MALARIA AND DDT

Malaria and DDT

Malaria and DDT

Introduction

Nowadays, like previous years within the past few decades, uncountable trillions of mosquitoes may inject malaria parasites into human blood streams billions of times. Some 400 to 400 million full-blown cases of malaria will result, and between two and three million people may die, most of them pregnant women due to breast cancer. (Cohn, Wolff, Cirillo & Sholtz, 2007) Very roughly, the malaria death toll rivals that of AIDS, which now kills about two and half million people every year. Malaria is reemerging in most diseaseendemic countries of South America. Even though disease incidence is increasing, the level of increase is undefined. More importantly, the reasons for the increase in malaria rates after decades of successful disease control have not been assessed. (DDT: An Introduction: http://www.chem.duke.edu/~jds/cruise_chem/pest/pest1.html)

The Global Malaria Control Strategy

The policies and strategies of the World Health Organization, the Pan American Health Organization (PAHO), and national donor agencies contributed to the successful control of malaria from the late 1940s to the late 1970s (WHO, 1957). However, the policies and strategies of these organizations have changed (Gilles, Warrell, 1993). In 1979, the World Health Organization Expert Committee on Malaria (WHO, 1979) developed a new malaria control strategy with four tactical variants. Variants 1 and 2 included no organized vector control measures. Variant 3 included limited vector control and only variant 4 included, for highly qualified countries, countrywide vector control. The goal for variant 4 was specified as eradication, not sustained malaria control.

The new strategy was adopted by the 31st World Health Assembly as resolution WHA 31.45 (WHO, 1979). During this assembly, the Director-General of World Health Organization stressed the importance of including curative and preventive services, including control of infectious diseases (malaria control), in the framework of primary health care. In 1985, the 38th World Health Assembly adopted resolution WHA 38.24, which recommended that malaria control be developed as an integral part of the national primary health care system (Gilles, Warrell, 1993). In October 1992, the Ministerial Conference adopted the Global Malaria Control Strategy that had been developed at World Health Organization (WHO) interregional meetings in 1991 and 1992 (WHO, 1993).

The Global Malaria Control Strategy calls for deemphasis of vector control and emphasizes case detection and treatment. The first conclusion and recommendation of the report is that malaria control should be fully integrated into general health services and should reflect socioeconomic development objectives. The World Health Assembly resolutions and committee reports document, from 1979 to the present, general, and sometimes specific, policy decisions that promote case detection and treatment and deemphasize residual spraying for national malaria control programs.

Failure to maintain control over malaria most likely results from failures in the functions of interventions or from failures to make proper application of interventions. Although DDT resistance is often posed as a reason for malaria control failure, resistance of vector populations to DDT is not widespread in South America (WHO, 1980). There are two common interventions for reducing malaria transmission within human ...