Africa's other deadly plague: malaria kills one child under age 5 every 30 seconds. DDT stops the disease, but environmentalists still oppose it, despite that controlled use seems harmless to humans

0 Comments | Insight on the News, August 5, 2002 | by Tom Carter

Each year, malaria causes millions of deaths worldwide--many (if not most) of which could have been prevented with limited use of DDT, the chemical insecticide that brings a grimace of horror at its mention. "What you need is a whole set of arrows in the quiver," says Amir Attaran, an immunologist and lecturer at Harvard University's Center for International Development. "Along with mosquito nets, other insecticides and drugs, DDT needs to be one of them."

Attaran, also a lawyer who once worked for Canada's Sierra Club, is leading a worldwide crusade to bring back DDT. People who oppose the insecticide are simply ignorant of the science, he argues. It is safe when used properly, and is cheap and effective.

"Agriculture doesn't need to be using DDT," says Attaran. "Saving children's lives is different. Malaria extracts a really bitter price in human and economic development."

Every year 300 million to 500 million people contract malaria, and more than 2 million--mostly pregnant women and children--die from the mosquito-borne disease. Although malaria is found on every continent and in more than 90 countries, 90 percent of those affected live in sub-Saharan Africa.

It is as deadly, if not more so, than HIV/AIDS (see sidebar) or tuberculosis. Every day, more than 3,000 African children younger than age 5 succumb to the shaking chills, the raging fevers, the drenching sweats and excruciating aches that accompany the infection.

In its later stages, children with malaria go into uncontrollable seizures. A virulent case can kill a child in 24 hours. Despite billions of dollars and decades of research, there is still no vaccine that is good for more than a few weeks.

But scientists almost are unanimous that many of these deaths could be prevented with the use of DDT It is three to five times cheaper than the pyrethroid insecticides prescribed by the World Health Organization (WHO) and the U.S. Agency for International Development (USAID). And it is effective--a few ounces sprayed on the inner walls of a dwelling once a year confers protection. Despite its pariah status, numerous scientific studies indicate that for humans, it is less poisonous than aspirin.

DDT's status as the ultimate icon of environmental evil began with the 1962 publication of Silent Spring by Rachel Carson. At the time, farmers were dumping an estimated 80,000 tons of DDT on fields each year. The chemical washed into rivers and streams and entered the food chain, contaminating the fish that bald eagles and other birds of prey ate and causing their eggs to become too fragile to hold embryos. As a result, the bald eagle was in danger of becoming extinct in the lower 48 states.

By then, DDT had settled in the fat deposits of almost every creature in the animal kingdom, including humans. One study in 1966 found that the average American teen-ager consumed 12.4 milligrams (0.0004 ounces) of DDT a year. Because it was so deadly to many birds, people assumed it had to be bad for humans as well, even if scientific evidence of human toxicity never entered the equation. In 1972, DDT was banned in the United States.

Today, advocates of limited DDT use in the battle against malaria warn against its use in farming. But yearly house-spraying in malaria-prone areas of Asia, Latin America and Africa would cut the toll dramatically, they claim. Indeed, many point to the experiences of South Africa and neighboring Mozambique in dealing with malaria.

For 50 years, South Africa used DDT to control malaria. But in 1996 its new democratic government, concerned about research finding DDT in mothers' breast milk, succumbed to international pressure and stopped using the chemical. Almost overnight, the country's malaria rate jumped from just a few thousand cases a year to more than 50,000, overtaking the number of new cases of HIV/AIDS infection.

Last year (to howls of protest from environmentalists, the WHO and other international agencies), South Africa began indoor residual spraying of house walls with DDT at two grams (0.07 ounces) per square meter (1.2 square yards)--and saw a raging malaria epidemic end in eastern South Africa along the boarder with Mozambique. South Africa is pressing Mozambique to follow suit, but Mozambique wants nothing to do with a chemical that is banned in most of the world.

In Uganda, government scientists and doctors who work to control the nation's No. 1 killer quietly are discussing the reintroduction of DDT. "South Africa has shown there are no problems with DDT as long as it is used only as an indoor spray for malaria and not for agriculture or to control other insects, like cockroaches," says Michael Okia, senior entomologist for Uganda malaria control. He would like to use DDT in areas where malaria epidemics break out like clockwork--during the two rainy seasons each year.

The high cost of alternative insecticides makes inexpensive DDT especially attractive. But there's a catch. International aid agencies, which keep Uganda afloat, could withdraw their financial support if the country reintroduces DDT to save its children. The World Bank recently gave Eritrea $5 million to deal with its rampant malaria rate--but only on condition that it cease using DDT within two years. Likewise, aid to Mozambique remains contingent on its rejection of DDT