Response to "DDT's pesky proponents," by Mara Kardas-Nelson

Jasson Urbach | 24 Apr 2014
Africa Fighting Malaria
Response to "DDT's pesky proponents," by Mara Kardas-Nelson, Al Jazeera, April 21, 2014.

Al Jazeera's report by Mara Kardas-Nelson (DDT's pesky proponents Apr. 21, 2014) rakes over old ground and is replete with misstatements and falsehoods. The piece is only useful as yet another example of the bias in reporting on DDT and insecticides in general.

Kardas-Nelson claims that AFM did not respond to Al Jazeera's request for an interview, yet we have no record of ever being contacted by anyone at Al Jazeera or by Kardas-Nelson.

Kardas-Nelson quotes Ellady Muyambi from Uganda Network on Toxic Free Malaria Control, an anti-insecticide group, who states, "[Uganda's] government first considered DDT after a visit from the non-governmental organization Africa Fighting Malaria". This is false. In 2003, before any AFM staff member ever visited Uganda, the country's then minister of health Brigadier Jim Muhwezi, announced that his government would begin a malaria control program using DDT as one of several interventions against malaria - see: AFM staff only visited Uganda to defend Muhwezi's decision in the face of the outlandish and sometimes inflammatory claims made against the insecticide and the country's malaria control program.

Brig. Jim Muhwezi's decision was grounded in historic and contemporary evidence. DDT has been used successfully to control malaria globally since 1945, eliminating malaria from many countries. South Africa's highly successful reintroduction of DDT in the late 1990s ended a severe malaria epidemic. This success, along with the successful use of DDT in other southern African nations informed the Ugandan Ministry of Health's decision. This same evidence led the US President's Malaria Initiative to fund DDT spraying in Uganda.

In AFM's paper in Research and Reports in Tropical Medicine, we expose the extraordinary attempts of the UN Environment Program and the Global Environment Facility to misrepresent the results of their own insecticide-free malaria control program conducted in Central America. These groups subverted the scientific method of its own program to achieve the results it wanted, promoting the idea that malaria can be controlled without insecticides. This is an extremely dangerous idea for millions of people living at risk from malaria. Yet instead of responding to the content of the research paper, Kardas-Nelson prefers to trash the reputation of the publisher. Kardas-Nelson thereby reveals her unwillingness to engage in any meaningful discussion or debate.

Contrary to Kardas-Nelson's claims, AFM has not promoted DDT as some sort of panacea for malaria, and we have always encouraged the use of other insecticides, and other evidence-based methods of malaria control. In addition we have long argued for investment - both public and private - in the search for new public health insecticides. We have also advocated for improved treatment and diagnosis, conducting research into drug quality and access. Kardas-Nelson ignores all of this, perhaps because it does not fit her narrative.

Kardas-Nelson quotes the WHO's Abraham Mnsava who downplays DDT's role in ridding the United States of malaria. We disagree. While other factors were undoubtedly at play, the massive DDT indoor spraying programs did in fact eradicate the disease and we believe the evidence supports our position. Mnsava also claims that resistance was the main reason WHO halted the use of DDT. Yet any cursory examination of WHO records from the 1970s, 80s and 90s will reveal the pressure placed on the malaria control community by environmentalist groups, activist groups, and some donor nations, such as Sweden and Canada, to halt the use of insecticides in malaria control due to concerns for the environment. Furthermore, Mnsava and Kardas-Nelson could easily consult the vast scientific literature dating back to the 1940s explaining that DDT acts primarily as a spatial repellent, not as a toxicant. The issue of resistance to DDT's toxic action, which arose from its use in agriculture, is largely irrelevant when it acts to keep mosquitoes out of houses and away from people.

Interestingly, Kardas-Nelson ignores the well-documented anti-DDT campaigns of the 1970s by Paul Ehrlich and others in the population control movement. These individuals and groups campaigned against DDT precisely because it was so successful in saving lives. We can only speculate as to why Kardas-Nelson omitted to inform readers about this sinister episode in environmentalism.

The scientific record is clear that DDT has played and continues to play a critically important role in malaria control, saving thousands of lives every year. Despite this, the environmentalist groups that Kardas-Nelson quotes campaign against its use, claiming there are better non-insecticide alternatives and that DDT is harmful to humans. Yet these groups continuously fail to present any credible data that non-insecticidal methods of malaria control work, hence UNEP's attempt to falsify its own data. The environmentalist groups that campaign against DDT are also unable to present any data that would comply with the most basic epidemiological criteria to show a cause and effect relationship between DDT and harm to human health.

Kardas-Nelson and the environmentalist opponents of DDT like to make AFM out to be some sort of Svengali operation, with inordinate influence over policy. This is a useful tactic as it creates an enemy, thereby assisting in fundraising for their causes. It also distracts readers from the flaws in the anti-DDT campaigns. It is, however, a false characterization. The reason that the World Health Organization, the President's Malaria Initiative, the Global Fund, and many African ministries of health support the use of DDT is because of the scientific evidence in its favour.

As an advocacy group, AFM defends the use of DDT and other public health insecticides in the face of well-funded and relentless opposition. Our position, and the positions of those agencies implementing and funding the use of DDT, is grounded in science. The environmentalist groups that oppose DDT ignore the science, and instead rely on cherry picked data, ad-hominem attacks, and smear campaigns to advance their cause. Regrettably children at risk of malaria pay the price.

Kardas-Nelson missed an opportunity for a balanced, informative piece on the role of insecticides in public health programs and chose instead to write yet another smear piece. This is unfortunate as it misleads readers and does a disservice to those millions of people at risk of malaria.