WHO gives indoor use of DDT a clean
bill of health for controlling malaria
WHO promotes indoor spraying with
insecticides as one of three main interventions to fight
malaria
http://www.who.int/mediacentre/news/releases/2006/pr50/en/
15 SEPTEMBER 2006 | WASHINGTON, D.C. -- Nearly thirty
years after phasing out the widespread use of indoor
spraying with DDT and other insecticides to control malaria,
the World Health Organization (WHO) today announced that
this intervention will once again play a major role in its
efforts to fight the disease. WHO is now recommending the
use of indoor residual spraying (IRS) not only in epidemic
areas but also in areas with constant and high malaria
transmission, including throughout Africa.
“The scientific and programmatic evidence clearly
supports this reassessment,” said Dr Anarfi Asamoa-Baah, WHO
Assistant Director-General for HIV/AIDS, TB and Malaria.
"Indoor residual spraying is useful to quickly reduce the
number of infections caused by malaria-carrying mosquitoes.
IRS has proven to be just as cost effective as other malaria
prevention measures, and DDT presents no health risk when
used properly.”
WHO actively promoted indoor residual spraying for
malaria control until the early 1980s when increased health
and environmental concerns surrounding DDT caused the
organization to stop promoting its use and to focus instead
on other means of prevention. Extensive research and testing
has since demonstrated that well-managed indoor residual
spraying programmes using DDT pose no harm to wildlife or to
humans.
"We must take a position based on the science and the
data," said Dr Arata Kochi, Director of WHO’s Global Malaria
Programme. “One of the best tools we have against malaria is
indoor residual house spraying. Of the dozen insecticides
WHO has approved as safe for house spraying, the most
effective is DDT.”
Indoor residual spraying is the application of
long-acting insecticides on the walls and roofs of houses
and domestic animal shelters in order to kill
malaria-carrying mosquitoes that land on these surfaces.
“Indoor spraying is like providing a huge mosquito net
over an entire household for around-the-clock protection,”
said U.S. Senator Tom Coburn, a leading advocate for global
malaria control efforts. “Finally, with WHO’s unambiguous
leadership on the issue, we can put to rest the junk science
and myths that have provided aid and comfort to the real
enemy – mosquitoes – which threaten the lives of more than
300 million children each year.”
Views about the use of insecticides for indoor protection
from malaria have been changing in recent years.
Environmental Defense, which launched the anti-DDT campaign
in the 1960s, now endorses the indoor use of DDT for malaria
control, as does the Sierra Club and the Endangered Wildlife
Trust. The recently-launched President’s Malaria Initiative
(PMI) announced last year that it would also fund DDT
spraying on the inside walls of households to prevent the
disease.
“I anticipate that all 15 of the country programs of
President Bush’s $1.2 billion commitment to cut malaria
deaths in half will include substantial indoor residual
spraying activities, including many that will use DDT,” said
Admiral R. Timothy Ziemer, Coordinator of the President’s
Malaria Initiative. “Because it is relatively inexpensive
and very effective, USAID supports the spraying of homes
with insecticides as a part of a balanced, comprehensive
malaria prevention and treatment program. “
Programmatic evidence shows that correct and timely use
of indoor residual spraying can reduce malaria transmission
by up to 90 percent. In the past, India was able to use DDT
effectively in indoor residual spraying to cut dramatically
the number of malaria cases and fatalities. South Africa has
again re-introduced DDT for indoor residual spraying to keep
malaria case and fatality numbers at all-time low levels and
move towards malaria elimination. Today, 14 countries in
Sub-Saharan Africa are using IRS and 10 of those are using
DDT.
At today’s news conference, the World Health Organization
also called on all malaria control programmes around the
world to develop and issue a clear statement outlining their
position on indoor spraying with long-lasting insecticides
such as DDT, specifying where and how spraying will be
implemented in accordance with WHO guidelines, and how they
will provide all possible support to accelerate and manage
this intervention effectively.
“All development agencies and endemic countries need to
act in accordance with WHO’s position on the use of DDT for
indoor residual spraying,” said Richard Tren, Director of
Africa Fighting Malaria. “Donors in particular need to help
WHO provide technical and programmatic support to ensure
these interventions are used properly.”
Indoor residual spraying is one of the main interventions
WHO is now promoting to control and eliminate malaria
globally. A second is the widespread use of
insecticide-treated mosquito nets. While the use of bed nets
has long been encouraged by WHO, the recent development of
“long-lasting insecticidal nets” (LLINs) has dramatically
improved their usefulness. Unlike their predecessors, the
long-lasting nets need not be re-dipped in buckets of
insecticide every six months as they remain effective for up
to five years without retreatment.
Finally, for those who do ultimately become sick with
malaria, more effective medicines are increasingly becoming
available. Unlike previous antimalarials that have been
rendered useless in many regions due to drug resistance,
Artemisinin Combination Therapies (ACTs) are now
recommended. These lifesaving medications are becoming more
widely available throughout the world. In January of this
year, WHO took stringent measures to help prevent future
resistance to antimalarial medicines by banning the use of
malaria monotherapy. An example of the negative consequences
of drug resistance is apparent in the threat it poses to
intermittent preventive treatment in pregnancy (IPTp), a
crucial strategic intervention to protect pregnant women
from the consequences of malaria.
Potential funding to scale up the availability of all
three of these strategic interventions has dramatically
increased over the past few years through the inception of
the Global Fund to Fight AIDS, TB and Malaria, World Bank
plans to significantly increase its funding for malaria, and
the launch of the President’s Malaria Initiative.
“With serious money finally becoming available to fight
malaria, it is more imperative than ever that WHO provides
sound technical guidance and programme assistance to ensure
timely and effective use of these resources,” said Dr Kochi.
Each year, more than 500 million people suffer from acute
malaria, resulting in more than 1 million deaths. At least
86 percent of these deaths are in sub-Saharan Africa.
Globally an estimated 3,000 children and infants die from
malaria every day and 10,000 pregnant women die from malaria
in Africa every year. Malaria disproportionately affects
poor people, with almost 60 percent of malaria cases
occurring among the poorest 20 percent of the world’s
population.
For more information contact:
In Washington, DC:
Jim Palmer at 1 (202) 262-9823
In Geneva:
Ed Vela at +41 22 791-4550 or Shiva Murugasampillay at +41
22 791-1019 |