PHA-Exchange> Advocates Push for DDT Use to Fight Drug-resistant Malaria

[Claudio]

 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 effective 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 options 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 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.
>
> 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 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 worldUs 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.
>
> Illustration omitted:
>       Map shows the incidence of malaria epidemics 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 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.
>
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