Winning Africa’s War on Malaria By Fiona Kobusingye
The war on malaria has been tragic and difficult. The disease remains Africa’s number one killer of children, sending 200 little Ugandans and 1500 African children a day to miserable deaths. But in recent months, several hard-fought victories have been won – offering the first hope the continent has had in many years that the disease might yet be controlled. Here is the inside story, from a brave and tireless Ugandan woman who has long been on the front lines. It is based on the testimony she presented to her country’s Parliament and First Lady last Friday.
I’ve had malaria more times than I care to remember. My son, two sisters and four cousins died from it. My once-brilliant brother is permanently brain-damaged from it. In just one year, 50 out of 500 children in the school that my husband and I help sponsor died from malaria.
This terrible disease infects 12 million Ugandans and kills up to 100,000 of our people every year. Even at only US $1,000 per life (and surely our lives are worth far more than that), this means a loss of US $100-million (180 billion Ugandan shillings), every year. It costs our country millions of lost working days and billions of shillings in lost wages, every year. It forces families to spend billions on medicines and hospital visits, and keeps tourists and foreign investment from coming to our country.
Stopping this death and devastation has to be our highest priority.
Thankfully, we now have the weapons and allies to win our war against Killer Malaria.
Archbishop Desmond Tutu, Greenpeace co-founder Patrick Moore, and hundreds of doctors, disease experts, religious leaders and human rights advocates signed a declaration, demanding that substantial money be spent on Artemisinin (ACT) drugs, insecticide-treated bednets and indoor spraying with DDT.
The American Congress agreed and told the U.S. Agency for International Development to do so. USAID is now buying these things and assisting countries with spraying programs.
Drug companies have increased their production of ACT drugs, to meet growing demand.
Maybe most important of all, the new director of the World Health Organization’s global malaria program has announced that indoor spraying with DDT from now on will be an integral component of WHO’s comprehensive malaria control strategies. Dr. Arata Kochi and his global healthcare organization have determined that indoor residual spraying (IRS) must be one of the primary methods for preventing the spread of this disease – and that DDT is perfectly safe for public health purposes.
His message at a Washington, DC press conference was simple: “Please help save African babies, as you are helping to save the environment.”
As my colleagues and I always emphasize, DDT can never replace the other weapons we also need to combat disease. But if it is sprayed just twice a year on the inside walls of homes, it keeps 90% of mosquitoes from even entering. It also irritates any mosquitoes that do come in, so they don’t bite, and kills any that land. No other chemical, at any price, does all that.
That’s why DDT can reduce malaria by 75% in many areas, and enable doctors to use the new ACT drugs to treat the much smaller numbers of people who still get sick. That’s how South Africa cut its malaria rates by 95% in just three years.
However, farmers and business leaders have worried that using DDT could disrupt our trade with Europe. One spokesman recently said any trace of DDT would cause “immediate banning of the product” – with devastating impacts on Uganda’s economy.
These are serious concerns, even though many feel they place economic interests ahead of people’s health and lives. In reality, our US $415 million in annual agricultural trade with Europe – as important as it certainly is – actually is small compared to losses we suffer due to malaria. The benefits of using DDT would be far greater than this trade revenue.
The good news, though, is that we don’t have to make this choice. We can have both trade with Europe and a healthy, increasingly prosperous Uganda.
Three weeks ago, EU President José Manuel Barroso wrote to US Senator Tom Coburn, to say the European Union recognizes and supports the right of countries to use DDT and other “appropriate malaria control techniques,” under Stockholm Convention and WHO guidelines. President Barroso also said exports to Europe would encounter problems only if they have DDT above maximum allowable levels.
That’s not likely, because only tiny amounts of the chemical will be sprayed, only on inside walls, and only by trained technicians. And Europe’s policy on DDT is exactly the same for other contaminants. If food, fish or flowers have bacteria or other insecticides or chemicals on them above EU limits, those shipments will also be turned away. We simply need to make sure there are no contaminants on products we send to Europe – or on anything we sell to Ugandans or other Africans, either.
As our CORE-Uganda T-shirts say, DDT is a weapon of mass survival. Using it saves lives. Preventing its use kills parents and children, teachers, politicians and businessmen.
Let me say it again. We need all our weapons: DDT, other insecticides, larvacides, bednets, education, medicines, more hospitals, strong, well-organized public health systems, and careful monitoring of malaria control efforts in every city and village, to make sure they are working.
It is time for all of us to work together. Take advantage of these new opportunities, weapons and allies. Make sure our disease control programs are based on science and facts – not on emotions, speculation or baseless fears. Ensure that DDT is used properly. And bring Uganda, and all of Africa, to a new era of cooperation, health and prosperity.
CORE-Uganda, the Kill Malarial Mosquitoes NOW Coalition and Africa Fighting Malaria are ready to work with all who care about trade and health. We hope everyone will join us in this great undertaking.