MAIL & GUARDIAN, Johannesburg
SA's
necessary evil
Sarah
Duguid 05 July 2023 07:00
A year
ago in Stockholm an audience of government representatives
and environmental groups applauded enthusiastically as Kjell
Larsson, the Swedish Environment Minister, announced that
a United Nations treaty banning or restricting 12 toxic
chemicals, known as the dirty dozen, had been adopted.
The
ban resulted from years of lobbying by environmental groups
and its success was given added credence: even the United
States, despite dogged rejection of other environmental
agreements, not only signed the Stockholm Convention, but
was instrumental in negotiating it.
By May
this year 151 countries had committed to eradicating the
dirty dozen, leading to an effusive declaration by Klaus
Topfer, executive director of the United Nations Environment
Programme and a driving force behind the convention: "The
Stockholm Convention is clearly one of the greatest environmental
accomplishments of the past decade."
Just
50 years ago, however, millions of Europeans and Americans
owed their lives to one of the outlawed dirty dozen. If
it wasn't for dichloro-diphenyl-trichloroethane (DDT) we
would be living in a very different world.
During
World War II The New Yorker reported that the First Marine
Division had to be pulled from combat and sent to Melbourne,
Australia, to recuperate. Ten thousand of its 17000 men
were put out of action by malaria.
It would
be a "long war" complained General Douglas MacArthur to
Paul Russell, a malaria expert. The army desperately needed
to find a solution if it was to win the war.
Paul
Muller, a chemist, had discovered DDT in the late 1930s
while trying to find a chemical that would protect woollen
clothing from moths. He was testing different powders by
spraying them inside a glass box filled with house flies.
DDT was so effective that even after the box had been scrubbed
clean with acetone, the flies were being killed by miniscule
traces of DDT left behind.
Muller
was working in Switzerland for the JR Geigy company. Excited
by the discovery, Geigy sent 100kg of the white powder to
its New York office. The year was 1942 and the powder was
finally passed on to the US Department of Agriculture's
entomology research station in Orlando, Florida.The
Orlando laboratory had been given the task of developing
pesticides to help the suffering US army.
The
laboratory found that the powder could kill insects four
times more effectively than its next best insecticide. It
pushed ahead with development. After safety tests on humans
caused no ill-effects, the Orlando laboratory had found
its panacea. With the manufacture of DDT kept a closely
guarded secret, it was shipped out in vast quantities to
every Allied theatre.
Spraying
and dusting missions began in earnest. A typhus epidemic
was avoided in Naples after a million people were dusted
with DDT. The US Army Air Force built DDT bombs by attaching
625-gallon tanks to the wings of bombers that sprayed vast
areas in the tropics before troops arrived. DDT ensured
the health and strength of thousands of men who would otherwise
have been rendered unable to fight for up to five weeks.
Such
was the importance and consequence to public health of Muller's
discovery of DDT that scientists could glimpse, for the
first time, the possibility of a world free of insect-borne
disease. In 1948 M?ller was awarded the Nobel Prize.
Riding
the wave of DDT exhilaration, a Global Malaria Eradication
Campaign was started after the war. Instead of piecemeal
efforts by individual countries, mathematical models were
devised and the ambitious global eradication programme was
under way. Malaria was completely wiped out in North America
and Europe within a few years.
At the
time the programme was conceived opinion was divided about
how malaria should be tackled. Was it more effective to
kill the parasite by treating people with drugs or should
the focus be on wiping out mosquitoes?
Social
reformers argued that malaria mainly affected the poor and
that to wipe out the disease social injustices needed to
be removed.
Eliminating
mosquitoes -- known as vector control -- was the American
way. It had its critics, who suggested that global eradication
through widespread spraying was a part of capitalism's fight
against communism. It was an expansionist plan, they said,
that did not take into account the needs of local people.
The
political intricacies of the Cold War also complicated the
programme, but in the end, the American way won and vector
control became the preferred method of eliminating malaria.
Richard
Tren, director of the NGO Africa Fighting Malaria, suggests
that the failure of the global eradication programme was
twofold.
A programme
that relied solely on spraying to kill mosquitoes was folly
-- though spraying programmes reduced the need for drugs
to treat malaria, they should still be part of an eradication
programme, he says. But the greater folly was the unilateral
way in which the West devised the eradication programme
-- it hadn't taken into account the budgets and infrastructure
of developing countries.
South
Africa began DDT spraying for malaria in 1946. Infections
in the Transvaal rapidly dropped to a tenth of what they
had been. Such was the success of DDT that the decision
was taken that it only needed to be used after heavy rainfall.
Complacency was another reason for the programme's failure.
People thought, too soon, that they had won the battle against
the disease.
DDT's
faultless powers were first widely questioned in Rachel
Carson's book Silent Spring, published in 1962 and seen
by many as the foundation of today's environmental movement.
Carson argued that the reckless spraying of DDT on cotton
fields in the US in the Fifties had polluted the water system
and was threatening the bald eagle, the symbol of America,
with extinction.
Scientists
dispute Carson's claims that DDT was responsible for problems
with the bald eagle and have dismissed her book as deeply
flawed. Tren points out that the back cover of the 1972
edition of the book states: "It makes no difference that
some of the fears she expressed 10 years ago have proved
groundless or that here and there she may have been wrong
in detail."
Maureen
Coetzee of the National Institute for Communicable Diseases
in Johannesburg claims studies showed that 90% of the bald
eagles found dead had been killed by gunshots.
DDT
was finally outlawed for agricultural purposes in 1972 in
the US and in 1974 in South Africa.
Malaria
control programmes were still allowed to use DDT because
they only used small quantities of the chemical inside houses.
But gradually, over the years, a swell of opinion against
DDT grew.
Leading
the South African anti-DDT lobbyists was the Poison Working
Group; a coalition between the Endangered Wildlife Trust
and agrochemical companies. The South African government
bowed to the pressure in 1996 and ceased using DDT altogether.
It chose to use the more expensive, but effective, insecticide
group known as pyrethroids.
In 1996
the Department of Health recorded 11000 cases of malaria
in South Africa. In 1997 that figure jumped to 22000. The
figure was alarming but fluctuations occur depending on
rainfall and so the scourge was brushed aside as a temporary
blip. But the figure continued to grow. By 2000, when 62
000 cases of malaria were recorded, the government became
aware that it had the beginnings of a national emergency
on its hands.
Worst
affected was KwaZulu-Natal, where long queues of feverish
patients formed outside hospitals. Manguzi hospital in KwaZulu-Natal,
just 15km from the Mozambique border, had 750 patients but
only 262 available beds. The province was being hit by the
worst attack of malaria since 1931.
The
number of infections was so high, that South Africa ran
out of malaria drugs. Andrew Hunt was a doctor at Bethesda
hospital in Jozini, KwaZulu-Natal, during the epidemic:
"We started treating patients with anything we could get
our hands on. We even used stuff that probably wasn't going
to work. We got used to patients dying. I felt very defeatist.
There was no answer. We were doing everything we could and
the problem was just getting worse."
Keith
Hargreaves, an entomologist at the Malaria Control Centre
in Jozini, began investigating the sudden epidemic. He collected
mosquitoes and, with Coetzee of the National Institute for
Communicable Diseases, began trying to isolate the cause.
To the scientists' surprise the mosquitoes were identified
as Anopholes funestus, a species prevalent in southern Mozambique
and now believed to have spread across the border, causing
South Africa's malaria epidemic.
Of the
thousands of species of mosquito, not all of which spread
malaria, funestus is the most highly efficient transmitter
of the parasite that causes the disease. Unlike most species
it can transmit the parasite in winter. Funestus was still
prevalent in southern Mozambique, but other than an isolated
sighting in Tzaneen in 1975, DDT had wiped it out of South
Africa in the 1950s.
The
scientists also proved that funestus was resistant to pyrethroids,
South Africa's chosen insecticide.
Research
began into compounds that might control funestus. Only DDT
worked.
In early
2000 these findings were sent to the health department in
Pretoria. The government invited the Poison Working Group
to a meeting in KwaZulu-Natal, where an agreement giving
the group assurance of strict controls on the use of DDT
was hammered out.
DDT
was being reintroduced in South Africa just as the international
community was moving to ban it. The health department diverted
disaster funds to malaria control and stockpiles of DDT
were located around the world and shipped to South Africa.
"DDT
is a known risk," says Dr Gerhard Verdoorn, chairperson
of the Poison Working Group, "but eight tonnes in five million
hectares is negligible."
Spraying
with DDT began in May 2000. By that time 330 people had
died from malaria at four hospitals in KwaZulu-Natal. By
2001, after the DDT had started to work, there were 10 deaths
throughout the whole year.
The
facts are indubitable. But the problem isn't doubt surrounding
DDT's efficacy as an insecticide, it is the clash of opinions
on DDT's threat to the environment and human health.
The
outlawed chemicals are known as persistent organic pollutants
(POPs). They are dangerous because they don't biodegrade
easily. In the US an orchid was found to contain 40% of
the DDT that had been sprayed on it 20 years previously.
The
chemicals can also travel long distances. When DDT was being
tested in the US during the 1940s two duck ponds, several
kilometres apart, were chosen as test sites. One was sprayed
with DDT, the other was left untreated. Insects in the treated
pond died immediately, but scientists were baffled to find
that a week later those in the untreated pond had also died.
When the ducks from the first pond went to the second there
was enough DDT residue stuck to their feathers to work effectively.
The
World Wildlife Fund (WWF), an environmental group at the
forefront of the Stockholm Convention, argues that DDT is
such a potent chemical that nobody will be safe as long
as it is being used anywhere in the world.
This
is the concern of Avertino Barreto, Mozambique's deputy
national director of health, epidemiology and environmental
health. Barreto says the World Health Organisation told
Mozambique that it does not promote the use of DDT and that
countries using it must phase it out. His department uses
most of its budget to spray with pyrethoroids and steadfastly
refuses to use DDT.
Last
year Mozambique recorded three million cases of malaria
in its popu- lation of 17-million. In some areas 90% of
children under five are infected and malaria is the leading
cause of death in children. Nevertheless, the health department
says it wants a sustainable and long-term programme and
says it needs $60-million to eradicate malaria.
Mozambique's
health department resents pressure to reintroduce DDT, but
its intransigence is leading pro-DDT campaigners to cry
corruption. Campaigners say somebody, somewhere must be
paying officials to reject DDT and use the agrochemical
companies' new ranges of insecticides.
Whether
the international community is the reason for Mozambique's
reluctance to use DDT or an excuse (perhaps to mask the
sheen of well-greased palms) the decision is costing the
country dearly. Thousands are suffering and dying.
The
country's health department acknowledges that "along with
other illnesses such as Aids, [malaria] very much undermines
economic development and poses a very serious challenge
to the health sector".
The
first cure for malaria, and one that is still widely used
today, was developed by Jesuit missionaries in South America
in the 17th century. They made quinine from the bark of
the cinchona tree.
The
drug was first exported to Europe in the 1630s. Some Protestants
would not take it; they chose to die nobly rather than be
saved by the Jesuit's powder.
A member
of Mozambique's health department was quoted in the press
taking a "if it's not good enough for Europe, it's not good
enough for Africa" line. This is a logic as principled,
and fatally flawed, as that of those early Protestants.
Africa and Europe's need for DDT fall off opposite ends
of the scale. What works in Europe will not necessarily
work in Africa.
Africans
are dying -- unwittingly -- for First World environmental
principles and the WWF slogan "Lets leave our children a
living planet" begins to sound very hollow indeed.
The
US and the other countries involved in drafting the Stockholm
Convention have not produced or used for many years any
of the pollutants listed in the treaty. The US garnered
no more than criticism when it refused to sign the Kyoto
agreement restricting greenhouse gas emissions.
Some
scientists say the threat DDT poses to the environment is
containable and the threat to humans is non-existent. DDT,
they say, is less poisonous than aspirin and less carcinogenic
than coffee.
The
Stockholm Convention on persistent organic pollutants will
not affect Western economies. Tren argues that the treaty
will aid European and American economies. The developing
world still relies on certain POPs, such as DDT, but the
West has already adopted new technologies. Insisting that
the developing world make the same changes and buy more
expensive chemicals takes away their competitiveness in
the marketplace.
"[The
banning of POPs] is geared towards benefiting developing
countries, benefiting bureaucrats and benefiting the First
World producers of the alternatives to POPs," says Tren.
In the
early Nineties a US tobacco company warned Zimbabwean farmers
that the US might stop buying its tobacco because Zimbabwe
was using DDT to fight malaria. The US didn't want traces
of DDT to find its way into cigarettes. The substance was
(and still is) suspected of being carcinogenic.
Tren
says such ludicrous reasoning amounts to nothing more than
unjustified barriers to trade. Tariffs are widely criticised
so governments use environmental issues instead, he says.
That way, the economy gets what it wants and even the most
politically conscious voter's concerns are assuaged.
The
Democratic Alliance has also jumped on the bandwagon. Errol
Moorcroft, the DA's spokesperson on environmental affairs,
released a statement that said: "We question the wisdom
of using an insecticide that is not degradable and that
has a devastating effect on wildlife. DDT has been banned
in most conservation-minded countries in the world."
A study
by development economists Gallup and Sachs concluded that
malaria reduces Africa's annual growth by an estimated 1%.
As it
stands South Africa has no choice. There is no effective
alternative to DDT and most scientists hold no hope that
will change in the next 10 years, the time frame given by
the United Nations Environment Programme for countries to
find an alternative to DDT.
The
market for agrochemical companies is agricultural pesticides;
the public health market is small and unprofitable, so health
departments have no option but to use insecticides designed
for agriculture.
Hargreaves
says: "DDT gives marvellous control of mosquitoes, but it
does have a lot of drawbacks. If there were something else
we would use it. But there is nothing else."
DDT
sprayed on walls leaves behind a white, powdery smear and
encourages bed bugs to flourish; unsurprisingly, the chemical
is unpopular with communities.
Hargreaves
is testing new insecticides for their mosquito-controlling
properties, but so far has had no luck.
For
DDT to retain its effectiveness it should be alternated
with another pesticide. As things stand there is no alternative
and genetic resistance will certainly begin to build. Africa's
miracle weapon might yet lose its potency.
With
problems such as this to contend with the scientific community
has little time for the environmental community. "You can
understand people's concern when DDT is found in whales'
fat tissue," says Coetzee, "but environmentalists would
have a lot more support if they didn't exaggerate. These
people have little understanding of Africa and malaria."
Verdoorn,
of the Poison Working Group, admits to having been shortsighted:
"In the beginning, we were so green we were stupid. I hate
DDT, but now we realise it's needed."
So,
as bureaucrats in Geneva and Stockholm mooch around drinking
organic cappuccinos and devising lengthy DDT forms for African
health departments to fill in, it might be worth their remembering
-- before they get too pleased with themselves -- that they
are standing at the helm of a serious health problem. With
political correctness taking the place of pragmatism and
expediency -- and, human life -- a catastrophe is snowballing.
A catastrophe for which this time Africa, with absolute
justification, can lay the blame wholly at the feet of the
West.
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