A recent posting by Christine Afandi summed up succinctly most of the human health concerns about DDT.Â While not downplaying human health effects, a bigger issue is, how can we keep DDT confined to the walls of homes? Shortly after Uganda announced its intentions to use DDT, neighboring Rwanda made the opposite decision and expressed concern that DDT use in Uganda would pollute its neighborâ€™s environment.Â How could this happen if countries follow WHO guidelines and use DDT only for indoor residual spraying (IRS)? Unfortunately, the answer is simple: leakage.
The newer donor programs are often focusing heavily on getting commodities out to communities at the expense of strengthening the management and oversight systems that ensure these commodities are used properly.Â Hence, one finds ACTs intended for public clinic use being sold in private pharmacies and drug shops. Stories about chemicals abound: pesticides intended for cocoa trees being used to kill and harvest fish; supplies of â€˜abateâ€™ intended for guinea worm control gone missing.
Leakage of malaria medicines costs individual lives by denying free treatment to poor children. Leakage of DDT supplies into the commercial and agricultural sectors threatens the whole environment. The question must be addressed: are malaria control programs and public health systems capable of safely managing and controlling DDT supplies?Â Until that question can be answered with strong assurance, IRS programs should be kept on the back burner.