The DDT ban myth that will not die

A NY Times article on Arata Kochi, new chief of the World Health Organization's global malaria program wrongly stated that DDT was banned and had to be corrected:

An article in Science Times on Tuesday, profiling Dr. Arata Kochi, the new chief of the World Health Organization's campaign against malaria, referred imprecisely to the pesticide DDT, which can kill the mosquitoes that spread the disease. Its use has been banned in many countries for environmental reasons; it has not been withdrawn entirely.

Kochi is shaking things up in the WHO anti-malaria effort:

In January, he attacked the drug industry, naming 18 companies that were selling artemisinin in single-pill form, and giving them 90 days to stop. Monotherapy encourages resistance, and if artemisinin was lost, he said, "it will be at least 10 years before a drug that good is discovered - basically, we're dead."

He got his way and now he's working on other areas:

For example, he wants to standardize mosquito nets so that, instead of a welter of competing styles that must be home-dunked in pesticide, a few makers of factory-coated nets, which kill insects for years longer, are left to compete on price. He dismisses "social marketing," in which nets are branded and sold cheaply instead of being given away, as with an early Bush administration policy that flopped. And, despite the objections of environmentalists, he wants DDT sprayed inside huts to kill mosquitoes where they rest on walls as they wait for dark.

Do you think this will stop folks from claiming that the WHO opposes DDT use?

Also, in the Washington Monthly Joshua Kurlantzick argues that the DDT obsession of many conservatives is a distraction from the use of artemisinin combination therapy (ACT):

Oddly, malaria has become something of a conservative cause celebre in recent years. Sen. Brownback has become a dedicated advocate for combating the disease. At congressional hearings, he and fellow Republican Sen. Coburn display an impressive knowledge of the crisis and the deficiencies of USAID's response. However, apart from a few such thoughtful exceptions, conservative energies have mostly been focused on another supposed solution: the insecticide DDT.

DDT, which helps kill malarial mosquitoes, was sprayed in America to eradicate malaria. But Rachel Carson's vivid portrayal of the horrors wrought by the chemical in her seminal book Silent Spring caused DDT to be banned in 1972, and helped launch the modern environmental movement. For some conservatives, malaria policy has now become an unlikely tool in the anti-environmentalist backlash. The Weekly Standard, The Wall Street Journal editorial page, and National Review have dedicated more than 10 editorials in recent years touting the benefits of DDT (although some conservatives like Bate, Brownback, and Coburn do advocate both DDT and ACT). At malaria hearings for the Senate Foreign Relations committee, Republican members have repeatedly asked why the United States doesn't promote DDT in malaria-stricken nations.

This preoccupation with DDT, however, is largely a distraction. Environmental leaders now agree that the pesticide should be used to combat malaria; few nations in Africa ban it; and USAID has agreed to spray DDT in countries like Ethiopia and Mozambique. What's more, DDT is no silver bullet. Malaria experts agree that it reduces transmission, but emphasize that it must be combined with other interventions, including ACT. The furor over DDT has undoubtedly hampered efforts to provide better access to antimalarial drugs. When another malaria expert met with Senate staffers to discuss malaria in 2004 and 2005, they badgered him about DDT. "I tried to explain the reality," he says, "and people in the U.S. say 'That's not what I was told.'" "DDT has become a fetish," adds Allan Schapira of WHO. "You have people advocating DDT as if it's the only insecticide that works against malaria, as if DDT would solve all problems, which is obviously absolutely unrealistic."

Ultimately, despite the efforts of lawmakers like Brownback, meaningful action on malaria needs White House support. President Bush has certainly been generous with his rhetoric. Last year, he pledged $1.2 billion to the cause, challenging the world to move past "empty symbolism and discredited policies." However, Rep. Tom Lantos pointed out that for the first year, this sum didn't actually include any new money--it simply reallocated previously budgeted funds.

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conservatives (in the US at least) are really fanatical to overturn any advance for humankind, all in the name of "capitalism" (at least their perverted form of capitalism). For example, we have:

1) their zeal to screw up and/or bankrupt any human social welfare programs; whilst making sure corporate/military welfare stays just fine & dandy

2) their screechings of "commie socialism" over everything from benefits to veterans, through public libraries, to funding for the arts

3) of course their zeal to overturn abortion rights and make sure it's only for rich & privileged women (it's the poor women who will go back to the back alleys)

4) even FDR's programs such as Social Security are still slammed as evil socialist welfare which is best left to buying crappy stock market shares...

"In January, he attacked the drug industry, naming 18 companies that were selling artemisinin in single-pill form, and giving them 90 days to stop. Monotherapy encourages resistance,"

Hmmm, wasn't January around the time Tim Curtin et al were braying loudest about the genocidal atrocities of the environmental movement and loudly and sanctimonously accusing people of not caring about Africans'lifes?

I wonder how many of those selfrighteous thunderers knew about the artemisin issue much less did any lobbying about it.

By Ian Gould (not verified) on 30 Jun 2006 #permalink

"Bush administration policy that flopped"

Redundant.

Hmmm, wasn't January around the time Tim Curtin et al were braying loudest about the genocidal atrocities of the environmental movement and loudly and sanctimonously accusing people of not caring about Africans'lifes?

How dare you criticize the right of companies to flood the market with drugs, quickly establishing resistance, thereby requiring new drugs to be developed

By Meyrick Kirby (not verified) on 30 Jun 2006 #permalink

Kochi seems ready to shake things up a bit and it looks like some good news.

Read the Washington Monthly article, doesn't do much for me and leaves a lot to be desired, but it's just a media piece, so no biggie. While I'm not a conservative, I'm not real big on the "these conservatives are worried too much about DDT and distracting from other problems" type meme in it, seemed kinda dumb to me.

Anyway, I just recently returned from a trip to a moderately endemic province in the Philippines. Such a beautiful place, especially their local national forest. *Way* too hot for my liking though...

By cytochrome sea (not verified) on 09 Jul 2006 #permalink

Kind of proves my point, doesn't it? The myth just will not die. Apoorva Mandavilli even manages to contradict herself in [the article](http://news.google.com/news/url?sa=t&ct=:ePkh8BM9E8JmByvQDgNWHLYYCcwXrc…), with this:

>On 2 May, the United States Agency for International Development (USAID), arguably the most powerful donor agency in the world, endorsed the indoor spraying of DDT for malaria control. The World Health Organization (WHO) is set to follow. In its new guidelines, a final version of which is expected to be released later this summer, the WHO is unequivocal in its recommendation of DDT for indoor residual spraying.

and this:

>The WHO recommends 12 insecticides including DDT--which is an organochlorine--six pyrethroids, three organophosphates and two carbamates.

Oh look, the WHO **already** recommends DDT.

No Tim it doesn't prove you point. Quite the opposite. It destroys your point. What is does clearly show is there has been a change of direction in several agencies. Even the title shows your interpretation is wrong.

"DDT RETURNS". Now how can something RETURN if it hasn't gone away?

By David Tribe (not verified) on 31 Jul 2006 #permalink

David, repeating a myth does not make it true. Finding an article that repeats the myth does not make the myth true. The title of the article is wrong.

Here's a challenge for you: find something the WHO has put out saying that they oppose the use of DDT.

The ball's still in your court Tim, to explain why an article titled "DDT returns" does not establish that DDT went away.

You are claiming that an article in a major medical journal is "myth" and the onus is therefore on you to establish the case for it to be a myth. Strong claims require strong evidence.

Merely asserting, as you do, that the article is a "myth", and that it's title is "wrong", when in fact the title covers the main thrust of the article (very ununsual I know, but in this case the article really is about DDT RETURNING), is inadequate and unconvincing reasoning.

In the article itself there is this passage (Arata Kochi is currently director of the WHO's Global Malaria Programme):

QUOTE "USAID never banned DDT outright, for instance, but nor did it fund DDT's purchase--which amounts to the same thing.
For that reason, the May announcement is widely seen as a change in policy even though the agency doesn't position it
as such.
The World Bank went one step further, making the ban of DDT a condition for loans.

The WHO supported the use of bednets dipped in insecticide over indoor spraying, even though malaria rates continued to increase.

DDT was "further ignored and intentionally or unintentionally suppressed," by these agencies, says Kochi.

"People are very emotional about DDT, even within the WHO," Kochi says, adding that much of the reaction to DDT was
a response to political pressure.

Since his arrival at the agency in late 2005, he has pushed for the return of indoor spraying not just to Africa, but wherever malaria continues to be a problem."UNQUOTE

Its worth noting that the phrase about WHO above refers to the WHO passivity in not promoting DDT wall spraying usage additional to insecticide soaked bednets in the face of the fact that

QUOTE "[DDT was] further ignored and intentionally or unintentionally suppressed," by these agencies, UNQUOTE

and noting also that the words in the passage

"even within WHO",

confirm that WHO were very passive about indoor spraying, and that the article is implying that even the WHO are repositioning themselves as a result of Kochi's appointment in 2005.

In this context it becomes clear that the article covers much more the WHO, and that your question about WHO is thus a diversion from the main point - DDT went away, and now returns (thanks to those courageous scientists such as Attaran and Roberts who argued the point against the huge weight of "emotion" and "political" activity referred to in the article ).

Despite noble and good intentions, misplaced emotion and political activity by various NGOS caused, and still causes huge mortality and morbidity in malarial regions which you seem to find difficulty in giving serious attention to. Misplaced emotion is the reason DDT policy went in the wrong direction and now must be reversed, as documented in the article.

Emotion (witness street theatre on the nightly news) is the reason for NGO political power, but the onus is on NGOs to use the power wisely if human misery is the conquence, and not let this emotion cloud their judgement.

By David Tribe. (not verified) on 01 Aug 2006 #permalink