The recent announcement from the World Health Organization (WHO) giving DDT a 'clean bill of health' for malaria control has generated dissension and resignations within the agency and sparked protests from environmental health and development experts around the world.

WHO's controversial malaria programme chief Dr. Arata Kochi spearheaded the 15 September press event promoting widespread use of DDT in Africa. Kochi's announcement overstates WHO's actual policies regarding indoor residual spraying, ignores widely accepted scientific evidence of the human health effects of low-level exposure to DDT, and directly undermines the international Stockholm Convention on Persistent Organic Pollutants (POPs treaty). The POPs treaty - supported by PAN and other NGOs around the world, and now ratified by 133 countries and the European Union - calls for the ultimate elimination of DDT allowing interim use in countries that still need it for malaria control while shifting to safer and more effective alternatives.

The misleading signal sent by WHO has already led to adoption of DDT-based malaria control strategies in several African countries not previously using DDT. It has been used by the European Chemical Industry Council to argue against the substitution principle in European policy debates. And it has been touted as a major victory by advocates on the far right, who have for years been aggressively promoting widespread DDT use in Africa for malaria control. Meanwhile, the controversy within WHO and between international agencies continues. So what is behind the recent push for more widespread use of DDT?

Ironically, the so-called 'DDT comeback'was spurred in part by efforts to target it for an international ban under the POPs treaty[1]. Amir Attaran, now a professor at the University of Ottawa, mobilized opposition to its inclusion in the POPs treaty and attacked environmental groups for supporting a global DDT phase-out. During treaty negotiations, the environmental health NGOs (who organized themselves into the International POPs Elimination Network) made clear their recognition of the severity of the malaria crisis in Africa and the need for some short-term use of DDT until safer and more effective alternatives could be put in place. In the end, the POPs treaty targeted DDT for ultimate elimination and brought long overdue attention to the deadly problem of malaria, which had been shamefully neglected by the international community for years.

However, the POPs treaty debate set in motion a campaign to paint environmental groups as racist for promoting the phase out of DDT which was 'saving babies in Africa from malaria'. This campaign has been embraced by a handful of conservative politicians and organizations in the US and is supported by among others Monsanto, the US pesticide company that was one of the original producers of DDT. DDT promoters have mobilized enough political support to pressure the US Agency for International Development to change its policies to include DDT use for malaria control. They may also have influenced the new support for DDT within WHO, and now hope to pressure European policy makers to follow suit.

In addition to the ongoing involvement of Attaran, one of the central US groups driving the DDT promotion effort is the Congress on Racial Equality (CORE). CORE, founded as an advocacy group for African-Americans, played an early leading role in the US civil rights movement. CORE's leaders, father and son Roy and Niger Innis, are known for their controversial stances on racial equality, including Roy's hailing as a 'bold step' the deportation of 50,000 Asians from Uganda by president Idi Amin in the 1970s[2]. CORE's senior policy advisory Paul Driessen has links to several anti-environmental, corporate funded think tanks, including the Atlas Economic Research Foundation, the Committee for a Constructive Tomorrow and Frontiers of Freedom. His 2003 book, Eco-Imperialism: Green Power, Black Death, asserts that environmentalists are directly responsible for poverty in developing countries[3]. In 2005 CORE produced a Monsanto-funded video called 'Voice from Africa' promoting the use of genetically modified crops in Africa[4].

CORE recently established an office in Uganda, which sponsored and organized a pro-DDT rally in Kampala following the WHO announcement. A CORE employee in Uganda, Fiona Kobusingye-Boyne, then attacked both PAN and Physicians for Social Responsibility (PSR) in an editorial in the African Executive Magazine, saying the two organizations 'use myths, scare tactics and outright lies' about the health impacts of DDT to pressure governments in Africa not to use the pesticide[5].

In fact, scientists know much more today about DDT's effects on human health than when its widespread use was banned in the 1970s. One recent study found higher levels of miscarriages among women exposed to DDT, and reproductive disorders associated with DDT are well documented in animal studies[6,7]. Another recent study found developmental delays among babies and toddlers exposed in the womb[8]. Other studies have linked DDT to reduced breastmilk production, premature delivery and reduced infant birthweights[9,10]. DDT is classified by US and international authorities as a probable human carcinogen[11].

These long term health impacts, however, are not immediately evident - unlike the deadly impacts of malaria. Fortunately many countries have developed safer and more effective ways to control malaria that do not force governments to put families at risk of long term health effects from DDT exposure. Vietnam, for example, reduced malaria deaths by 97% and malaria cases by 59% when they switched in 1991 from trying to eradicate malaria using DDT to a DDT-free malaria control programme involving distribution of drugs and mosquito nets along with widespread health education organized with village leaders[12]. A programme in the central region of Kenya is focusing on reducing malaria by working with the rice-growing community to improve water management, use livestock as bait, introduce biological controls and distribute mosquito nets in affected areas[13]. In Mexico and the Philippines, successful national programmes have relied on community- based education, improved sanitation and water controls, better access to health care, treated bed nets and spraying of alternative chemicals[14,15].

What countries fighting malaria need is strong support for effective solutions, not increased reliance on DDT. If those who have been so actively promoting DDT want to truly serve the interests of families and communities in Africa, they will put their resources and energy into addressing the poverty that breeds malaria and promoting safe and effective malaria control solutions. While these approaches may not be as dramatic as widespread house-spraying with DDT, they can be significantly more effective and sustainable and do not further jeopardize communities already facing health risks from malaria.

For more case studies and additional information on malaria control, see PAN North America's DDT and Malaria Resource Center.

1. The treaty targets chemicals that meet certain criteria for toxicity, persistence, bioaccumulation and global transport. The other chemicals on the initial list of 12 include mirex, toxaphene, chlordane, heptachlor, dieldrin, endrin, hexachlorobenzene, dioxins, furans and PCBs.
2. CORE profile at http://www.lobbywatch.org
3. http://www.eco-imperialism.com
4. http://www.coreonline.org/newindex.html
5. 'DDT' Hippocratic Oath Turned Hippocritical?, African Executive Magazine, October, 2006 at www.africanexecutive.com/modules/magazine/ articles.php?article=985&magazine=91
6. Venners SA, Korrick S, Xu X, Chen C, Guang W, Huang A, Altshul L, Perry M, Fu L, and Wang X, Preconception Serum DDT and Pregnancy Loss: A Prospective Study Using a Biomarker of Pregancy, American Journal of Epidemiology, 162(8):709- 716, 2005.
7. Toxicological Profile for DDT, DDE, DDD: Draft for Public Comment, Atlanta, GA: Agency for Toxic Substances and Disease Registry, September 2000, http://atsdr1.atsdr.cdc.gov/toxprofi les/tp35.html; and Orris P, Charsy LK, Perry K and Asbury J, 2000. Persistent Organic Pollutants and Human Health, World Federation of Public Health Associations, USA.
8. Eskenazi B, Marks AR, Bradman A, Fenster L, Johnson C, Barr DB, and Jewell NP, In Utero Exposure to Dichlorodiphenyltrichloroethane (DDT) and Dichlorodiphenyldicholorethylene (DDE) and Neurodevelopment Among Young Mexican American Children, Pediatrics 118(1):233- 241, July 2006.
9. Gladen BC and Rogan WJ, DDE and Shortened Duration of Lactation in a Northern Mexican Town, American Journal of Public Health 85:504-08, 1995.
10. Longnecker MP, Klebanoff MA, Zhou H, Brock JW, Association between maternal serum concentration of the DDT metabolite DDE and preterm and small-for-gestational-age babies at birth, The Lancet, 358:110-114, 2001; and Rogan W and Chen A, Health Risks and Benefits of bi (4- chlorphenyl) 1,1,1-trichloroethane (DDT). Lancet 366:763-73, 2005.
11. DDT is classified as 'reasonably anticipated to be a human carcinogen' Ninth Report on Carcinogens (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program, January 2001) available at http://ehis.niehs.nih.gov/roc/ninth/rahc/ddt.pdf; DDT falls into Group 2B ('possibly carcinogenic to humans') under the IARC Carcinogenicity Classification scheme in Overall Evaluations of Carcinogenicity to Humans, compiled from IARC Monographs Vol. 1-79, available at http://monographs.iarc.fr/ENG/Classification/crthall.php
12. World Health Organization. A Story to be Shared: The Successful Fight Against Malaria in Vietnam, 2000, available at http://www.afronets.org/files/malaria.pdf
13. International Development Research Center. Malaria and Agriculture in Kenya: A New Perspective with Links between Health and Ecosystems. Case Study: Health and Ecosystem Approach. 2003, at http://www.idrc.ca/uploads/ user-S/10530071320Ecohealth_2_Kenya_e.pdf
14. González BF, The Phasing Out of DDT in Mexico, Pesticide Safety News, 2001 Milan, Italy, International Center for Pesticide Safety, 5(2):5, 2001; and Situacion actual de la malaria y uso del DDT in Mexico. Centro Nacional de Salud Ambiental. Centro de Vigilancia Epidemiologica. Secreteria de Salud. Diciembre 2000; and Participación ciudadana y alternativas al DDT para el control del la malaria. Memorias. RAPAM. World Wildlife Fund. Julio 1998. Texcoco, México.
15. Matteson PC, The Philippine National Malaria Control Program, in Matteson PC, ed. Disease Vector Management for Public Health and Conservation (Washington, DC: World Wildlife Fund, 1998).

[This article first appeared in Pesticides News No.74, December 2006, page 4]