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Commentary

The Revival of a Notorious Solution to a Notorious Scourge
Tina Rosenberg, The New York Times, 10-5-06

Rosenberg takes wealthy nations to task for not supporting the effective and responsible use of DDT to control malaria in developing nations—but also notes that the U.S. is now leading the fight for better malaria control programs.

The United States, which used DDT irresponsibly to wipe out malaria, ended up blocking much poorer and sicker countries from using it responsibly. Under American pressure, several Latin American countries that had controlled malaria stopped using DDT—and in most of them, malaria cases soared.

The other reason for DDT's demise was donor tightfistedness. DDT has to be sprayed inside houses, an activity that needs to be carried out by governments. In most African countries, this means donors must pay. They balked, and insecticide–treated bednets became bureaucrats' preferred solution. Donors liked the program because it was cheap and sustainable, as consumers would buy the nets—often at subsidized prices. But it has failed. The nets work—but even at $5, few can buy them. The most recent data show that only 3 percent of African children sleep under treated nets.

The eradication of malaria in rich countries turned out to be the worst thing that happened for people with malaria in poor countries. Malaria lost its constituency, and the money dried up. Throughout Africa, until recently, countries were using chloroquine to cure malaria, a medicine that cost pennies, and so could be bought by rural families. But mosquitoes had become resistant to it. And donors were unwilling to spend the money for effective medicines.

But this is changing. The AIDS pandemic has raised interest in third–world disease, and malaria financing has more than doubled in the last three years. African countries are also learning from South Africa, which doesn’t have to depend on donors. Since 2000, South Africa has been successfully beating malaria using the new medicines and house spraying with DDT.

Conservatives in the Senate, led by Tom Coburn and Sam Brownback, have forced a revolution in Washington’s malaria programs. America now promotes effective malaria drugs, gives away bednets, and has brought back house spraying—including with DDT.

Malaria soared because the forces allied against it quit the battlefield. Now the humans are back.



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