Cyrus Kinyungu
19 May 2006
Nairobi — Almost two decades after the country banned the use of DDT, the Government is under pressure to lift the ban as one of the effective ways of controlling the spread of malaria.
At the same time, there is pressure on the Government not to lift the ban on the insecticide, which remains banned in many countries in the world. The pressure comes in the wake of the heads of state conference in Abuja, which passed a resolution to put emphasis on and promote the use of indoor residual spraying to help fight the malaria vector.
DDT (dichloro-diphenyl-trichloroethane) is used as an effective indoor residual spraying pesticide in many countries. It is known to have a residual effect of up to one year.
Brainstorming meeting
This means that the chemical can continue killing mosquitoes for a one year after it is sprayed at a place. DDT is believed to have wiped out Malaria in Europe and North America.
Health assistant minister Dr Enock Kibunguchy recently announced that a brainstorming meeting that will inform the Government's position on the DDT issue would be held before the end of the year.
The assistant minister, however, said he would support the reintroduction of DDT since "it is the best alternative Africa has to control Malaria."
"We will only be paying lip service to the fight against Malaria if we ignore the re-introduction of DDT," said Kibunguchy, who is a medical doctor.
UN's decision to classify DDT as "a persistent organic pollutant" will be under scrutiny by scientists in Kenya, just as it has been the case in other African countries that have defied the ban.
The World Health Organisation (WHO) ranks the chemical as a class two poison.
The head of Malaria control Programme, Dr Willis Akhwale, says the meeting by experts from research organisations, as well as doctors and scientists from universities in the country, will inform the Government position.
Legalising use of DDT
A technical working group will be appointed to evaluate the advantages and disadvantages of using DDT as a pesticide for indoor residual spraying, based on current evidence, and advise the Government accordingly.
Kenya Medical Research Institute (Kemri) director Dr Davy Koech, one of the expected experts, has already stated his stand on the DDT issue. He has called for the lifting of the ban on DDT to help fight the malaria vector.
On the other hand, the International Centre of Insect Physiology and Ecology (ICIPE) scientists are against the idea of lifting the ban. They argue that there are better ways of controlling malaria.
The Kenya Flower Council (KFC), through its CEO Ms Jane Ngige, has also added its voice to those opposing the lifting of the ban.
Persistent non-pollutants
The Stockholm convention, ratified in 2001 and which came into effect on May 17, 2004 calls for the elimination of DDT and other persistent non-pollutants barring health crises.
The global treaty limits the use of 12 chemicals that are toxic to human beings and wildlife, and which remain intact in the environment for long periods. DDT is among the listed chemicals.
While most of these chemicals were supposed to be banned immediately, a health-related exemption was granted for DDT, which is still needed in many countries to control mosquitoes. The Convention was signed by 98 countries and is endorsed by most environmental groups.
It is estimated that malaria kills about 100 children in the country every day. It claims 70,000 children under five years every year worldwide. In Kenya, it kills about 34,000 children every year. It is estimated that 20 percent of the country's hospital bed capacity is occupied by malaria patients. Worldwide, the disease kills around 100,000 people each year.
Sulphur-based drugs withdrawn
South Africa, Uganda, Mauritius, Tanzania and Mozambique are among the African countries that still use the chemical to control the spread of malaria. Tanzania is the latest country to lift the DDT ban. In the fight against malaria, DDT is sprayed inside buildings and in household products in small quantities.
The Government in April this year stepped up the fight against malaria after it ordered the withdrawal of sulphur-based drugs used for the treatment of the disease.
The drugs were replaced by a combination treatment of Artemisinin-based combination Therapy (ACT), which medics argue is more effective against the disease.
Director of medical services Dr James Nyikal said the SP drugs were phased out because malaria strains were getting resistant to the drug. Out of every four people treated with the SP drugs, one will not recover, said Nyikal while launching the new treatment.
The introduction of the new treatment, only about three years after the SP treatment was introduced, is an indicator of how malaria has become a big health challenge to the country.
This therefore calls for adoption of a new method to fight against the disease.
DDT banned for agricultural use
DDT was banned in 1988 in Kenya because of its negative effects on the environment. Experts, however, argue that it is still the best alternative to fight malaria.
The Wikipedia encyclopedia says that DDT was developed as the first of the modern insecticides early in World War II.
Initially, it was used with great effect to combat mosquitoes, typhus and other insect-borne human diseases, both in civilian and military population. It was also used as an agricultural pesticide.
A Swiss chemist, says the encyclopedia, was awarded the Nobel Prize in physiology of Medicine in 1948 for his discovery of the high efficiency of DDT as a contact poison against several arthropods.
The chemical's woes started in 1962 when an American biologist, Rachel Carson, published a book, Silent Spring, which claimed that DDT caused cancer and harmed bird production by thinning eggshells.
As a result of the outcry that came with the revelation by the book, the insecticide was banned for agricultural use in the USA. It was banned in many other countries in the 1970s.
Its use was banned in the UK in 1984.
Indoor residual spray
Though DDT was first synthesised in 1874, its properties as an insecticide were discovered in 1939 by a Swiss scientist, Paul Hermann Muller.
It is believed that DDT was responsible for eradicating malaria from Europe and North America through a campaign carried out in the 1950s. This, therefore, left malaria as a tropical disease.
Through the DDT campaign, it is believed that Malaria deaths were reduced from 192 per every 100,000 people to only seven people for every 100,000 people. Dr Davy Koech argues a responsible use of DDT to fight malaria should be encouraged. Instead of condemning the drug wholesale, says Koech, scientists should employ the latest technology and available data to take care of the environmental concerns.
He says the scientists should re-examine afresh the merits and demerits of DDT, any new information and the factors that led to its ban.
"As long as it is used as an indoor residual spraying," says Koech, " DDT can be very useful in the fight against malaria. Anything that can reduce malaria deaths by 80 percent should actually be given another thought".
Effect on horticultural industry
Ngige says DDT, which is part of the "dirty dozen", will compromise the perception of the country's food safety if allowed.
Violating the ban, she adds, means that the country will have a bad image that will affect the horticultural industry.
She says even if DDT were to be allowed in controlling malaria, it would be hard to control it to ensure that it does not contaminate food.
Icipe's director of research Prof Ole -Moi Yoi was at one time quoted by the Science in Africa online magazine opposing the use of DDT. He said that the country had several environmental-friendly ways of controlling malaria. He called for the production of Bacillus Thuringiensis, a kind of bacteria that kills mosquito larvae, as an alternative and effective malaria control strategy that has no severe impacts on the environment.
Dr Akhwale says as scientists look for solution to the malaria problem, there is need to realise that the vector is becoming resistant to some pesticides.
The country has the choice of using artificial pyrethrin, natural pyrethrins, organo phosphates and DDT for spraying. In the past, the country has not been placing emphasis on indoor residual spraying because of the costs involved.
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