Tren surveys the growing acceptance among international donors of the use of residual indoor spraying with DDT to help control malaria outbreaks in developing nations–although he also warns that EU sanctions may undercut IRS spraying.
Last year, the US Agency for International Development (USAID) announced its $1,2bn President's Malaria Initiative. Having discouraged IRS [indoor residual spraying with DDT] for many years, this new initiative is putting substantial resources and efforts into IRS programmes in Angola, Uganda and Tanzania. Following pressure from congress, USAID will be measuring the effect of its malaria spending, so that we will be able to see whether its various interventions are reducing malaria cases and deaths.
This along with WHO's latest endorsement and encouragement of IRS means that prospects for malaria control are improved. Not only is there more money for malaria control, but the policies are improving too.
It is no coincidence that the new head of WHO's Global Malaria Programme and the driving force behind the reforms to malaria control policy, Dr Arata Kochi, released the new policy in Washington. For while the US government is getting things right, most other donors are lagging behind. Few European donors will support IRS and the European Union has set the proverbial cat among the pigeons in east Africa by suggesting that agricultural exports could be turned away from Europe if DDT is used in malaria control. These threats have been partially retracted, but the damage has been done and now exporters in Uganda and Kenya vehemently oppose IRS using DDT.
Opposition to DDT remains from some environmentalist groups such as Greenpeace, but many, such as the Sierra Club and SA's Endangered Wildlife Trust, support IRS using DDT and other insecticides.
The WHO and USAID are now endorsing and encouraging what many malaria scientists and governments in southern Africa have been doing for years. Now is the time for other donors, nongovernmental organisations, and the private sector to do the same. With more than a million preventable deaths every year, there is no time to lose.