By Ellady Muyambi
Prof. George Kirya ignores evidence from Mexico, Vietnam, and Kenya that shows how malaria can be eradicated without using DDT.
I was compelled to write this article after reading an opinion titled “DDT use would save many lives in Uganda” published in the New Vision of June 27, 2013 by Prof. George B Kirya. I agree with Prof. Kirya that malaria is a major problem in Uganda but I reject his argument that DDT use can help eradicate it. The spiraling death rate from the malaria mortality rates in Uganda and Africa in general are not due to lack of DDT but other factors.
Malaria is not like HIV/AIDS, Ebola or SARS which do not have known cures. It must, therefore, be confronted with the best available technologies and solutions and DDT is not such a solution. Appropriate malaria control measures should be anchored in eliminating
the parasite from the human host while promoting personal hygiene and better sanitation practices. DDT is not a medical intervention and neither a preventive measure. In most cases, it is never advisable to solve a problem with another complex problem. DDT and its metabolites is a known endocrine disrupting chemical (EDC), a persistent organic pollutant (POP), a reprotoxin and a carcinogen. Previous and recent studies conducted in areas where DDT has been used for malaria vector control even at low doses reveal negative human health impacts. DDT use, therefore, will put the health of Ugandans and our already deteriorating environment at a great risk.
Although Prof Kirya and his likes argue that DDT was used to eradicate malaria in the developed world in a global program launched by the World Health Organization (WHO) in 1955, they should know that malaria had already been wiped out in the developed world before the advent of DDT use. In fact, one physician who was working with the Centre for Disease Control (CDC) and was involved in the United States’ DDT spraying campaign remarked that “we kicked a dying dog”. DDT could not wipe out malaria in the developed world due to resistance of the malaria transmitting mosquitoes, concerns about its health and environmental safety as well as problems in administrative, managerial and finance implementation. As such, much attention was put on controlling and treating the disease.
The Stockholm Convention on Persistent Organic Pollutants (POPs), an international agreement aiming at the elimination of organic pollutants which accumulate in the environment, allows the use of DDT indoor residual spraying (IRS) for disease vector control such as malaria vectors only when there are no safe, affordable, effective and local available alternatives. Even then, the use must be in accordance with the World Health Organization (WHO) guidelines. Uganda and more than 170 other countries signed and ratified the Stockholm Convention. But the inventory report by the National Environment Management Authority (NEMA) on POPs reveals that, Uganda has no capacity to use DDT to the standards required by the WHO.
DDT spraying is very expensive. It requires trained personnel, expensive monitoring teams, testing equipments and a special way of disposing its waste. There is no proper technology to dispose of DDT waste in Africa. DDT use is highly suspicious and requires a lot of resources in mobilising and sensitizing the public in order to accept it. In fact, the available experience shows that, during the DDT pilot phase in Oyam and Apac districts in 2008, most people closed their houses and went hiding into the bush. Some other people whose houses were sprayed had to replaster their walls and most of them viewed it as an inconvenience. This therefore means that using DDT will cause social distress among the members of the communities.
Uganda being an agricultural country, using DDT will affect its agricultural and fish export market. Some Uganda exporters had already received warnings. Buyers from the European Union (EU), Japan and United States of America (USA) say they will reject products found contaminated with DDT. Already, over 150,000 certified organic farmers from Oyam and Apac lost their business when a company; Shares Uganda Ltd, withdrew from buying their products when their areas were sprayed with DDT in 2008 and are up to now still languishing in poverty. Despite its small use here in Uganda, DDT continues to leave its footprints not only on our environment but also in our genes as well.
DDT use may have little impact especially where the malaria vector tends to rest and bite outdoors and does not enter houses. DDT is therefore not a “silver bullet” to solve the malaria problem. Case studies from Mexico, Vietnam and recent evidence from Kenya show that malaria can be eradicated without using DDT. These countries focused on informing endangered residents about the threats posed by mosquitoes and the elimination of breeding sites through community work, treatment of stagnant bodies of water (breeding sites) with environmentally friendly products, distribution of bed nets and treatment of the malaria disease itself. Key to success is political will and involvement of the affected communities instead of a top-down approach with DDT. This is what is needed to protect both, people living in malaria affected areas and their natural environment.
In fact, the United Nations Environment Programme (UNEP) and World Health Organisation (WHO) are now hosting a Global Alliance on DDT Alternatives and the DDT Expert Group whose task is to research and evaluate safe, effective, affordable and locally available alternatives to DDT in disease vector control. This trend is what is being advocated for by our organisation, Uganda Network on Toxic Free Malaria Control (UNETMAC) and many other organizations including the Biovision Foundation for Ecological Development.
The writer is the Secretary General, Uganda Network on Toxic Free Malaria Control (UNETMAC)