Kill Malarial Mosquitoes NOW!

Malaria is transmitted by mosquitoes, which carry deadly protozoa from infected to non-infected people. Killing or repelling malarial mosquitoes has the bonus effect of halting other mosquito borne diseases such as yellow fever and dengue fever. Shortly after the Second World War, DDT was used to eradicate or dramatically reduce malaria in the U.S., Europe, Canada, Australia, Brazil, Sri Lanka, India, and many southern African countries.

In 1971, WHO said DDT is the "major single factor that made the concept of time-limited eradication possible." It recommended continuing insecticide availability, "particularly DDT."  Why? Because sprayed once or at most twice a year on mud and thatch huts and cinderblock homes common in Africa and other poor countries, DDT keeps most mosquitoes from entering, irritates those that do so they rarely bite, and kills most that land on the walls.

DDT both repels AND kills mosquitoes. Even mosquitoes resistant to DDT’s insect-killer properties are repelled from homes and buildings whose walls have been sprayed with the insecticide, thereby protecting all the people therein.

No other pesticide – at any price – is as effective, long-lasting, cost-effective and safe as DDT for killing and repelling malarial mosquitoes. In fact, DDT keeps up to 90 percent of mosquitoes from even entering a home. However, to kill (but generally not repel) DDT-resistant mosquitoes, alternative pesticides like synthetic pyrethroids and carbamates can also be effective.

No anti-malaria vaccine exists today, and there is little prospect of an effective vaccine being available in the next ten years. Until that day, as history has shown, the best way to reduce or eliminate the incidence of malaria is to prevent the disease in the first place, by controlling the Anopheles mosquitoes that carry it. Otherwise, millions more will die, awaiting a vaccine.  Careful spraying of tiny amounts of DDT inside houses in indoor residual spraying programs has been proven to be the most effective way to do this, and thereby reduce the burden of malaria.

Many malarial countries have woefully inadequate healthcare and transportation systems. As a result, many of those in need of treatment go without, and many die. If proper malaria controls were in place, fewer people would be infected, and those that are infected would have a better chance to receive effective drugs.  With improved malaria control and fewer cases, malaria will become a much easier disease to treat, especially when compared to HIV/AIDS or tuberculosis.

The US government promotes the use of anti-malarial drugs and insecticide-treated bed nets.  These have a place in malaria control. But they cannot and should not replace other interventions, such as indoor spraying with insecticides, which have been shown to reduce malaria cases and deaths dramatically.

While insecticide treated nets have a place in malaria control, they often get torn. They only protect one person at a time. People often don’t use them, because the insecticide irritates their skin – or they forget … kick them off when it gets too unbearably hot under the net to sleep …don’t have enough for every family member … or are still doing homework or housework when mosquitoes arrive.

Sleeping under a bed net is nearly impossible during torrid African nights, says Omololu Falobi, a journalist in Nigeria. Use the net anyway, and you get heat rashes all over your face and body.  Most villages have no electricity to power fans or air conditioners, and many of the same environmentalists who oppose pesticides also oppose electricity generation on any scale that would power these cooling systems. Even in cities like Lagos power outages are frequent, rendering fans and AC useless. "Even if you have a generator," says Falobi, "you don’t want to put it on throughout the night, for fear of carbon monoxide poisoning."

Drugs that actually cure malaria (Artemisinin-based) are in critically short supply. USAID hopes to have 55 million pediatric doses by 2006 – for 500 million critically ill malaria patients worldwide. That means 445 million will not even have a chance to get treated.

Drugs designed to prevent (through prophylaxis) the onset of malaria (Chloroquine, Malarone, Doxycycline and others) are likewise inadequate for 2.2 billion people at risk from malaria. In any event, people living in malarial areas cannot take malaria prophylactics over an extended period of time, because of the expense and the side-effects they will suffer.

Only by slashing the number of people getting malaria, can malaria-wracked countries get the best drugs to those who still get sick. To do that, they need insecticides, especially DDT.  DDT and other insecticides helped eradicate malaria in the United States and Europe, saving countless lives. Today, insecticides are still our first line of defense against West Nile virus and other diseases. It is callous and hypocritical for the United States to tell African and other malarial endemic nations that they cannot spray insecticides, when we use aerial and ground spraying every day. Moreover, we spray insecticides directly into the environment, whereas spraying for malaria control only sprays insecticides inside houses.

The USAID once funded very effective indoor residual spraying programs around the world. It can and should revive our once-proud anti-malaria programs.

Used by trained specialists in indoor residual spraying programs, almost no DDT gets into the environment. It’s safe for humans, too. In its latest review of DDT, the National Institute of Environmental Health Sciences admits it cannot prove that DDT harms human health.

DDT junk science drove the world to the brink of imposing a universal ban on DDT via the Stockholm Convention on Persistent Organic Pollutants (POPS). The convention, known as the POPs Treaty, would have made the de facto ban legally binding and permanent. However, conscientious scientists and public health officials rallied to carve out a "DDT exemption" in the treaty. That exemption:

1) restricts DDT use and production to disease vector (e.g. mosquito) control only and does not permit the insecticide’s renewed use for agriculture;

2) requires countries using DDT to follow WHO guidelines for disease/vector control;

3) requires countries to notify the WHO if they use DDT;

4) requires rich countries to pay the "agreed incremental costs" of more expensive alternatives to DDT (this is located elsewhere in the treaty); and

5) encourages rich countries to support research and development of alternatives to DDT.

What the treaty does NOT require is equally important.

1) It does NOT require a country to notify WHO before it sprays DDT; thus, in an epidemic, a country may spray first and report to the WHO later.

2) It does NOT require that a country obtain the WHO’s approval at any time.

3) It does NOT require that poor countries bear the added cost of alternatives to DDT.

4) It does NOT set a deadline by which countries must stop using or producing DDT.

Overall, the world spends about $400 million a year in connection with malaria, most of it US money, but almost none of it is actually goes to killing and repelling mosquitoes.

Thankfully, although signed in 2001 by the Bush Administration, the POPS treaty has not yet been ratified by the U.S. Senate. Therefore, ratification, if it occurs at all, should be conditioned on prior legislation tying US aid monies to DDT deployment for killing and repelling malarial mosquitoes.

Even big media have seen the light on DDT.  In recent years, the New York Times, Washington Times, Newsweek, Forbes, Wall Street Journal, Chicago Sun-Times and other papers have run editorials strongly advocating the use of DDT to control mosquitoes and reduce malaria. The New York Times Magazine, New Yorker, Time, Washington Monthly, Washington Post and numerous other periodicals have carried articles and opinion columns advocating expanded DDT use to combat malaria and save lives.

DDT proponents advocate it primarily for indoor residual spraying on unpainted mud or cinderblock walls, which usually is the most cost-effective way to kill/repel malarial mosquitoes.  This is akin to Americans spraying Raid insect killer on the walls of their homes, though DDT application typically would not involve aerosols and would have to occur far less often. With indoor spraying, there is a vanishingly-small risk that DDT will reach the environment.

DDT opponents, however, downplay or ignore the undeniable disease, disability and death tolls that their anti-DDT policies have wreaked in Africa and other malaria-endemic regions.  They falsely equate indoor residual spraying (IRS) with aerial spraying – which itself involves only hypothetical, unproven risk to birds, and may be cost-effective and appropriate (whatever the insecticide) in swampy areas near population centers. They elevate minor hypothetical environmental risks from pesticides over major, very real human risks that those pesticides would reduce or eliminate.

DDT opponents ignore the fact that Dade County, Florida and numerous other U.S. communities routinely spray insecticides to control mosquitoes and other insects that carry far less lethal diseases, like West Nile virus, or simply prove irksome to residents and tourists. They refuse to acknowledge that, in the wake of Hurricane Katrina, the US government sprayed much of the flooded and devastated areas with insecticides, to halt the spread of insect-borne diseases.

DDT opponents choose birds over little boys and girls, in a false dichotomy that requires the sacrifice of neither. They advocate the development and distribution of vaccines, bed nets and treatment drugs, plus the implementation of sanitation and other programs. But these interventions will likely take decades to become effective, if they ever do so – and during that time malaria will needlessly slaughter millions more people, who would live if their countries could acquire and deploy DDT and other pesticides now.

We recognize that achieving our objective may require aggressive and public discrediting of these institutional opponents of DDT for IRS – who may, even now, be willing to sacrifice the lives of countless millions of men, women and children in Africa and on other continents before the altar of junk science, nature worship and callous eco-imperialism. We will not hesitate to expose these organizations or the individuals who set their policies.

Deploying DDT in developing countries is good for the United States. Cutting malaria and other mosquito-borne disease rates: (1) permits strides in education, individual productivity and economic growth in Africa and elsewhere – reducing foreign aid claims on U.S. politicians and taxpayers; (2) eliminates or quells the kinds of misery and non-productivity that often underlie regional unrest and result in requests for US military intervention, and (3) diminishes the ever-present danger of outbreaks, and even pandemics, of exotic, insect-borne diseases in the United States as a result of global travel by infected persons.

Probably no other single action by the United States has the potential for saving more lives, reducing or eliminating more disease, curtailing more human misery, and promoting greater development and prosperity than support for DDT use to control malaria.

Adding this insecticide to the world’s disease control arsenal, by compelling USAID and other aid and healthcare agencies to support its use, would arguably be the greatest single humanitarian and human rights action taken in the past quarter century. Its potential for changing world perceptions about the United States is likewise extensive.

By contrast, failing to Kill or Repel Malarial Mosquitoes NOW will clearly and inevitably result in the needless sickness of billions of children and parents in Africa and other malaria endemic regions of the world – and the needless deaths of millions. It will be seen by the world as a callous continuation of a DDT ban that Michael Crichton properly called "one of the most disgraceful episodes of the twentieth century history of America."

It is fraudulent science, incompetence and adamant refusal to face reality – rather than deliberate, calculated murder – that has spawned and perpetuated this slaughter. But the death toll equals or exceeds that of the Holocaust (6 million men, women and children) every five years. Since the ban on DDT was first implemented, the body count has surpassed that of all World War II.

2005 ("Malaria infections and deaths plunged 96% in a three-year period," Naik noted, when South Africa combined new Artemisin-based drugs with DDT indoor spraying in KwaZulu-Natal Province, a region the size of Indiana.)