Malaria imposes enormous human suffering and economic costs on many poor countries including Uganda. Globally, malaria infects between 300 million and 500 million people and kills more than two million every year.
Most victims are children: one child dies every 20 to 30 seconds. In Uganda, we lose about 320 people especially children due to malaria every day. The economic injury caused by malaria is enormous: it is estimated to reduce per capita growth by 1.3 percent per annum. The methods of fighting malaria are well known and include indoor residual spraying of insecticides such as Dichloro-Diphenyl-Trichloroethane (DDT) which Uganda is introducing.
DDT was initially used during the World War II to combat mosquitoes spreading malaria, typhus, and other insect-borne human diseases among both military and civilian populations, and as an agricultural insecticide. Inspired by its effectiveness, public health officials used DDT to eradicate malaria from Europe and US. Though today malaria is considered a tropical disease, it was more widespread prior to an extensive malaria eradication program carried out in the 1950s.
Environmentalists oppose DDT use in malaria control. The attacks against DDT began with Rachel Carson's book The Silent Spring, which was first published in 1962. That work popularised the scare about DDT and claimed that its use was having widespread and devastating impacts on wildlife and human health. Despite this scaring publication, to date, no scientific study has proved a case of actual human harm from DDT. Since the discovery of DDT, the only suspected case of a death is of a one year old boy who accidentally consumed an overdose of DDT and paraffin in 1945.
DDT can be applied directly to clothes and used in soap, with no demonstrated ill effects. DDT is administered orally to humans as a treatment for barbiturate poisoning. Although there have been some claims that DDT exposes an individual to cancer, scientists have found no evidence.
Surprisingly, coffee carries a higher risk to cancer than DDT. No study has been able to link DDT use by sprayers with any negative health impact, even though sprayers work with the chemical many hours everyday. In one study, humans voluntarily ingested 35 mg of DDT daily for about two years, and were then tracked for several years afterwards and no elevated risk was observed.
The environmental impact of DDT are also highly questionable. For instance, The Silent Spring alleged that DDT use had led to depletion of bird populations in America but evidence later showed that the bird population had actually increased. The arguments against DDT have largely been political other than scientific. The 1972 edition of The Silent Spring acknowledged that some of the initial assertions were either wrong or exaggerated. Arguably, a poor and sick population is more harmful to the environment than DDT.
What Uganda is proposing is the public health use of DDT through indoor residual spraying, where it is sprayed in small quantities on the inside walls of houses. Suspended DDT is usually sprayed at a concentration of 2 grams per square metre and it adheres better to the non painted walls that characterise most of Uganda's rural houses. This way, DDT does not simply escape into the wider environment and poses no threat to wildlife and plants.
The Stockholm convention allows DDT use for public health measures. The European Union has assured that DDT use will not affect agricultural exports to their markets. WHO has approved. Many countries including South Africa, Swaziland, Mozambique, Zambia, Ethiopia, Eritrea, Mauritius, Morocco and others in and outside Africa are successfully using DDT. Why is Uganda fearful?
Does it have more agricultural exports than South Africa? Why do Ugandans consume apples from South Africa? Let NEMA and Ministry of Health act in the interests of poor Ugandans. Any further delay means more lives lost. Let us use DDT now.
The writer is a medical expert and MP for Kinkizi East in Kanungu