World Health Organization to pump pestisides into poor countries

[Guest guest]

WHO guidelines may increase DDT use By LAURAN NEERGAARD, AP Medical

Writer

Fri Sep 15, 1:43 AM ET

<h1>More poor countries may soon be pumping up their arsenal against

malaria with DDT, the pesticide long banned in the United States.

The difference: DDT is no longer sprayed outdoors, but to coat the

inside walls of mud huts or other dwellings and kill mosquitoes

waiting to bite families as they sleep.

New World Health Organization guidelines are poised to expand the

small number of malaria-plagued countries already using DDT. The push

is for more indoor spraying with a number of insecticides — including

DDT as a safe, effective and cheap option, say officials familiar

with the announcement scheduled for Friday in Washington.

" It's a big change, " said biologist Amir Attaran of Canada's

University of Ottawa, who has long pushed for the guidelines and

described a recent draft. " There has been a lot of resistance to

using insecticides to control malaria, and one insecticide

especially. ... That will have to be re-evaluated by a lot of people. "

The WHO will say that " indoor residual spraying, including with DDT,

has been underutilized, which has hampered international efforts to

effectively combat malaria in Africa, " said a Bush administration

official, speaking on condition of anonymity.

The U.S. government already has decided to pay for DDT and other

indoor insecticide use as part of President Bush's $1.2 billion, five-

year initiative to control malaria in Africa.

WHO officials would not discuss the guidelines on Thursday.

But a draft report from the office of WHO malaria chief Dr. Arata

Kochi describes indoor spraying as an important but neglected third

weapon — along with insecticide-treated bed nets and new medications —

in the war on malaria.

WHO " will in the coming year greatly intensify its work to assist

countries to make the best use of " indoor spraying, the document says.

Proponents say Friday's WHO announcement is important in ending mixed

signals.

" Whereas before they were kind of discouraging and stigmatizing the

use of DDT, now they're promoting it, " said , a spokesman

for Sen. Tom Coburn, R-Okla., a physician who has urged stronger anti-

malaria programs.

DDT is easily history's most notorious insecticide. While it isn't

classified a human health hazard, it was banned in the U.S. in 1972

after decades of widespread agricultural spraying led to

environmental damage around the globe.

DDT never disappeared in developing countries, although political

pressure and lack of funding meant few continued to use it. Then a

2001 United Nations treaty that aims to wipe out a dozen of the

world's most dangerous chemicals carved out one exception for DDT:

indoor anti-malaria spraying, under strict conditions to prevent

environmental contamination.

Why? When small amounts are sprayed on interior walls, DDT forms a

residue that both repels mosquitoes — discouraging them from flying

into the house — and kills those that rest on the walls, explained

Clive Shiff, a professor at s Hopkins University's Malaria

Research Institute. It has to be applied only about once a year.

Bednets soaked in different insecticides already are used to protect

sleeping families. But if the nets are torn or aren't used every

night, a mosquito can infect someone. Plus, mosquitoes can develop

resistance to those nets' chemicals, Shiff added, pointing to a 2002

malaria outbreak in part of South Africa using bednets. DDT in those

houses quelled the outbreak.

" It would be naive to say DDT is a magic bullet for malaria. It

isn't, " stressed Attaran. It won't work in some places where

mosquitoes already are resistant to a range of insecticides, he

noted. He suspects DDT will be of most use in eastern Africa, where

that problem hasn't yet emerged.

Attaran called for research " to make sure we're using insecticides

and DDT not in a willy-nilly way but in an optimal way in the right

places. "

Nor, scientists cautioned, is indoor spraying alone a solution, as

mosquitoes bite everywhere. Countries are being encouraged to adopt

comprehensive malaria programs that also include newer, more

effective medications, as Bush's malaria chief, Admiral R.

Ziemer, was to outline Friday.

" President Bush has directed Admiral Ziemer to use the most safe and

effective tools available to control and combat malaria in Africa, "

said White House spokeswoman Lawrimore. Indoor

spraying " programs are an important part of his Presidential Malaria

Initiative to save thousands of people from a highly treatable and

preventable disease. "

___

AP White House Correspondent Terence Hunt contributed to this report.