Congress is about to appropriate $105 million for malaria control, and the money will be wasted--yet again.
European interests threaten poor African countries that use the best method to prevent malaria--indoor DDT spraying. While the EU action is marginally more odious, Congress will act like the European champagne socialists by throwing money at a problem regardless how it is spent.
It doesn't have to be this way. And if those signing the Kill Malaria Mosquitoes Now (KMMN) declaration have their way, it won't be for long.
Ninety-three percent of Uganda's population is at risk from malaria, with millions of cases and thousands of deaths annually. Uganda does not use DDT to control the mosquitoes that carry the parasites. Southern African countries spray tiny amounts of DDT on inside dwelling walls, in carefully controlled programs that save countless thousands of lives, mainly children, every year.
But chemical company Bayer sees things differently. "We fully support [the EU's decision] to ban imports of agricultural products coming from countries using DDT," Bayer's Vector Control Manager Gerhard Hesse proudly proclaimed in an e-mail exchange with malaria scientists.
Admitting "DDT use is for us a commercial threat," Dr. Hesse expounded a series of half-truths and outright falsehoods, mostly denigrating use of DDT.
Bayer Crop Sciences reported sales of more than $7 billion in 2004, and Bayer's Dr. Hesse is a board member of the World Health Organization's Roll Back Malaria (RBM) coalition--as are other commercial contractors to the U.S. Agency for International Development (USAID). It has been rumored these potentially conflicting interests undermine the anti-malaria coalition, charged in 1998 with cutting malaria rates in half by 2010. Instead, RBM has overseen an increase in disease and death rates, due partly to shunning DDT. The British Medical Journal characterizes RBM as "a failing public health program."
Until now, Uganda has bowed to such outside pressure. But Ugandan Health Minister Jim Muhwezi is determined to use DDT: "DDT has been proven, over and over again, to be the most effective and least expensive method of fighting malaria."
Many malarial countries rely on international aid to fund their programs and therefore must adopt policies preferred by aid agencies and the European Union but that are not necessarily what the countries need.
The U.S. so far has not overtly used trade protectionism to prevent DDT use. However, USAID, the recipient of malaria aid budgets, has lobbied against DDT use. Today it rarely buys any commodities, and never DDT, spending less than 10 percent of its funding that way. Most expenditures are for "technical assistance" to poor countries. In several cases, it convinced locals to sleep under bed nets or doctors to prescribe better drugs, but failed to provide either.
The KMMN declaration, doing the rounds of medical schools and policy institutes, demands that two-thirds appropriated malaria control funds be spent on DDT spraying or other methods proven more effective. There is probably nothing better than DDT, but the signers appreciate flexibility is required. By demanding efficacy, they also undermine another unpleasant truth about USAID. The agency doesn't measure the performance of its malaria programs, probably because they fail so badly. In other words, KMMN throws down the gauntlet: show us something better than DDT or buy it.
The White House should take note; its new malaria initiative will be run by USAID. Of course, there is resistance from USAID and its contractors to a hard earmark since they don't want to buy commodities but continue conducting business as usual. Congress must not keep giving them such a pass. U.S. taxpayers, to say nothing of Africa's children, deserve better.
Roger Bate is a resident fellow of the American Enterprise Institute and a director of Health Advocacy group Africa Fighting Malaria. Dr. Bate has signed the KMMN Declaration, now posted on the AFM Web site.