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Is DDT the answer to Malaria?

December 21, 2012

The United States and many other countries got rid of malaria using DDT. If it is such an effective tool in the eradication of the disease, why don’t countries in the developing world with malaria use it? The reason is environmental groups lobbied to have it banned based off the belief that it was bad for both the environment and people:

But by then, the tide had begun to turn against DDT. During the 1960s, reports began to emerge of increasing resistance to the drug among insects, probably sparked by its widespread use in agriculture. At the same time, case-detection followed by medical treatment began to emerge as the new model for malaria control. (By 1979, the World Health Organization had formally endorsed this approach over that of preemptive insecticide spraying.) Most important, however, was the publication of Rachel Carson’s book Silent Spring in 1962.

Silent Spring practically launched the modern environmental movement. The Environmental Defense Fund cut its teeth in national politics raising public alarm over–and bringing lawsuits against–DDT use, which in turn pushed the recently created Environmental Protection Agency to hold a series of hearings on DDT. The critics were so successful that, although the administrative judge presiding over the hearings concluded that “DDT is not a carcinogenic hazard to man … DDT is not a mutagenic or teratogenic hazard to man,” the EPA banned it anyway in 1972. (Chemical companies, of course, were more than happy to supply the less practical, more expensive alternatives.) The U.S. ban was a turning point; soon after, anti-DDT sentiment went global. Environmental organizations campaigned against its use abroad, wealthy countries began to restrict funding for DDT projects, and the World Health Organization shifted away from promoting it for public health uses. By 2000, a group of environmental activists, led by the World Wildlife Fund, was promoting a U.N. “persistent organic pollutants” treaty known as the Stockholm Convention, which would have banned DDT worldwide for all uses. Only at the last minute was an exemption added for public health use.

The above quote and the ones that follow come from an article by Alexander Gourevitch. I remember having to read Silent Spring by Rachel Carson for science class in middle school. I remember that it was extremely dry and boring. I also remember DDT being painted in such a horrific light that you couldn’t fault people for being completely scared by its use.

But has DDTS gotten a bad rap? The evidence suggests that this is indeed the case:

Around the same time, the U.S. government launched an ambitious DDT-centered malaria eradication project which by the early ’60s had virtually eliminated malaria from Southern Europe, the Caribbean, and parts of East and South Asia. (In India, for example, annual deaths went from 800,000 to zero.) At the time, DDT was thought to be such an effective and useful substance that in 1948, Muller received a Nobel Prize in medicine. “To only a few chemicals does man owe as great a debt as to DDT,” declared the National Academy of Sciences in a report in 1970. “In little more than two decades, DDT has prevented 500 million human deaths, due to malaria.”

…over the years, mainstream scientific opinion has absolved DDT of many of its supposed sins. Indeed, the Stockholm Convention partially backfired because it brought to light a slew of studies and literature reviews which contradicted the conventional wisdom on DDT. Like nearly any chemical, DDT is harmful in high enough doses. But when it comes to the kinds of uses once permitted in the United States and abroad, there’s simply no solid scientific evidence that exposure to DDT causes cancer or is otherwise harmful to human beings.

Not a single study linking DDT exposure to human toxicity has ever been replicated.

Fear of going against the environmental lobby is preventing aid organizations from using and recommending DDT as a safe tool in the Malaria fight:

…It is difficult to get a clear answer from aid agencies why they won’t fund DDT. They may be hesitant because they receive contradictory guidance: National DDT bans conflict with WHO guidelines saying it’s safe and effective, which in turn conflict with Roll Back Malaria’s blueprint for phasing out DDT. Nobody seems to want to stick his or her neck out to clarify things. Most importantly, already-underfunded Western aid agencies are concerned about a backlash if they did fund DDT, since doing so might well provoke the lingering fear of DDT among the citizens of wealthier countries. Several experts told me that they are specifically afraid of tangling with the environmental lobby. When Attaran circulated a letter two years ago protesting a total ban on DDT, the head of Roll Back Malaria excoriated him for undermining RBM’s relations with environmental groups. Attaran, formerly a lawyer for the Sierra Club, thinks the environmentalists should correct the misperceptions they have perpetuated. They should do what “the pharmaceutical [companies] did on access to AIDS medicine in Africa. They did a mea culpa. The environmentalists need to do the same thing.”

In 2010, 219 million people were infected with malaria and 660,000 those died from the disease. According to the CDC, “Direct costs (for example, illness, treatment, premature death) have been estimated to be at least US$ 12 billion per year. The costs are many times more than that in lost economic growth.” DDT has been shown to be an effective tool in the fight against malaria. There is no reason 660,000 people need to die when we have a tool that we know works. However, we continue to spend money on less effective alternatives because we cannot seem to see past the initial reports that DDT is bad and see all the mounting evidence that shows that it is not only safe, but effective.

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