Rollback Malaria (RBM) was established in 1998 in part to reinvigorate the worldwide fight against malaria, and in part to facilitate the negotiations for what became the Stockholm Convention, the Persistent Organic Pesticides Treaty of 2001.
That’s about the time the ungodly assault on WHO and Rachel Carson started, by hysterical DDT advocates. We now know that Roger Bate, Richard Tren, Donald Roberts and their comrades in pens are stuck in that 1998 fight.
Here’s a short account, from RBM, about just what happened:
The DDT Controversy
In 1999 the RBM Secretariat was called upon to help resolve a controversy emerging from intergovernmental negotiations to establish an international environmental treaty. At the centre of this controversy was DDT, former hero of the malaria eradication campaign and current totemic villain of the environmental movement. The treaty being negotiated was intended to eliminate the production and use of twelve persistent organic pollutants. DDT, still used for malaria control in over 20 countries, was included among ‘the dirty dozen’ chemicals slated for elimination, eliciting a strong reaction from public health activists and malaria specialists who claimed that its elimination would result in unacceptable increases in malaria morbidity and mortality. Environmental specialists and others claimed that environmentally friendly alternatives to DDT, although more expensive, could easily be deployed to guard against such a negative impact.
The controversy over the role of DDT in malaria vector control and the dangers posed to the environment escalated and attracted considerable media attention. The controversy was perpetuated in part because of a relatively weak evidence base on the human toxicity of DDT, the cost-effectiveness of proposed alternatives, and the probable impact of public health use of DDT (compared to agricultural use) on the environment. Resolution was also hampered by the relative lack of public health expertise among the Intergovernmental Negotiating Committee delegates, who were primarily active in the fields of foreign and environmental policy.
The challenges presented to the RBM Secretariat in responding to the controversy were many and varied. They included: evaluation of the evidence base and the drafting of policy guidance (a WHO normative role); a major communications effort; and the establishment of new cross-sectoral partnerships and working relationships. In the process, RBM formed new and highly effective ‘partnerships’ or ‘working relations’ with the United Nations Environment Programme (UNEP), the US Environmental Protection Agency, the environmental policy apparatus of core RBM partners, as well as a variety of health and environmental NGOs. RBM conducted country and informal expert consultations and convened and chaired a special working group on DDT which was able to establish a position on the use of the insecticide in public health and the process for evaluating and moving to alternatives. The weight of WHO’s technical authority contributed greatly toward establishing the credibility of the working group. Information about the treaty negotiations and the WHO position on DDT was disseminated to health specialists via the WHO regional networks and to treaty focal points via UNEP.
The RBM Secretariat led the WHO delegation to all meetings of the Intergovernmental Negotiating Committee and prepared information and media events for each, supporting the participation of health/malaria specialists from a number of countries. The RBM Secretariat also served as the media focal point on malaria and DDT and provided interviews and information to all major media, as well as presentations to professional meetings and interest groups.
RBM’s objectives throughout this process were:
- to establish consensus on the present and future role of DDT and alternatives in malaria control;
- to encourage greater involvement of public health specialists in country-level discussions about the treaty and in country delegations to the negotiating sessions;
- to provide information to negotiators and others that would reduce controversy and result in a win-win situation for public health and the environment (in which the longer term goal of DDT elimination is achieved through strengthened, more robust malaria control);
- to benefit from the media attention to inform the public about malaria; and
- to mobilize resources to support malaria control from outside the health sector.
All of these objectives have been met and the final treaty, known as the ‘Stockholm Convention on Persistent Organic Pollutants’ provides for the continued public health use of DDT and international assistance for the development and implementation of alternatives.
Resources to support the initial work of the RBM Secretariat were provided by environmental agencies/offices. In addition, the Pan American Health Organization (PAHO) and the WHO Regional Office for the Americas (AMRO) and most recently the WHO Regional Office for Africa (AFRO) have been awarded project development grants from the Global Environment Facility (GEF) to promote regional efforts to strengthen malaria control and reduce reliance on DDT.