The future role of DDT

DDT made a huge revolution in the fight against malaria during and after World War II. Many countries in the western part of the world used DDT before a thorough investigation about the consequences of such use was assessed, and an uncritical attitude towards the pesticide caused an extensive and massive use of DDT in many different applications. After a while, however, the use of DDT was followed by an increasing scepticism, and research was performed to evaluate what potential hazards were involved with the use of DDT. This led to developing the current restrictions that limit the use of DDT today (4).

In this part, we will discuss the consequences of the sceptical attitude towards DDT, and what the following ban for most uses of DDT means for the world. We will look at why it can be difficult for some countries to use DDT today, in part because of international attitudes and pressures. In addition, we have discussed what kinds of restrictions we think are necessary when it comes to the use of DDT, and what may perhaps be done in the future to change the current worldwide attitudes towards DDT.

During the past years, there has been an extensive debate about how the positive effects of DDT have largely been neglected. The big focus on the uncontrolled and ignorant application of DDT may have drawn the attention from the fact that the use of DDT has achieved many goals that would otherwise not be achieved. It is easy to look back and decide the best course of action in hindsight, but it is important to ask whether DDT would have been used less if the potential harm was known beforehand. Many of the results in the fight against disease-bearing insects were achieved before an assessment of the potential human health risks was even possible; in the beginning, there was no real dilemma in the use of DDT, because the cons were simply not known (4).

In addition, it is possible that it became easier for the West to ban DDT because of potentially negative health effects, considering that they had already achieved many goals through its use.

Without taking into account the current situation in malaria endemic countries, a ban on DDT might make sense; however, considering the heavy burden of malaria in large parts of the world, it is entirely possible that the potential benefits greatly outweigh the risks. However, the West shares its knowledge about the risks involved with the use of DDT in good faith, without, perhaps, fully

realizing the pressing need for solutions that many malaria endemic countries so desperately need.

For industrialized countries, the potential harm involved in the use of DDT may seem so severe that its use should be banned outright, even though its benefits may counterbalance the risks in other areas.

Another challenge is that researching increasingly demands thorough precursory investigation, and extensive evaluations of the results before a conclusion can be reached. Criticism is an important part of research, and meeting new methods and products with scepticism is natural in today’s scientific landscape, for better or for worse. In order to approve of a new product, vast resources have to be used first to assess and reassess all aspects. For the developing world, particularly in comparison with the industrial world, there is a pressing need for solutions, and the need to evaluate all aspects of a new product or measure constantly, may compromise the economy of the country, as well as the quality of life and the ability to fight the disease effectively in a reasonably timely matter.

In the end, it is not likely that this problem will be solved, as it is intrinsic to the ethical values of our society today; in order to do no harm, one first has to assess the benefits and risks involved, and that can be a costly and time-consuming affair.

In the WHO guidelines for DDT, statistically significant investigations that confirm the harm DDT has on human health are rejected. Instead, the aspect of DDT that causes most concern is the increasing resistance, which is currently the limiting factor of its use. In addition, WHO mentions that there is a need for further investigation on potential harmful effects of DDT on humans, as there is no clear answer to this question today (132).

WHO concludes that there still is a role for DDT in the fight against malaria, but that there is a need for developing new and effective insecticides (132). The scepticism and following ban of DDT in the industrialized nations has probably affected Africa’s opportunity to be able to make use of DDT.

Because many countries in Africa, including Malawi, depend on the support and contributions from industrialized countries in the fight against malaria, the industrialized countries also have a lot of impact on decision-making. This may lead to several challenges. It may be difficult for industrialized countries to understand the plight of developing countries when it comes to malaria, and perhaps especially when it comes to time as a critical factor. Malaria is a preventable, treatable disease, and

reasons why malaria is still a problem in large parts of the world.

Since DDT was banned in the USA in 1972, there has been little development of new and effective insecticides (82), especially when compared to the pharmaceutical industry, which has made huge progress in developing new medicines over the last decades (2). Is this a question about priorities, or is it a result of other factors? For a profit-driven industry, the priority is to develop novel solutions that are economically sound. Uncertainty about the long-term profitability of developing new insecticides may be one of the reasons why this development has been slow (4).

DDT has achieved wonders when it comes to fighting insect-borne diseases in large parts of the world, but concerns about the potential harmful effects has led to limitations in today’s use. As a result, countries in Africa have not had the full opportunity to exploit the potential of DDT in the fight against malaria, for better or for worse.