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Evaluating Alternatives to DDT for Malaria Control: A Comprehensive Review

This report, prepared by Janice Jensen for the USEPA LRTAP POPs Task Force, assesses the availability and practicality of safer and economically viable alternatives to DDT for malaria vector control. It emphasizes coordination with WHO, UNEP, and FAO, reflecting on global production and use of DDT under the Stockholm Convention. Factors influencing DDT reliance, such as vector ecology, health services, and available resources, are discussed. The report concludes that while DDT may be cost-effective, other strategies and insecticides are increasingly being used in areas where malaria re-emerges.

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Evaluating Alternatives to DDT for Malaria Control: A Comprehensive Review

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  1. Alternatives to DDT Janice Jensen, USEPA LRTAP POPs Task Force March 1, 2004

  2. Purpose • Review availability & feasibility of safer and economically viable alternatives to DDT • Coordinate with WHO, UNEP, FAO • Final review due by one year after EIF

  3. DDT Global Production & Use Intend to produce - Stockholm Convention • China • India • Russian Federation Indicated the need to use - Stockholm Conv • Disease vector control (32 countries) • Intermediate to produce dicofol (Brazil, China) • As contaminant in dicofol (Korea)

  4. World Health Organization • Action Plan to reduce reliance on DDT • Component of Roll Back Malaria • WHO will assist countries to reduce reliance on DDT • Concerned about re-emergence of malaria in areas considered “eradicated”

  5. Alternative Vector Control Strategies Factors that contribute to DDT use: • Malaria transmission intensity • Vector biology and ecology • Health and vector control services • Available resources • Insufficient knowledge base • Lack of safe, cost-effective alternatives

  6. Instead of DDT, countries rely on… • Other residual insecticides • Biological control • Personal protective measures such as impregnated bed nets • Environmental management

  7. Chemical Pesticides • WHO pesticide evaluation scheme • Evaluates new products • Identifies pesticides that meet WHO standards and guidelines for malaria control • Assesses pesticide cost effectiveness-case by case • DDT may be least expensive-cost per house

  8. 1990 Cost Comparison of Insecticides Reference: K. Walker, Medical and Veterinary Entomology (2000) 14, 345-354.

  9. WHO Insecticides Suitable for Indoor Spraying

  10. Conclusions • DDT is not produced or used by most countries in the UNECE region • Malaria is not a significant health problem in the region • However, malaria is re-emerging in areas where it was considered “eradicated” • Several pesticides are routinely used for vector control in place of DDT • Cost data indicate that DDT may be the least expensive pesticide on a cost per house basis • Insect resistance, high cost, and market access may limit insecticide choice • Other interventions (early diagnosis and treatment) may be more cost effective than VC

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