The World Health Organisation recently estimated that there are 515 million cases of malaria a year, with probably two million deaths. Malaria used to ravage the United States and Europe 100 years ago and wasn’t eradicated from either place until the late 1960s. Malaria is spread by the female anopheles mosquitoes and is the leading cause of death among children and pregnant women in Africa. In addition to the human toll, the disease costs Africa an estimated $12 billion—1.2 percent of its GDP—every year.

Perhaps the most tragic aspect of the disease is how simply it can be prevented and cured with available technology. Indoor Residual Spraying—the spraying of house walls with tiny amounts of an insecticide, traditionally DDT— can prevent mosquitoes from reaching their human targets (by deterring them from entering dwellings and killing those that do). If a person does become infected, a plethora of medications, especially artemesin based combination therapy (ACT), can effectively remedy his illness.

DDT for malaria control causes no environmental problems because such tiny amounts are used. But from the 1980s aid agencies have been loathe to fund its use, given the concerns raised by Rachel Carson and others about egg-shell thinning. Only nations not dependent on aid (such as South Africa) or the private sector (such as Konkola Copper Mines in one small part of Northern Zambia) defy international opinion and use DDT. The result in South Africa is an 80% reduction in cases and an 85% reduction in deaths (primarily due to use of ACT drugs), and in the Chingola and Chililobombwe districts of Northern Zambia a 75% reduction in cases and an astonishing 100% reduction in deaths.

Meanwhile the WHO and the world’s aid agencies don’t buy DDT, but oversee a global rise of about 10% in malaria cases in the past 5 years.

So what do these agencies buy with their funds?

The largest donor is the United States Agency for International Development (USAID). USAID spent nearly $80 million to fight malaria worldwide, and over $40 million in Africa alone in 2004. It spent roughly $5 million on actual purchases of malaria drugs, bed nets, larvaciding or IRS equipment (it probably buys no actual insecticides and certainly no DDT) in 2004. That’s only 7 percent of its entire non-research budget for malaria on the interventions that are proven to save lives.

Those numbers come directly from figures provided by USAID after years of ambiguity over the agency’s use of malaria funds. In order to persuade the agency to properly account for the figures, Senators Feingold (D-WI) and Gregg (R-NH) had to first call for a General Accountability Office investigation into the matter, and former Assistant Administrator Anne Peterson had to be embarrassed at a Congressional hearing for failing to provide Senator Brownback (R-KS) an adequate explanation for the destination of USAID malaria funds.

Now that USAID has delivered some basic numbers, in a document replete with mistakes and ambiguities, a plethora of questions still remain. From its disclosures, what USAID does NOT spend money on—IRS, nets, larvaciding, and drugs—is much clearer than what it does support. Indeed, descriptions of funded activities are filled with ambiguous phrases like “supporting the provision of technical assistance” and “strengthen the overall capacity.”

Though vague in describing an actual program, these terms are clear euphemisms for the kind of training and policy programs that require teams of American consultants racking up frequent flyer miles. Surely, USAID’s contracting agencies must love this kind of work, but is this the best way for America to use its considerable financial resources to fight malaria?

Though it is extremely important that basic health systems are adequate to absorb aid, simply improving policies and strengthening capacity does not save lives. The balance USAID has struck with regard to providing resources and strengthening capacity—virtually none of the former and nearly exclusively the latter—is unconscionable for a wealthy country.

The US has opted to fund capacity building programs with no hope of actually easing health burdens. For example, programs that win grants from USAID’s ‘Child Survival Program’, a key component of USAID’s on-the-ground malaria programming, do not even bother to measure if they have had any impact on child mortality. With no money for buying drugs, ITNs or IRS, what would be the point?

If President Bush wants to live up to his promise of “extending American compassion throughout the world” and delivering aid because “it’s the right thing to do,” he should start funding malaria programs that actually have a chance to succeed. That means ignoring pressure from uninformed environmentalists who rail against the use of DDT, buying the most effective drugs available, and ensuring that the tools to combat malaria are made available.

USAID must reallocate its budget by targeting countries with the ability and willingness to absorb health aid—like Botswana and Ghana, for instance—but simply lacking in money. Current funding is so scattered and disorganized—not even USAID’s “Malaria Team” can fully account for all the programs—that each existing initiative has little chance of achieving sustainable success.

Four children have probably died unnecessarily while you read this article. Its time to reintroduce DDT and to fire the entire malaria team at USAID.

The event series Revelations is off to a strong start. The first episode garnered 15.6 million viewers for NBC during the 9 p.m. hour boasting a 5.2 rating among adults 18-49. The third of six episodes aires this Wednesday night.

New Report Says Half Billion People Affected by Malaria

"A new global malaria estimate dramatically increases the number of cases worldwide, especially in Southeast Asia.

An international team of researchers from Kenya, Thailand, and Britain says the number of malaria cases is much higher than previous estimates by the World Health Organization (WHO). Their new map of malaria distribution, published in the journal Nature, estimates that about a half a billion cases occurred in 2002. This is about 50 percent more than WHO estimates globally and double for areas outside Africa."

Dr. Gordon Edwards Challenged Carson's Science and the DDT Ban it birthed"Divorce is always an option, not murder!"

Millions in the third world die from malaria every year in large part because of a virtual ban on the controversial insecticide DDT.

The removal of the unwarranted stigma from DDT and the saving of many future lives is now nearer at hand than it has been in the last 30 years thanks to the efforts of Dr. J. Gordon Edwards, who passed away on July 19, 2004 at the age of 85.

Dr. Edwards led the opposition to environmental extremist efforts to ban DDT in the wake of Rachel Carson's infamous 1962 book Silent Spring. The testimony of Dr. Edwards and others during Environmental Protection Agency hearings in 1971 on whether to ban the insecticide led to an EPA administrative law judge ruling that, 'DDT is not a carcinogenic hazard to man. DDT is not a mutagenic or teratogenic hazard to man. The uses of DDT under the regulations involved here do not have a deleterious effect on freshwater fish, estuarine organisms, wild birds or other wildlife.'

Inexplicably — or so it seemed — DDT was nonetheless banned by EPA administrator William Ruckleshaus. Dr. Edwards investigated and uncovered disturbing statements and troubling connections between Ruckleshaus and anti-DDT environmental extremist groups."

Rethinking Carson's Conclusions

Rachel Carson's obituary contains a great irony. The book she penned that launched the environmental movement sparked an overreaction that does not now, nor did it on the day of the DDT ban in 1972, prove consistent with Carson's own objective "Miss Carson's position, as a biologist, was simply that she was a natural scientist in search of truth and that the indiscriminate use of poisonous chemical sprays called for public awareness of what was going on.

She emphasized that she was not opposed to the use of poisonous chemical sprays--only their "indiscriminate use," and, at a time when their potential was not truly known." The truth is that hundreds of millions of people, most of whom are children, are dying every year as a result of the banned use of DDT.

The truth is that fighting malaria does not require "indiscriminate use" of DDT. The truth is that public awareness turned into public paranoia that obscured the facts about DDT and numbed awareness of the people who are most impacted by the decision to ban its use.

Would Rachel Carson want to be remembered for that?

NYT challenges reigning misconceptions

What the world needs now is DDT

"The worst thing that ever happened to malaria in poor nations was its eradication in rich ones."

"William Ruckelshaus, the head of the newly created Environmental Protection Agency, banned DDT in 1972. It remains one of the most controversial decisions the E.P.A. has ever taken. Ruckelshaus was under a storm of pressure to ban DDT. But Judge Edmund Sweeney, who ran the E.P.A.'s hearings on DDT, concluded that DDT was not hazardous to humans and could be used in ways that did not harm wildlife. Ruckelshaus banned it anyway, for all but emergencies.

Ruckelshaus made the right decision -- for the United States. At the time, DDT was mainly sprayed on crops, mostly cotton, a use far riskier than indoor house spraying. There was no malaria in the United States -- in part thanks to DDT -- so there were no public health benefits from its use. "But if I were a decision maker in Sri Lanka, where the benefits from use outweigh the risks, I would decide differently," Ruckleshaus told me recently. "It's not up to us to balance risks and benefits for other people. There's arrogance in the idea that everybody's going to do what we do. We're not making these decisions for the rest of the world, are we?"

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