False reporting and the fight against malaria
The Big Read At the dawn of the new millennium, hospitals and clinics in northern KwaZulu-Natal were inundated with patients and graveyards were filling up fast. The area was in the tragic grip of one of the most severe malaria epidemics in its history. Luckily, though, by 2001, malaria cases had fallen by more than 80% thanks to the reintroduction of DDT. Spraying small amounts of DDT inside houses stopped the malaria epidemic in its tracks.
South Africa and several other countries rely on DDT to save lives. Many environmental groups oppose the use of DDT - and all other insecticides - in public health.
Some UN groups appear to be so captured by radical environmental interest that they are prepared to put millions of dollars into a disingenuous campaign to claim that insecticides are not needed to control insect-borne diseases. And, if they get their way, all such use will be stopped. And most regrettably, the UN seems prepared to abuse science and publish false data to achieve its political goals.
The Global Environment Facility (GEF), a partnership of various UN agencies and the World Bank, funded experiments in so-called environmentally sound malaria control. Starting in 2004, in selected areas of Mexico and seven countries in Central America, GEF attempted, over several years, to demonstrate that malaria could be controlled without using any public health insecticides, in particular DDT.
These environmentally sound interventions included using fish to eat mosquito larvae, whitewashing the interior of houses and planting neem and oak trees around them. At the end of the experiments, GEF, the UN Environment Program (UNEP), and even elements of the World Health Organisation (WHO), claimed that they had achieved more than a 60% reduction in malaria.
In reviewing the evaluations of these experiments, we found the claims of success to be based on manipulated and false data. Our research paper was published in Research and Reports in Tropical Medicine.
The GEF/UNEP projects established demonstration areas where "environmental" interventions were used, and scientific controls where there were no such interventions.
Both the demonstration areas and the controls were situated in high malaria burden areas, where, as a separate activity to the GEF/UNEP experiments, malaria control programmes were distributing malaria medicines widely.
At the end of the GEF/UNEP experiments, it was shown consistently, across all countries, that there were no differences in malaria rates between demonstration areas and controls. This confirmed something that most malaria scientists have known for a long time; malaria cannot be controlled with environmental management alone.
To arrive at their impressive results, GEF/UNEP ignored the outcomes of their own experimental design with controls and instead claimed that the national reductions of malaria cases were as a result of their experimentation.
Malaria cases in six of the eight countries had indeed fallen, thanks not to the environmental methods, but rather, to the widespread distribution of anti-malaria medicines.
Not a single, peer-reviewed scientific study documenting the project was published. Yet, despite this, and the obvious manipulation of data, UNEP's Executive Director, Achim Steiner, described their false results, in an Orwellian moment, as "calculated and tested science".
Of more urgent concern is that, when it comes to Africa, even if GEF had been honest about the reasons for the reductions in malaria cases, the successful strategies employed in the "test" countries would be irrelevant.
Those same drugs when used in Africa are useless because of the degree of resistance to them that has built up and because the countries' health systems are totally inadequate for any widespread drug distribution programmes.
The global use of DDT is governed by the Stockholm Convention on Persistent Organic Pollutants (POPs). This UNEP Convention allows DDT to be used in malaria control until a safe, effective and affordable alternative is developed. And this is probably the reason why these agencies were prepared to be involved in such tawdry false reporting.
UNEP and its partners have set an arbitrary and scientifically unjustifiable goal of stopping all production of DDT by 2017 and halting all use by 2020. But these goals can be met only if it can be demonstrated that safe, effective and affordable alternatives are available.
UNEP has gone even further than just misleading the public on the outcomes of their wasteful experiments in Latin America. In an effort to find new areas over which to exert their control, senior UNEP officials have publicly said they are seeking to reformulate WHO's global malaria programme to focus it more on the global elimination of DDT and other insecticides.
SADC governments must vigorously oppose the UN agencies that seek to put their own political power and budgets ahead of the lives of their countries' children who are at risk from malaria. These governments should insist that UNEP officials visit the graveyards of northern KwaZulu-Natal to see the devastation their policies cause.
- Tren is executive director of research and advocacy group Africa Fighting Malaria. Roberts is Professor Emeritus of Tropical Public Health at the Uniformed Services University of the Health Sciences. These views are not necessarily shared by the Health Policy Unit.