity depend, ominously, on sensible decision- making by global bureaucrats. 

Mr. Bate is a director of Africa Fighting Malaria, a South African humanitarian group, and an adjunct fellow at the Competitive Enterprise Institute. His coauthored paper, "When Politics Kills," is published on www.fightingmalaria.org.




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