Yesterday brought reports that two 11-year-old Boy Scouts in Long Island, N.Y., had been stricken with malaria at a scouting camp. Malaria, once close to eradication, is rare enough in the developed world to make news when it strikes. But in developing Southern nations, this parasitic blood disease has returned with a vengeance. Every year it kills some 2.7 million people and leaves another 500 million chronically ill.
Malaria is carried by mosquitoes, and the most cost-effective weapon against the disease is the pesticide DDT. Yet next week U.N. Environment Program delegates meet in Geneva to vote on whether to ban DDT world-wide. In its haste to save the world from a much-exaggerated threat, the U.N. could exacerbate a real health crisis that already affects the lives of millions of people.
Environmentalists have already had much success in thwarting the use of DDT. In Africa they have hounded chemical manufacturers so that they have been reluctant to make or sell DDT. The result is that the pesticide is unavailable in developing countries such as Tanzania and Botswana. Most South American countries, under continuous pressure from lobby groups such as the International Pesticide Action Network, have also stopped using the pesticide.
The exception is Ecuador. It has increased DDT use since 1993 and has seen a 60% decline in new malaria cases. By contrast, Bolivia, Paraguay and Peru, which stopped DDT spraying altogether in 1993, have seen new cases rise more than 90%.
Environmentalists fear that DDT used in the Southern Hemisphere will somehow drift north and harm wildlife. But malaria control requires only that the insides of houses be sprayed with a small amount of DDT. The amount of DDT a U.S. cotton farmer would have used on a 100-acre crop in 1968 is enough to protect every high-risk house in Guyana for a year or more.
The Malaria Foundation International, a group of more than 350 physicians and scientists who have spent their lives fighting malaria, this week published an open letter to the U.N. delegates urging them not to ban DDT until an alternative is available. It is essential that such a replacement be inexpensive, because many of the afflicted countries are extremely poor.
The World Health Organization's experts and statistical committees have consistently endorsed house-spray methods and recommended DDT as the insecticide of choice. But WHO's leaders have decided to turn their backs on preventive measures. The organization's high-profile "Roll Back Malaria" campaign does not even mention house spraying, preferring to promote the development of new drugs and a vaccine.
Such efforts are embryonic and underfunded. No suitable drug is available, and no commercial company is developing one. The Walter Reed Army Institute of Research, which invented three of the four malaria drugs developed since World War II, now receives only $5 million a year from the U.S. government for malaria-drug work. An effective vaccine is years away. The U.S. Army and Navy, which have the leading vaccine laboratories in the world, together spend another $5 million a year on malaria vaccine research. Even if a successful vaccine were found tomorrow, a vaccination program for the Third World would probably be costly and unrealistic in the short term.
Malaria is an economic disaster, too. For every person who dies of malaria some 200 survivors are burdened by the disease. They cannot work productively, and often need expensive hospitalization. According to a report by South African economist Richard Tren for the Institute of Economic Affairs, malaria may cost Southern African countries more than $1 billion a year--4% of their combined total economy. In South Africa, where malaria rates are up 500% in recent years, the disease kills far more people than AIDS. But South Africans are reluctant to defend chemical pesticides for fear of losing foreign aid, trade deals and political goodwill from First World politicians.
The DDT-malaria issue is a stark illustration of the conflict between the developed and developing world. For the sake of a possible environmental threat to birds of prey in the "civilized" world, millions of people in developing countries are dying. This must stop. The U.N. delegates in Geneva should vote against banning DDT.
Lorraine Mooney is a medical demographer for the European Science and Environment Forum, based in Cambridge, England. She is co-editor of "Environmental Health: Third World Problems; First World Preoccupations" (Butterworth-Heinemann, 1999).
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