United Press International - Friday, 13 July 2001
Susan Helen Moran, Written for United Press International

Other think tanks, ambivalent about the effects of DDT, however take a more moderate view and emphasize alternative solutions.

"Malaria and the DDT Story," published by the Institute for Economic Affairs in London, says that onerous reporting on pesticide use required by international aid organizations, combined with pressure from environmentalists and others to eventually ban DDT, will lead to an increased death toll and to weakened economies. An estimated 500 million people suffer from malaria and about 2.7 million of those die each year.

The study, co-authored by IEA fellows Roger Bate and Richard Tren, links the recent rise in malaria with the decreased use of DDT over the past several decades.

"Nearly 1 million people in India died from malaria in 1945, but DDT spraying reduced this to a few thousand by 1960," according to Bate. "Today there are once again millions of cases of malaria in India, and over 300 million cases worldwide -- most in sub-Saharan Africa. Cases of malaria in South Africa have risen by over 1,000 percent in the past five years. Only those countries that have continued to use DDT, such as Ecuador, have contained or reduced malaria," he writes.

The study lays responsibility for the rapidly growing malaria problem in part on environmental groups -- such as the World Wildlife Fund and Greenpeace -- and on international aid organizations including the U.S. Agency for International Development (USAID) and the World Health Organization. These organizations have encouraged developing countries to reduce and eventually eliminate the use of DDT for malaria prevention in favor of alternative solutions.

"We (in the West) are very hypocritical," says Dennis Avery, a senior fellow at the Hudson Institute in New York City. "Once we've solved our malaria problem, we tell the developing world they cannot use DDT without losing aid funding. If America was losing 1 million people (to malaria) each year, we would find a way to use (DDT)."

"The American public thinks DDT is dangerous to people, which is entirely untrue," says Avery, a former agricultural analyst for the U.S. State Department.

Over the past few years, however, international aid organizations have cited studies on DDT that, if true, give legitimate cause for concern. In its 1998 and 1999 correspondence with the World Bank regarding an aid proposal for Madagascar, USAID refers to a study that describes possible effects of DDT on humans: "Citizens on the high plateau are required to allow (DDT) application to the inside of their homes for malaria control every year. The chronic human health effects of this chemical can include liver damage, degeneration of the central nervous system, dermatitis, weakness and convulsions.

"Tremors are one of the most noticeable effects of long-term exposure to DDT, even at fairly low concentrations."

But the memo goes on to say: "In spite of these potential problems, no one has monitored or kept systematic records of this or any other pest-management campaign. As a result, little information is available about pesticide impact on human health and the environment in Madagascar."

USAID ended up requesting that the World Bank "assure (DDT) user safety, address storage and handling issues, and most importantly make an effort at addressing the issue of long term use or even single exposures through appropriate studies, (and to inform USAID whether) ... the spraying is only an interior household campaign or if it implies the immediate surrounds as well."

The World Wildlife Fund also approaches the use of DDT cautiously and focuses on DDT's alleged deleterious effects on human health.

"I think most people understand that one cannot ban DDT for malaria control," says Richard Liross, director of Alternatives to DDT, a WWF program. "It would be prudent, however, to lower DDT use for malaria control." Liross proposes that before banning DDT, developing nations must be given "substantial resources to replace it with tools that are as effective."

Other think tanks agree that alternatives to DDT should be pursued, but that many of them remain more costly than DDT, and some are cost-prohibitive. According to an article by Jeffery Sachs at the Harvard Center for International Development: "In Africa ...very poor and malarious countries such as Benin, Ethiopia, Madagascar, Mozambique, Nigeria, Tanzania, the Gambia, and others have annual public-sector health budgets of under $8 per capita. That is not much more than the retail price of a single pill of Lariam, a leading malaria drug, and it is a negligible amount with which poor countries must somehow deal not only with malaria but also with water-borne diseases, AIDS, and other health needs."

To offset the high costs of drugs for malaria and other diseases, researchers at CID have proposed establishing an international vaccine purchase fund to assure pharmaceutical firms of a market if they develop vaccines for malaria, tuberculosis or HIV, the world's three most deadly infectious diseases.

As for the economic costs of malaria, Sachs estimates that lost productivity from malaria costs about 1 percent of Africa's wealth every year and reduces by half the economic growth that would otherwise occur.

"CID's Malaria, Economics, and Human Affairs project investigates the economic consequences of malaria ... and the ways in which economic analysis may be brought to bear in ameliorating the enormous burden of this disease," says a CID Web publication. The project draws upon the input of clinicians, epidemiologists, public health specialists, scientists and economists from across the globe.

In June the Brookings Institution in Washington published "A Patent Policy Proposal for Global Diseases." The proposal states that patent protections could encourage investment in drug research and development for "developing world diseases" that hold back development and economic growth.

"The fact that 99 percent of developing world diseases (such as malaria) occur in low-income countries deters investment in research and development for new drug therapies," writes the author, Jean O. Lanjouw, a visiting fellow at Brookings. This is because the potential return of investment is much lower than for a new drug that cures or treats diseases prevalent in the developed countries.

"Without patent protection in the developing world, there has been little prospect of profit from therapies for these diseases and therefore almost no private investment," she says.

But for Avery, Bate, and Tran, the malaria-DDT policy debate comes down to something less complex than patent rights or economic theories: it comes down to life or death: "If we can conquer malaria -- and then don't -- society will carry the guilt of millions of deaths and tens of millions of pain-ridden, ruined lives," says Avery.

Jennifer Zambone, an environmental policy analyst at the free-market-oriented Competitive Enterprise Institute, voices similar sentiments: "Nearly 3,000 children die of the malaria every day. I think that's a compelling enough reason to use DDT."

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