Thursday, 19 May 2011

MALARIA: As DDT Makes a Comeback, Uganda Must Weigh Its Costs

JOSH KRON : May 18, 2011
 Marc Hofer for The New York Times
Bosco Acope and his family tend their farm in Atek, Uganda, where the government's use of DDT has threatened their livelihood.

Growing up as a child here along the muggy, isolated plains of northern Uganda, life was not easy. His parents were poor. He did not attend secondary school. Many of his friends died from bouts of malaria, a scourge that has plagued this agrarian society.
Mr. Acope, 49, survived. At 19, he became a small-time farmer, with one acre of land. He married. He sowed. “I have been a farmer in this life,” he said.
When the American government, a generous and close friend to Uganda, began an organic-farming program to help rural economies here, Mr. Acope expanded, selling a wide variety of commodities at good rates.
His one acre became seven. Mr. Acope fathered 11 children. Uganda was developing, and Mr. Acope was one of many who were riding high, he said.
But the very next year came winds of change. Faced with unrelenting malaria, which threatened both lives and livelihoods, Uganda’s government teamed up with the United States to use chemical insecticide sprays — including DDT — to try to eliminate the disease. Mr. Acope’s home district, Apac, which has some of the highest malaria rates in the world was chosen for spraying in early 2008.
Mr. Acope said an official from the organic-farming company he sold to, which was also supported by the United States, warned that the sprays were dangerous. Mr. Acope’s produce would no longer be guaranteed to be organic — especially since many crops were stored indoors, where the spraying occurred — nor would it be bought at a lucrative price.
“I was told to protect my market, to try to stop the spraying,” Mr. Acope said. “But the whole village was sprayed.”
One morning, he recalled, he watched a group of men in gas masks who were carrying metal canisters pass through the village, and just like that, Mr. Acope’s organic-food market was gone. He said he had to pull three of his children out of school. Furthermore, the chemicals in the insecticide lasted so long that the organic-farming companies said they would not be back for 15 years.
So Mr. Acope is helping to take his government to court.
Once condemned as poisonous and inhumane, DDT has staged a recent comeback. In 2006, the World Health Organization strongly endorsed the chemical’s use on indoor walls as a cheap and long-lasting weapon in the fight against malaria. The United States also sanctioned DDT to combat the disease in African countries with “a high burden of malaria,” including Uganda.
The United States sprayed DDT to eliminate the last remnants of malaria across North America. The disease’s eradication was a milestone in public health and development. Malaria almost thwarted construction of the Panama Canal and “influenced to a great extent human populations and human history,” the Centers for Disease Control and Prevention says.
But the United States banned the use of DDT in 1972 over the chemical’s hazardous environmental impact. Studies have also linked DDT to diabetes and breast cancer. One examination of the consequences of using DDT to fight malaria in sub-Saharan Africa, conducted by the National Institute of Environmental Health Sciences, said the chemical might have increased infant deaths.
Still, the risks of not spraying are clear as well. In Africa, malaria kills 2,000 children each day, according to Unicef, and costs approximately $12.5 billion in lost incomes each year, the Malaria Consortium says.
“It really affects the whole fabric of the economic system in Africa,” said Dr. Patrick Lukulay, a consultant to a United States Agency for International Development initiative to treat malaria. “It prevents people from being productive citizens.”
In the Apac region of Uganda, the United States focused on two conflicting agendas: developing organic farming and eradicating malaria, ultimately affecting the livelihoods of tens of thousands of farmers.
U.S.A.I.D. “has supported agricultural development in Uganda for many years, including the promotion of organic farming in Northern Uganda,” said Michael Brander of BioVision, a Swiss organization focused on eco-friendly economic development. “Organic farming provided a good price at low production costs for farmers; however, it was exactly in those areas they also supported spraying of DDT.”
Now Uganda’s constitutional court is expected to hear a case brought by a Ugandan environmental organization against the government that asserts that officials failed to meet W.H.O. standards for using DDT, including failure to properly prepare the local population.
But given the prevalence of the disease, “chemical spraying with strict monitoring and supervision is one of the most effective measures to control malaria in high-risk areas,” said a United States Embassy official, who was not authorized to speak publicly.
The village of Atek is a place where mangoes can be eaten directly from trees and children walk to school shoeless. Farming is a way of life, and the American aid agency’s organic-farming program gave the village a competitive edge.
When the DDT was sprayed, organic-farming companies say they lost the bulk of their supply immediately. An American-owned company, Dunavant, had 50,000 certified organic farmers in areas affected by the spraying, according to the Uganda Network on Toxic Free Malaria Control, the organization taking the government to court. Shares, another farming company, said at least 16,000 of its suppliers were affected.
“All that got lost,” said Jan-Alex Fokkens, the director of Shares. “It was game over.”
The organic-farming companies sued the Ugandan government after the first rounds of spraying, and a high court issued a temporary injunction on the use of DDT in 2008, but the case was later dismissed.
The American government says it has not returned to using DDT in Uganda since the court ruling, even though the Ugandan government has made numerous references to reinstituting the chemical. Now, the main chemical being used in the insecticide-spraying program, bendiocarb, has also been discontinued in the United States, and it is considered to be more expensive and less efficient than DDT.
“At a certain point bendiocarb will fail,” said Richard Onen, a field coordinator for Abt Associates, a business contracted by U.S.A.I.D. to carry out its indoor spraying program. “I cannot rule out the possibility of using DDT. It is cheap.”
But there are questions as to how well DDT worked in Uganda in the first place. “Mosquitoes had become resistant to the DDT,” said Kale Dickinson, a nursing officer at a local health center. “DDT was not effective.”
For Lillian Etime, Mr. Acope’s neighbor and a mother of six, the death of her chickens during the first round of spraying set off alarm bells. “We feared that the children could touch the wall,” where spray was administered, “and they could die,” said Ms. Etime, 32. Ultimately, it was business that suffered the most, she said, with her revenue reduced by more than half. “The problem I experience is the problem of money,” she said.
Underneath a mango tree nearby, Mr. Acope lamented his own reversal of fortune, but remained stoic. “I am now working on my own,” he said. “Still growing.”
http://www.nytimes.com/2011/05/19/world/africa/19uganda.html?_r=1&pagewanted=all

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