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"And ye shall know the truth, and the truth shall make you free." - John 8:32
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Date:  July 25, 2006
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Real risks – and irrelevant risks
by Fiona Kobusingye-Boynes

Responsible researchers, journalists and officials should focus on malaria – not insecticides.

Few parents want themselves or their children on drugs that cause anemia, nausea, diarrhea, increased infection risks, fertility problems, fetal defects and hair loss. But when those chemotherapy drugs prevent death from cancer, it’s an easy choice.

That’s the situation facing Africa – only for us it’s not cancer. (Most Africans simply don’t live long enough to get cancer.) Our concern is malaria, which infects nearly 400 million of us, and kills 1 million of our precious children, every single year.

We desperately need the African equivalent of chemo drugs – DDT and other insecticides – to prevent this terrible disease. Thankfully, the USAID, World Health Organization and other agencies are helping us launch spraying programs. Just spraying tiny amounts of DDT on the walls keeps 90% of mosquitoes from even entering homes, irritates those that do come in so they don’t bite, and kills any that land – for six months or more. No other chemical, at any price, can do that.

But chemical-hating activists continue to oppose these life-saving programs and raise constantly changing “concerns” like: “Some researchers think DDT could be inhibiting lactation and might be related to premature births, low birth weights and slow reflexes in babies.”

The latest “concerns” come from the University of California-Berkeley and LA Times. They claim “very high exposure” to DDT causes mental test scores in two-year-olds to drop slightly. They say the problem may disappear by the time the children enter school – but still argue that Africa should consider “alternative anti-malarial controls,” and “balance” risks carefully against benefits.

However, the study isn’t even relevant to Africa. No one is talking about massive DDT spraying for agriculture, or even insect control. We’re talking about limited, controlled spraying on walls of houses.

There are no viable “alternatives” for DDT. Nothing repels mosquitoes as well or as long as DDT does, or costs so little. However, larvacides, bednets, drugs, sanitation and other insecticides are also vital weapons in our war on malaria.

Moreover, every chemical has risks. In fact, DDT is 100 times less toxic to humans than nicotine in cigarettes, just as safe as pyrethroids used in agriculture and mosquito control, and far less toxic than chemotherapy drugs, say experts like Dr. Donald Roberts, professor of tropical disease at the Uniformed Services University of the Health Sciences.

Anti-malaria drugs are also powerful chemicals. Fansidar can cause severe vomiting and lung and liver damage; Chloroquine (which no longer even works well) has harmful physical effects; and even Artemisia-based drugs have neurological side effects. People aren’t just exposed to them. Babies, little children, pregnant women and old people alike must ingest them, every time they get malaria.

Bed nets are impregnated with pyrethroids, to make them kill mosquitoes – and people have to sleep under them, breathing in the vapors and rubbing their skin up against the nets.

Researchers and activists have never studied or compared these side effects, or evaluated their risks and benefits. Nor have they recommended taking these products (or chemotherapy drugs) off the market – which would be shortsighted and tragic.

A half-billion people worldwide get acute malaria every year. Hundreds of thousands are left with permanent brain damage. Up to two million die.

School children age 6-14 who had more than five malaria attacks scored 15% lower than those who had fewer than three attacks, researchers from Sri Lanka and the WHO found. The DDT effects claimed by the Berkeley study were trivial by comparison. 

I have had malaria over a dozen times. I lost my son, two sisters and three nephews to it. My nephew Noel got malaria at age two, and he is still four years behind high school boys of his age in reading and writing skills, because it affected his mental powers so horribly. My nephew Joseph used to help in an office and with complex farming tasks, but his mind no longer works well because of malaria.

Many mothers have anemia, premature births and tiny babies because of malaria, and many people die from other diseases they would survive if they weren’t so weakened by malaria. These tragedies are repeated all over Africa, Asia and Latin America.

How can these impacts from malaria possibly be compared to minor effects of DDT on babies, two-year-olds or nursing mothers?

Africans must use every available weapon to combat malaria. We cannot afford to let a million of our children die every year, while we wait decades for a vaccine, better drugs, alternatives to DDT or genetically modified mosquitoes that can’t carry malaria parasites.

What we need are risk-benefit studies comparing mothers and children in communities where DDT is used, versus where it is not used – assessing days absent from work or school, days severely ill, mental impairment, financial well-being, amounts spent on anti-malaria medicines, and death rates.

We need to calculate the value of lives affected by being sick with malaria for weeks every year … of mental capacity lost due to malaria … of 1.5 million African lives lost every year. Even at $1,000 to $10,000 per life, the impact of malaria – and the value of DDT – is monumental.

This month, another malaria outbreak hit the Kabale district in southern Uganda. Over 6,000 people were admitted to clinics in one week. Spraying with Icon resulted in the deaths of two students. That is terrible, but last year 70,000 Ugandans died from malaria. In 65 years, DDT never killed anyone.

Should we stop spraying, to prevent more deaths from Icon or possible learning delays from using DDT – and sacrifice another 70,000 Ugandans again this year, and next year, and the year after that?

Yes, there are risks in using DDT – or other anti-malaria weapons. But the risk of not using them is infinitely greater. Irresponsible, one-sided “studies” and “news” stories frighten people into not using the most effective weapons in our arsenal – and millions pay the ultimate price. That is unethical and unconscionable. 

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Notes:  Fiona Kobusingye-Boynes is coordinator of the Congress of Racial Equality Uganda and a tireless advocate for effective, life-saving malaria control. She can be reached at

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