Dear
Colleagues
At
the end of this long and successful campaign, the Malaria Foundation
International (MFI) and the Malaria Project (MP), led by Amir Attaran,
would like to both thank and congratulate you and the many parties
for valuable assistance that helped to succesfully obtain an exemption
for DDT at the INC 5 POP's negotiations recently in South Africa.
In particular, we thank the over 400 doctors and scientists from 63
countries, who lent strong support last year when this issue was first
brought to the attention of the scientific community. It was due only
to this strong support of yourselves, voiced together with others
in the public health community, that DDT was not slated for elimination
along with the 11 other chemicals on the treaty.
This outcome will save many lives, and it also demonstrates the power
of coherent advocacy in achieving public health goals, which is a
critical function served by the Malaria Foundation International.
In
March 1999, the MFI and the MP wrote an open letter to treaty
delegates arguing against a DDT ban without replacement.
We thank the following SIGNATORIES for their support. |
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READ THE LETTER
THAT WAS PRESENTED TO THE DELEGATES
English English
(pdf) French French
(pdf)
Background
information on why the MFI has supported an eventual but not
immediate ban of DDT:
In certain situations
[see KwaZulu-Natal and Ethiopia]
there are few effective or affordable alternatives. This puts
hundreds of thousands of lives at risk from malaria - in countries
where DDT is used to spray homes to block transmission of malaria.
Malaria and leishmaniasis are diseases that are in resurgence
in many parts of the world. Diminished control efforts are,
at least in part, responsible for this resurgence (Roberts et
al. 1997, Roberts et al. 2000, Baird 2000).
The MFI has supported an eventual (not immediate) ban, with
the proviso that an effective and affordable replacement is
found before DDT is banned.
DDT is one tool of many in the malaria control worker's toolbox.
The reason that it is being discussed at this site is that,
unlike other tools, there is an imminent danger of it being
taken away. This puts not just health, but lives, at stake.
The MFI wants to see all possible tools
for malaria control be readily available, because malaria is
a serious, resurgent problem with drug resistance and increasing
numbers of illnesses and deaths.
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Baird,
J.K. 2000. Resurgent malaria at the millennium: control
strategies in crisis. Drugs. 59(4):719-743. Abstract.
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Further
details about the negotiations:
At
7:28 am on Sunday, 10 December 2000, the delegates in Johannesburg,
South Africa, approved a treaty allowing for the continued use of
DDT in disease vector control as the United Nations Environment Program
concluded the fifth and FINAL round of negotiations on a treaty to
ban persistent organic pollutants. The official mandate of the treaty
was to "reduce and/or eliminate" twelve POPs, of which DDT was one.
This led groups such as Greenpeace, World Wildlife Fund, Physicians
for Social Responsibilty and over 300 other environmental organizations
to advocate for a total DDT ban, starting as early as 2007 in some
cases. Although the open letter you signed made considerable progress
in persuading these environmental groups to change their views, it
was only the diplomats and delegates of 120 countries at the Johannesburg
negotiations who could take the final decision. I am delighted to
report to you that They decided that DDT is a unique case, and whereas
the other eleven POPs dealt with by the treaty are on a list to be
"prohibited or eliminated" (Annex A of the treaty), DDT alone is on
a list to be merely "restricted" (Annex
B), with the primary restriction being that DDT use in agriculture
is hereby eliminated. The future public health uses of DDT are safeguarded
by a "DDT exemption" written into the treaty. That exemption:
(1) restricts DDT use and production to disease vector control only
(not agriculture);
(2) requires countries using DDT to follow WHO guidelines for disease
vector control;
(3) requires countries to notify WHO if they use DDT;
(4) requires rich countries to pay the "agreed incremental costs"
of more expensive alternatives to DDT (this is located elsewhere in
the treaty); and
(5) encourages rich countries to support research and development
of alternatives to DDT;
and having said this, what the treaty does NOT require is equally
important:
(1)
it does NOT require a country to notify WHO before it sprays DDT,
so in an epidemic a country may spray first and report to WHO later;
(2) it does NOT require a country to obtain WHO's approval at any
time;
(3) it does NOT require poor countries to bear the added cost of alternatives
to DDT;
(4) it does NOT set a deadline by which countries must stop using
or producing DDT; and
(5) it does NOT restrict DDT use to malaria control, but allows for
controlling any vector-borne disease.
The
outcome of the treaty is arguably better than the status quo going
into the negotiations over two years ago. For the first time, there
is now an insecticide which is restricted to vector control only,
meaning that the selection of resistant mosquitoes will be slower
than before.
Also, there is a clear procedure that endemic countries may follow
to use DDT, and having done so, they have the RIGHT at international
law to use DDT, without pressure from the developed countries or international
institutions who have in the past threatened them against doing so.
Finally,
it provides a legal understanding that rich countries should do more
to research and develop alternative control measures for malaria,
with the goal of "decreasing the human and economic burden of disease".
This will, we hope, translate into additional funds for malaria research
and control. The provisional text of the DDT exemption (Annex
B) may be read here.
Respectfully
submitted by Dr. Amir Attaran |
