Few parents want themselves or their children to be prescribed drugs that cause anemia, nausea, diarrhea, increased infection risks, fertility problems, fetal defects, hair loss and even death. But when those chemotherapy drugs mean not dying from cancer, it’s an easy choice.
That’s the situation facing Africa — only for us it’s not cancer. Our concern is malaria, which infects nearly 400 million of us, and kills 1 million of our precious children, every single year.
We desperately need the African equivalent of chemo drugs — DDT and other insecticides — to prevent this terrible disease. Thankfully, the U.S. Agency for International Development, World Health Organization and other agencies are helping us launch spraying programs. Just spraying tiny amounts of DDT on walls keeps 90 percent of mosquitoes from even entering homes, irritates those that come in so they don’t bite, and kills any that land — for six months or more. No other chemical, at any price, can do that.
But chemical-hating activists continue to oppose these lifesaving programs and raise constantly changing “concerns” like: “Some researchers think DDT could be inhibiting lactation and might be related to premature births, low birth weights and slow reflexes in babies.”
Recently, the University of California-Berkeley and Los Angeles Times reported that “very high exposure” to DDT can cause mental test scores in 2-year-olds to drop slightly. They say this minor problem may disappear by the time the children enter school — but still urged that Africa consider “alternative antimalarial controls” and “balance” risks carefully against benefits.
However, these concerns aren’t even relevant to Africa. No one is talking about massive DDT spraying for agriculture, or even insect control. We’re talking about limited, controlled spraying on walls of houses.
There are no viable “alternatives.” Nothing works as well as DDT, does what it does, for as long, or at such a low price. Moreover, every chemical has risks. In fact, DDT is 100 times less toxic to humans than nicotine in cigarettes, just as safe as the pyrethroids used in agriculture and mosquito control, and far less toxic than chemotherapy drugs, say experts like Dr. Donald Roberts, professor of tropical disease at the Uniformed Services University of the Health Sciences.
Antimalaria drugs are also powerful chemicals. Fansidar can cause severe vomiting and lung and liver damage. Chloroquine (which no longer even works well) has harmful effects; and even Artemisia-based drugs have neurological side effects. People aren’t just exposed to them. Babies, little children, pregnant women and old people alike must ingest them every time they get malaria.
Bed nets are impregnated with pyrethroids, to make them kill mosquitoes — and people have to sleep under them, breathing in the vapors and rubbing their skin against the nets.
Researchers and activists have never studied or compared these side effects, or evaluated their risks and benefits. Nor have they recommended taking these products (or chemotherapy drugs) off the market — which would be shortsighted and tragic.
A half-billion people worldwide get acute malaria every year. Hundreds of thousands are left with permanent brain damage. Up to 2 million die.
Schoolchildren ages 6-14 who suffered more than five malaria attacks scored 15 percent lower than those who had fewer than three attacks, researchers from Sri Lanka and the WHO found. The impact of DDT on children in the Berkeley study was trivial by comparison.
I have had malaria more than a dozen times. I lost my son, two sisters and three nephews to it. My nephew Noel got malaria at age 2 and is still four years behind high school boys his age in reading and writing skills, because it affected his mental powers so horribly. My brother Joseph used to help in an office and with complex farming tasks, but his mind no longer works well because of cerebral malaria.
Many mothers have anemia, premature births and tiny babies because of malaria, and many people die from other diseases they would survive if they weren’t so weakened by malaria. These tragedies are repeated all over Africa, Asia and Latin America.
How can this possibly be compared to a couple points in mental tests for 2-year-olds? Africans must use every available weapon to combat malaria, our biggest killer of children. We cannot afford to let a million of our children die every year, while we look for a vaccine, better drugs or alternatives to DDT.
What we need are risk-benefit studies comparing mothers and children in communities where DDT is used, versus where it is not used — assessing days absent from work or school, days severely ill, mental impairment, financial well-being, expenditures on anti-malaria medicines, and deathrates.
We need to calculate the value of those lives affected by being sick with malaria for weeks every year … of mental capacity lost due to malaria… of 1.5 million African lives lost every year. Even at $1,000 to $10,000 per life, the impact of malaria — and the value of DDT — is monumental.
This month, another malaria outbreak hit the Kabale district in southern Uganda. More than 6,000 people were admitted to clinics in just one week. A spraying program with Icon (a pyrethroid also used in agriculture, and which thus can quickly breed mosquito resistance) resulted in the deaths of two students. That is terrible, but last year 70,000 Ugandans died from malaria. In 65 years, DDT never killed anyone.
Should we stop spraying, to prevent more deaths from Icon or possible learning delays from using DDT — and sacrifice another 70,000 Ugandans again this year?
Yes, there are risks in using DDT — or other antimalaria weapons. But the risk of not using them is infinitely greater. One-sided studies and news stories frighten people into not using the most effective weapons in our arsenal — and millions pay the ultimate price. That is unconscionable.
Fiona Kobusingye-Boynes is coordinator of the Congress of Racial Equality in Uganda and a tireless advocate for effective, life-saving malaria control.