WHO liberalises DDT use in Africa.
1.1 After years of uncertainty about the fate of
DDT use in Malaria control, the statement on 22/06/06 by the WHO
liberalizing the use of DDT in Africa has taken the world,
certainly Africa, by surprise. The statement �calls upon
countries (in the African Region) to build or strengthen
relevant capacities to plan, implement, monitor and evaluate
appropriate Malaria vector interventions, including IRS with
It will be recalled that since the USA banned the
Agricultural use of DDT in 1972 2 and the Stockholm
convention placed DDT among the dirty 12 persistent organic
pollutants, 3 the use of DDT in Malaria Control has
been controversial and uncertain. Countries like South Africa
which could fund it beneficially used DDT at their own expense
4, Donor agencies like the USAID, DFID refused to
give support to poor countries which insisted on DDT use 5.
It is worth noting however that the WHO had never banned the use
of DDT in Malaria control and indeed praised the South African
Malaria control policy which involved Indoor Residual Spraying
of DDT 6. The New Director of the WHO Global Malaria
Control Programme, Dr. Araka Kochi, deserves to be congratulated
by all who care about the lives of Black Africans who are the
worse victims of Malaria illness today.
2.0 Incidence of
2.1 It is often recited without much thought that
1.5-2.7 million people die of Malaria annually 7,
that 90% of these deaths occur in tropical Africa and that
most of the deaths occur among women and children (as if these
were disposable commodities) and that 60% of clinic attendances
in Nigeria is due to Malaria.
2.2 Malaria was endemic throughout much of Europe,
Asia and Africa as early as historians could trace 8.
Though there were mosquitoes in the Americas, malaria was
introduced there by African slaves and their slavers, there
having been no record of Malaria in the �Medical Books� of the
Mayans and Aztecs before then 9. So up to 1951,
Malaria was endemic in parts of every continent of the World.
But in 1952, the USA declared itself Malaria free! 8
3.0 The first
(American) Malaria Eradication Effort
3.1 This declaration was possible because shortly
after World War II, between 1947 and 1952, the USA decided to
eradicate Malaria from its territory by sheer determination
backed by enough money to fight mosquitoes with
DDT and treat Malaria with chloroquine
8. The need to eradicate Malaria was paramount
because the USA appreciated the devastating effects of Malaria
on its military personnel during its Civil War and the
debilitating effects of Malaria on its work force and economy.
In the 18th century a major Malaria epidemic had
spread as far North as Montreal in temperate Canada.8
3.2 The American determination to eradicate Malaria
was a product of its genuine concern for the welfare of its
people and not pay lip service to matters that affect its
strategic interests, matters that affect the lives of its
citizens and its economy. The rapidity with which the USA
converted the discovery of the insecticidal properties of DDT by
Dr Paul Muller of Switzerland in 1939 to its beneficial use,
first to rid its soldiers of Typhus in Italy in 1944 10
and then Malaria eradication from its territory between
1947 to 1952, bears witness to this view.
Second (WHO) Malaria Eradication Effort
The USA experiment to eradicate Malaria was so
successful that the WHO decided to copy the method. In 1955, the
WHO declared an Eight-year Global Malaria Eradication Campaign8
that saved 500 million human lives that would otherwise have
been lost due to Malaria 10. DDT was praised in
superlative terms by the American National Academy of Science
3 and declared a miracle pesticide2.
But its very success was to become its doom. Such saving
of so many lives in such a short time in the developing
countries became a problem to the Malthusians 12.
Whereas DDT was beneficially used in parts of Europe, Asia and
Latin America where Malaria was endemic, only three Sub Saharan
African countries were selected for the purpose 11.
Clearly the vast majority of the 500 million lives saved were
not Africans. This discriminatory use of DDT explains why 90%
of all Malaria illness in the World now occurs in Black
5.0 The fight
against DDT use.
5.1 The declaration of the ban on the use of DDT in
America in 1972 2, twenty years after America was
declared Malaria free, was clearly due to its Agricultural use
which was responsible for the depopulation of birds which in
turn inspired the writing of the then popular book, Silent
Spring by Rachel Carson in 1962 13. The
importance of this book is that it gave birth to the
environmental groups13 who joined forces with the
Malthusians to fight against the use of DDT and created
unprecedented menticide of generations of people against DDT use
to this day 12. Black Africans in Africa who oppose
DDT use are clearly victims of this menticide.
The environmentalist groups gradually took over control
of the WHO Global Malaria Programme and created the Panel of
Experts on Environmental Management, PEEM 3. PEEM
gradually but progressively changed the WHO Vector Biology
Control policy which favoured Malaria Eradication by
moving Malaria control to the Primary Health Care System3
which favoured Malaria treatment over Eradication.
Environmental Care thus became more important than public
Health, malaria treatment became more important than Malaria
Eradication and the yardstick for measuring success was changed
from incidence of Malaria illness to incidence of
deaths due to Malaria. All this was in spite of the well
known Public Health Axiom that Prevention is better than
cure. This is the genesis of Roll Back Malaria Initiative
which was created by a partnership of WHO, World Bank, UNEP, and
UNICEF in 1998 14. This policy was adopted wholesale
and helplessly by African countries at its conference in Abuja
in April 2000. Over the years, Africa had been treating Malaria
with herbs, herbal steam baths and other methods and the fittest
survived. No efforts were made to Eradicate Malaria. Roll Back
Malaria favours treatment over eradication so we must go back to
where we were, to our roots, not make progress!
5.3 A look at the Newspaper summary15 of
the 2007 budget of the Federal Ministry of Health vindicates
this point absolutely. The budget provides funds for the
purchase of new antimalaria drugs and Insecticidal Treated Bed
Nets, not a kobo for larvicidal or other methods of eradication.
Yet it is generally known that the ITNs provided are not
being widely used and their use is not enforceable. Are we
paying lip service to Malaria control? Are we not determined
like the Americans to fight malaria? Are we merely interested in
the business of Malaria control? Spending 60% of the National
Health Insurance Funds on Malaria alone? Recurrently?
(African) Malaria Eradication Effort.
6.1 As of today, ten African countries, mainly in
East and South Africa and adjacent Central Africa, are using IRS
with DDT in an attempt to eradicate Malaria from their
territory. Politically stable North Africa is largely free from
Malaria. Only West Africa and adjacent Central Africa are not
using DDT Indoor Residual Spraying. The pyrethroid insecticides
being used to treat bed nets are up to twenty times dearer than
DDT. So we waste our scarce resources voluntarily whereas India
had to be compelled to do so in 1997 3
6.2 Malaria Eradication or its reduction to
insignificance in Africa is possible. What is lacking is
determination, not even funding. With the creation of
the Suez Canal, Africa is merely an island, albeit a Giant
Island. Unless West Africa and adjacent Central Africa also use
cheap, safe, tested, sustainable DDT to fight Malaria, it will
constitute itself into a breeding ground for reinfesting the
rest of Africa and the World as it did to the Americas. With all
the available experience at our disposal, endless
experimentation at Local Government or State level is merely
As mentioned earlier, Funding problems are
surmountable. The DFID assured me in writing that once the
policy decision to use DDT is made and the WHO agrees, as it has
now done, it will donate funds16. I believe that
other donor agencies will do the same. Indeed the Millennium
Development Goals demand their cooperation. Further, I believe
that the environmentalists will come round to support IRS with
DDT once agricultural use can be controlled. Besides, it is in
the interest of Europeans and Americans to rid Africa of
Malaria. REID, et al 7 report that many English
visitors to Tropical Africa return home to suffer from kidney
complications, die or be treated at great costs. Africa is the
continent of the future and the world cannot do without Africa.
At the country level, it will be a sad day for Africa if
Nigeria with its size and influence refuses to use DDT when
others do so. Nigeria cannot be isolated from the rest of
for success of the Africa Malaria Eradication Effort
7.1 True friends of Africa and the Scientific Community
are invited to sincerely fight Malaria here on this planet as
they find their way to Mars. The fear of population growth
should not deter them. Let Africa use the same methods of
population control as the rest of the World.
The United Nations must go further to make the use of DDT in
Malaria control an African Union policy 17 and not
leave it to the financial constraints or whims and caprices of
each country. African Malaria eradication programme needs to be
centrally funded and organized just as the WHO World Eradication
Campaign was. African Malaria eradication success will lead to
World Eradication success as envisaged in 1955.
Lastly, Africa owes a debt of gratitude to all
individuals and groups who have campaigned ceaselessly for the
return of DDT use in Malaria Control. Africa congratulates Dr.
Araka Kochi for his humanity and sensitivity to the efforts and
pleas of all these people.
I thank you
statement on the use of DDT for Indoor Residual spraying in the
22/6/2006, Brazzaville, Republic of Congo
Environmental Protection Agency, DDT Ban Takes Effect. Press
R, DDT and Malaria Control, Past, Present and Future. 21st
Century Science and Technology Magazine 2002,
Tren, Richard; Bate, Roger: South Africa�s
War Against Malaria, Lessons for the developing world. Policy
Analysis No. 513. 25/3/2004. Cato Institute,
Bate Roger, How Good Intentions Kill.
Banning the use of DDT would cost lives and wealth in the
developing world. Africa
fighting malaria 8/12/00; South Africa,
DDT and Malaria Euro Chlor, Fact Sheet. 2002, http//www.eurochlor.org
Reid A.J.E, Whitty C.J.M, Ayles H.M,
Jennings R.M, Bovill B.A, Felton J.M. Malaria at Christmas:
risks of prophylaxis versus risks of malaria British medical
Journal. 1998; 317 1506-8,
Pautian Timothy, The World-Wide Malaria
Eradication Effort. Science Education 2000,
Desowitz Robert S. The History of Malaria.
The Malaria Capers 1991; W.W Norton & Company, New York,
Gordon, Mosquitoes, DDT and Human Health, 21st
Century Science and Technology Magazine. (Fall 2002),
Quoted in Grott, Gerald J, Reviewing DDT.
Mazel. Bring Back DDT, and Science with it (Editorial) 21st
Century ScienceTechnology Magazine
Al Gore, Introduction, Silent Spring by Rachel Carson
Meeting the Malaria Challenge. Africa Health 2001;23 (6)
Newspapers, 14/10/2006; 10.
Eradicating Malaria by the use of DDT, 2004.
Global Press Abuja
M. O. Offoboche, OON,
FRCOG, FICS, FWACS, FMOG
America and Malaria
Dr. Arata Kochi�s admission of WHO Malaria �policy mess� is
refreshing. He must be congratulated for his courage in
addressing the �green opposition� to the use of DDT in malaria
control in Africa. Since June 2006, Indoor Residual Spraying of
DDT in Africa has been officially allowed under his watch.
Governments and Donor Agencies should now freely support the
widespread use of DDT in Africa. This has been the tested method
of eradicating malaria from the USA and thirty-six other
countries in the world. Its current successful re-run in South
Africa and usage in parts of East and Central Africa testifies
to this. Since stable North Africa is largely free of malaria,
only West Africa and parts of Central Africa need to be
supported in the use of IRS with DDT. It needs to be stated that
DDT may be bad for America now but malaria has always
been worse for Africa.
But malaria will not be eradicated from Africa till the
insidious Malthusian opposition to malaria eradication from
Developing Countries is addressed by the WHO. Indeed, apart from
�green opposition�, the unspoken opposition by the Malthusians
is probably another reason for the �WHO fault� mentioned by Dr.
Kochi. It is also probably responsible for the diversion of huge
donor funds to the purchase of mosquito bed nets the use of
which is unpopular, unenforceable and less effective in the long
The business of Bed Nets is booming at the expense of malaria
control, their purchase is more profitable than their usage. One
technical leadership will be to support research into the
Genetic modification of the DNA of the plasmodium-bearing
mosquito so that it may self-destruct. Surely mosquitoes are
nearer than Mars!
The use of non-governmental organizations rather than Government
organs in the deployment of funds and project execution will
render accountability more easily verifiable. The channel of
Government organs, meaning a country-by-country approach, with
policy inconsistencies and accountability challenges is doomed
to fail. Since malaria eradication from an Island (e.g.
Zanzibar) is relatively easy, Africa for this purpose must be
regarded as a giant island under the control of one supervising
NGO appointed by the WHO with supporting NGOs down the line to
the villages and wards, from the Atlantic Ocean to the Pacific.
Simultaneous Indoor Residual Spraying with DDT in all
sub-Saharan African countries will give the mosquito no quarters
and lessen the incidence of resistance. A ten-year programme of
such activity will free Africa for universal business activities
uninhibited by the fear of malaria illness. It will wipe out 90%
of world malaria problem.
The personal interest shown by Mr. and Mrs. George Bush and
others like Bill Gates means that there is hope yet for African
I thank you.
Matthias Offoboche, OON