Malaria cases rising

-Ramsammy urges review of DDT ban
Health Minister Dr. Leslie Ramsammy says the sector is struggling to sustain reduced levels of malaria incidences in the country and he is calling for a review of global policies on the production and use of DDT indoor spraying.

The health sector is basically out of options, Ramsammy explained, noting that efforts to control malaria have stagnated this year and the recorded cases are climbing. He said malaria reductions were significant between 2004 and 2008—almost 80%—as a result of investment in the use of long-lasting insecticide impregnated bed nets, training for health workers and use of better medicines.

However, Ramsammy noted that there were “significant problems” in containing the spread of malaria within the last year and according to him, DDT residual indoor spraying for malaria prevention and control has been effective in the past, particularly in eliminating malaria from the coast in the 1950s. But DDT was phased out in many countries following the Stockholm Convention and is prohibited for use in malaria treatment with a few exemptions.

Ramsammy noted that manufacturing of DDT has been severely curtailed since the Convention with only a few countries including India and China in production.  He said too that while the World Health Organisation (WHO) still endorsed and support DDT for Vector Control, transportation of the insecticide is prohibited.

Ramsammy released a statement on Saturday last pointing to DDT as an effective tool to control mosquito population in countries around the world before the virtual ban. He said it is the most effective and affordable chemical “we have to control malaria,” adding that the global response to the burgeoning malaria rates in the world should allow for DDT residual spraying. “My position is that the benefits in the use of DDT for public health purposes far outweighs the risk for low-level usage of this chemical. Regulations and policies of industrialized countries and international agencies that block financial assistance to countries for the use of DDT for malaria control should be eliminated,” he said.

The Health Minister said that sustained international donor support for vector control activities is not available at this time and he argued that without such support the availability of expensive recommended IRS commodities will remain unreliable and therefore the battle against the malaria vector will remain weak.

Dr. Leslie Ramsammy

He continued that there are many other examples of poor international policies relating to DDT that have contributed to morbidity and mortality of mosquito-borne diseases. He cited Belize, saying that in 2000 that country was threatened by USAID with withdrawal of support if it were to use DDT.

Ramsammy stated that many of the rich countries used DDT to once control vector like mosquitoes and today are the countries in the forefront of the policies to ban the use of DDT in developing countries. “Guyana, like many other poor countries need increase donor funding for not only malaria prevention and control but also for research and with the present non-availability of DDT–either allowing its availability or the international community providing sustained support for alternative control methods,” he stated.

Ramsammy suggested the establishment of a global mechanism for the production and distribution of DDT for prevention and control of malaria, dengue and other mosquito-borne diseases. He argued that the low-level usage for public health purposes will not have any environmental impact. “The removal of DDT from the arsenal of tools we can use against mosquito is  not only a foolish policy, but a deadly and impoverishing one,” he declared, adding that the case against DDT as a harmful environmental chemical is weak compared to the fact that millions are dying and hundreds of millions are sick and disabled and becoming impoverished because of mosquito-borne diseases.

He said also that the virtual banning of DDT is a policy that cannot be justified, and as climate change causes a new surge in mosquito population, “we need to use all effective vector control chemicals at our disposal”. Ramsammy said further that the battle against malaria will also benefit from education and awareness, eradication of the vector (mosquito), as well as medically treating the parasite itself.

Since DDT was phased out Pyrethroids have now largely replaced other insecticides as the main IRS insecticide. Ramsammy said that mainly because of their short residual life-cycle and biodegradable property, the pyrethroids have been the preferred insecticide for IRS control of mosquito (vector) population, in preference to DDT.

However, he said the use of the pyrethroids has been limited because of their extremely high cost and the need for greater frequency of application when compared to DDT in the hot, humid conditions of the endemic malarious areas which are also far, isolated and difficult to access. “These areas are the rich, biodiversity areas of the Amazon of Regions #1, 7, 8, 9 and parts of 2 and 10.  Also, they are the areas of Guyana’s forest, mineral deposits and vast water resources and the home of the poor, vulnerable indigenous Amerindians,” he added.