Malaria continues to ravage communities and economies and claims the life of a child approximately every 45 seconds. Some progress has been made in recent years, but this could be undone if some UN agencies continue their campaign to stop the use of public health insecticides in the fight against malaria. Unless the donor nations that fund global malaria programs, such as the US, firmly reject the unscientific, fear-based opposition to insecticides, progress against this preventable and curable disease will be lost.
The Global Environment Facility (GEF), a partnership of various UN agencies and the World Bank, funded experiments in so-called environmentally sound malaria control. In selected areas of Mexico and seven countries in Central America, GEF attempted, over several years starting in 2004, to demonstrate that malaria could be controlled without any public health insecticides, in particular DDT. The environmentally sound interventions included using fish to eat mosquito larvae, whitewashing the interior of houses and planting neem and oak trees around houses.
At the end of the experiments, GEF and UN Environment Program and even elements of the World Health Organization (WHO) made the bold and impressive claim that they achieved a reduction in malaria of over 60%. We recently reviewed these experiments in a paper published in the peer-reviewed journal, Research and Reports in Tropical Medicine (RRTM), and found them to be based on manipulated and false data.
The GEF/UNEP projects employed demonstration areas where the “environmental” interventions were used and controls where they were absent. The results reveal what most malaria scientists have known for a long time; that indeed malaria cannot be controlled with these environmentally sound methods. Consistent across all countries was the fact that there were no differences in malaria rates between demonstration areas and controls.
GEF/UNEP arrived at their impressive results by ignoring their own experimental design with controls and claiming national reductions of malaria cases as their own. Indeed, purported successes were claimed by GEF, UNEP and others of the environmental sector, not by those who managed the national malaria programs. Importantly, malaria cases in six of the eight countries have fallen in recent years, but not thanks to the environmental methods. The successful reduction of malaria cases has been principally due to widespread distribution of anti-malaria medicines.
Even if GEF had been honest about the reasons for reductions in malaria cases, the strategies employed would be irrelevant for Africa, where the drugs used are useless because of resistance and where the health systems are totally inadequate for any widespread drug distribution program.
The question of course arises as to why these agencies would be involved in this tawdry false reporting. The answer may well lie in those age-old motivators: money and power.
The global use of DDT is governed by the Stockholm Convention on Persistent Organic Pollutants (POPs). This UNEP Convention allows for DDT to be used in malaria control until a safe, effective and affordable alternative is developed. Millions of taxpayer dollars have been made available via the GEF to find those alternatives. In Mexico and Central America, GEF spent around $14 million on failed experiments. Reporting back that its efforts had nothing to show would not reflect well on GEF and its partners and would probably jeopardize future funding.
UNEP has gone further than just mislead the public on its wasteful experiments in Latin America. In an effort to find new areas over which to exert their control, senior officials within the agency have publicly said they seek to reformulate WHO’s global malaria program so that it is more focused on eliminating DDT and other insecticides. The malaria scientists within WHO are, quite rightly, focusing on eliminating malaria rather than the tools they need to do the job. Based on the evidence we have uncovered, any further UNEP power over global malaria control would only cost lives.
Global budgets for malaria control and treatment have risen sharply, thanks in large part to funding from the US taxpayer. These funds have helped to reduce the malaria burden and have most likely been an effective use of donor aid. The new Congress however should jealously guard the investments that the US has made to date and ensure that US funds are spent on the best possible interventions for which there is strong evidence of success. This means rejecting the UNEP/GEF false claims and working to ensure that the funds they have allocated for their anti-insecticide work are re-allocated to those agencies that have the expertise and motivation to beat malaria.
Richard Tren is executive director of malaria research and advocacy group, Africa Fighting Malaria. Donald Roberts is Professor Emeritus of Tropical Public Health at the Uniformed Services University of the Health Sciences.