Three years ago, the World Health Organization decided to get tough on malaria, a disease that in 2017 alone killed more than 435,000 people, more than half of them children under the age of five.
A special research group was convened to study the feasibility of wiping the disease from the face of the Earth. Last month the group’s long-awaited report duly concluded that “malaria can and should be eradicated by 2050.”
Malaria eradication had been “a distant dream” for too long, pronounced one of the distinguished members of the WHO Strategic Advisory Group. Now, eradication was possible within a generation.
Such a major public-health triumph would, of course, be a wonderful achievement, especially for the citizens of the 15 countries, chiefly in sub-Saharan Africa, that in 2017 accounted for 80% of the 219 million global cases of the mosquito-borne disease. But the report failed to acknowledge a shameful truth: that malaria could have disappeared from these regions generations ago if it were not for a perverse decision by the West.
Before World War II, malaria was as rife in Europe and the US as it is today in some developing countries, where it continues to wreak havoc. It was defeated thanks largely to a chemical so effective at destroying mosquitoes and other disease-carrying insects that in 1948 it earned its discoverer, the Swiss chemist Paul Hermann Müller, the Nobel Prize in Physiology or Medicine.
For millions across Europe and in America, dichloro-diphenyl-trichloromethylmethane, better known as DDT, was a life-saving miracle, first deployed during the war to cut short epidemics of diseases such as typhus, malaria and sandfly fever that were claiming more lives of Allied troops than enemy action in some arenas of the conflict.
In 1955 the WHO recruited DDT as the weapon of choice for its first Global Malaria Eradication Program. A host of scientific papers – now conveniently forgotten – testified to its success and by 1967 malaria had been eradicated from all developed countries.
Yet, as the director-general of the WHO wrote in The Lancet medical journal last month, the 14-year eradication program launched in 1955 “was flawed from the start by leaving out tropical Africa, the region that still bears the heaviest burden of the disease.” Worse, after DDT had eliminated malaria in most of the developed world, the West developed a conscience about the potential broader effects of the chemical on the environment and decided it was no longer a suitable agent. Needless to say, tropical Africa was not consulted for its views on DDT’s “suitability.”
The trigger was Silent Spring, a book published in the US in 1962 and widely credited with kickstarting the global environmental movement. Inspired by a letter from a friend about the absence of birds in her garden one spring morning, biologist Rachel Carson launched a passionate assault on DDT and other insecticides that, she claimed, had “silenced the voices of spring in countless towns in America.”
The book was hugely influential. Organizations and institutions, including the WHO, took on board the book’s qualms about the potential impact of DDT on ecosystems and set about restricting and then in effect banning its use. By 1969 the WHO had abandoned its strategy of eradication by DDT and later decided to rely on mosquito nets and “early diagnosis and adequate treatment” – a policy that required the sort of efficient health-care systems not found in many of the countries worst hit by malaria.
The threat to human health posed by DDT was insignificant compared with the harm caused by malaria. Furthermore, it was impossible to ignore the implication that lives in the developing world carried less weight than those in the West, where use of the chemical had transformed public health
The hypocrisy surrounding the demonizing of DDT was summed up by the attitude of the World Wildlife Fund. In a report published in 1998, it stated that while “both malaria and the chemicals used to control it pose a threat to human health,” DDT also posed a threat to biodiversity, and therefore human beings should no longer benefit from its protection.
This false equivalence typified the new ecologically virtuous attitude. The threat to human health posed by DDT was insignificant compared with the harm caused by malaria. Furthermore, it was impossible to ignore the implication that lives in the developing world carried less weight than those in the West, where use of the chemical had transformed public health.
Scientists have tried periodically to restore DDT’s reputation, but to no avail. In 1999, as the United Nations Environment Program was working on banning “persistent organic pollutants,” including DDT, a group of 380 doctors and scientists from 57 countries, including three Nobel laureates in medicine, wrote an open letter pleading with negotiators to see sense.
The DDT ban, they wrote, may have been “supported by most wealthy Western countries and several environmental NGOs,” but the cheap and effective chemical was “a critical tool in the fight against malaria, which remains a terrible scourge of the developing world.”
The only relevant question was not whether DDT posed health risks, but “whether those risks outweigh the tremendous public health benefits of DDT for malaria control.” They did not, the scientists concluded. Indeed, banning DDT “would result in a tremendous number of additional deaths.”
As for the risks of DDT, a paper published in The Lancet the following year pointed out that although the chemical had been in widespread use for 55 years, the supposed threat to human health and the environment had “not been confirmed by replicated scientific inquiry.”
Rachel Carson, whose book first demonized DDT, died in 1964, just two years after it was published. Under the headline “What the world needs now is DDT,” an article in the New York Times Magazine in 2004 noted that nowhere in her book had Carson mentioned that DDT had been responsible “for saving tens of millions of lives, perhaps hundreds of millions.” The article was unflinching in its conclusion: Silent Spring was “now killing African children.”
Today, Carson is a hero of the environmental movement. Nobel laureate Paul Müller, whose discovery saved millions of human lives, died a year after Carson, his reputation in ruins. DDT will not play a part in the WHO’s latest “ambitious, achievable and necessary” drive to eradicate malaria within a generation, but money will.
In 2017, more than US$3 billion was invested in malaria control and elimination efforts in countries where the disease remains endemic. But that is far from enough, says the WHO. To hit the target of reducing the number of malaria cases and deaths by 90% in the 29 countries that account for 95% of the global burden of the disease will require an extra $34 billion.
Finding it, says the WHO, will be “challenging,” but eradicating malaria would prevent 2 billion cases and save 4 million lives. And that would indeed be “an astonishing humanitarian triumph.” But how much greater that triumph would have been and how much more humanitarian if the world had not balked at achieving it half a century and countless millions of lives ago.
This article was provided to Asia Times by Syndication Bureau, which holds copyright.