WHO’s New Guidelines Supporting DDT To Control Malaria Help Reinvigorate Efforts To Control Disease, Kochi Says

The World Health Organization's new guidelines supporting indoor insecticide spraying using the chemical DDT to control malaria are crucial to reinvigorate global efforts to eradicate malaria, according to Arata Kochi, head of WHO's Malaria Department, the New York Times reports. Previously, the agency had recommended that spraying be conducted in regions with seasonal or episodic malaria transmissions, but under the guidelines announced Friday, the agency promotes spraying where chronic malaria transmission causes the most deaths (Dugger, New York Times, 9/16). The agency on Friday also urged countries with malaria control programs to establish clear policies on indoor insecticide spraying using DDT and specify exactly where and how the spraying will be conducted to comply with WHO guidelines, as well as how the countries will support and manage the spraying (GlobalHealthReporting.org, 9/15). WHO anticipates that environmentalists who believe DDT is harmful to humans and the environment will oppose the new guidelines. In an appeal to environmentalists, Kochi on Friday said, "I am here today to ask you, please help save African babies as you are helping to save the environment," He added, "African babies do not have a powerful movement ... to champion their well-being" (Brown, Washington Post, 9/16).

Reaction
Richard Tren, director of Africa Fighting Malaria, said environmental organizations in Africa backed the use of DDT to control malaria (Zabarenko, Reuters, 9/15). However, Paul Saoke, director of Physicians for Social Responsibility in Kenya, in a statement released by the Pesticide Action Network, said, "It is about time the international community focused on combating malaria, but this approach takes us exactly in the wrong direction" (Carter, Washington Times, 9/16). Kristin Schafer, program coordinator for Pesticide Action Network North America, said, "While we agree that short-term DDT use may be appropriate in limited cases, we are very concerned that WHO appears to be bowing to pressure from these advocates and backtracking from their commitments to help countries fight malaria without DDT." She added that after Vietnam in 1991 implemented a malaria control program involving drug distribution, insecticide-treated nets and education, but not DDT, malaria-related deaths decreased by 97% and malaria cases decreased by 59% (Lobe, IPS/Mail & Guardian, 9/18). Ed Hopkins, director of the Sierra Club's environmental quality program, said, "Reluctantly, we do support [use of DDT]. Malaria kills millions of people and when there are no other alternatives to indoor use of DDT, and where that use will be well-monitored and controlled, we support it." He also emphasized the importance of safer alternatives to DDT, saying the pesticide "is not a silver bullet to solve this problem" (Reuters, 9/15). Pierre Guillet, WHO specialist for indoor insecticide spraying, called for further research of the pesticide, saying, "We do not feel the product is toxic, but we want to take all necessary precautions" (Washington Times, 9/16). Friends of the Earth and the World Wildlife Fund have suggested they would not oppose WHO's new guidelines (Sherwell, Sunday Telegraph, 9/17).

Editorial, Opinion Piece

• Tren, Business Day: WHO's endorsement of the use of DDT to control malaria is an indication that "policies are improving" in the fight to control malaria, Tren writes in a Business Day opinion piece. "Now is the time for other donors, nongovernmental organizations and the private sector" to endorse the pesticide, Tren says, concluding, "With more than a million preventable deaths every year, there is no time to lose" (Tren, Business Day, 9/18).
  
• Wall Street Journal: It is "nice to see WHO finally come to its senses," according to a Wall Street Journal editorial. There is "no evidence that DDT use in the amounts necessary to ward off malarial mosquitoes is harmful to humans, wildlife or the environment. Period," the editorial says. But there is evidence that "spraying DDT is the best intervention," according to the Journal. "One insecticide won't end malaria," the editorial says, adding, "But by keeping more people alive and healthy, DDT can help create the conditions for the only lasting solution, which is economic growth and development" (Wall Street Journal, 9/18).
  

  Broadcast Coverage
  
  
  APM's "Marketplace Morning Report" on Friday reported on the WHO recommendations. The segment includes comments from Nii Akuetteh, a member of the Scholar's Council at TransAfrica Forum, and Natasha Bilimoria, executive director of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria (Marshall Genzer, "Marketplace Morning Report," APM, 9/15). The complete transcript and audio of the segment in RealPlayer are available online. In addition, NPR's "All Things Considered" on Friday reported on the recommendations. The segment includes comments from Jay Feldman, executive director of Beyond Pesticides; Kochi; and Tren (Silberner, "All Things Considered," NPR, 9/15). The complete segment is available online in RealPlayer.
  
  
  In related news, NPR's "Weekend Edition Saturday" profiled George Moore, a physician who was part of the 1952 U.S. public health service delegation to Nepal. According to NPR, "the first order of business" on the trip was to fight malaria by spraying inside huts with DDT, a process that Moore estimates saved approximately 300,000 lives during his first year in the country. The segment also examines how Moore was able to vaccinate a village population against smallpox without access to refrigeration for vaccines and the necessity of combining medicine with cultural diplomacy (Rosenbaum, "Weekend Edition Saturday," NPR, 9/16). The complete segment is available online in RealPlayer.