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April 06, 2008

DDT spraying for malaria will not jeopardize Uganda's agro-exports

by Myers Lugemwa

I wish to respond to a story in The New Vision of March 31, titled, "Bundibugyo rejects DDT spraying." The article said the district council had rejected the Government's programme of indoor residual spraying because cocoa buyers threatened to stop buying the produce if the area was sprayed with DDT.

The Ministry of Health is aware of the many alternatives that exist for the control of malaria, including the insecticide-treated nets. But Uganda, like many other countries, decided to use DDT for public health, based on the World Health Organisation and the National Environmental Management Authority guidelines as well as the Stockholm Convention.

The use of DDT in the above countries has dealt a big blow to malaria. Like Bundibugyo, some of these countries grow cocoa and export it to Europe and beyond.

There are certain levels of DDT acceptable in the food chain, regardless of the levels in the environment and living tissue. Even if there was no market for such produce abroad, no country would wish to have its citizenry consume foods impregnated with harmful toxic substances.

It would be naïve, therefore, for the Government to make futile decisions to use DDT at the detriment of the wanainchi economy or agriculture, the backbone of Uganda. The European Union advised Uganda that it will allow all its agro exports if DDT levels do not exceed the internationally-stipulated levels.

Indoor residual spraying is an exercise that entails the spraying of any chemical meant for public health use within (inside) the dwelling of household members and not outside where agriculture takes place.

Moreover, there is an ordinance regarding storage of agricultural produce which stipulates that crops/produce shall not be stored in the same environment with man and other animals. This is why in the past, every household was compelled to have granaries.

The ordinance still holds and we should invoke it to protect our agro-exports from vermin and other contaminants. This falls within the mandate of Bundibugyo district council and others.

While the district council implored the Government to use "less toxic" alternatives, such alternatives have been used at one time or another and will continue to be used where and whenever applicable.

However, the cost benefit analysis of such alternatives, including the insecticide-treated nets, has been on the lower compared to DDT. Indeed, malaria remains the number one killer in Bundibugyo yet the district has benefited from alternative prevention programmes.

This does not mean that DDT is a magic bullet solution in the fight against malaria. Rather, it is part of a combination of strategies such as case management, Intermittent Preventive Treatment in pregnancy, use of insecticide-treated nets, good environmental management, behavioural change, communication and information, communication and education, and use of other insecticides such as Iconare.

Fourthly, the Public Health Act alludes to mosquitoes as a nuisance and failure to have the environment in which the mosquitoes live disinfected is in itself an offence. Wana inchi should be reminded of this act in order to have healthy people who will grow more cocoa and fight poverty, thus addressing government programmes like Poverty Eradication Action Plan and Bonna bagagawale.

It would be naïve, therefore, for the Government to make futile decisions to use DDT at the detriment of the wana inchi economy or agriculture, the backbone of Uganda. The European Union advised Uganda that it will allow all its agro exports if DDT levels do not exceed the internationally-stipulated levels.

Indoor residual spraying is an exercise that entails the spraying of any chemical meant for public health use within (inside) the dwelling of household members and not outside where agriculture takes place.

Moreover, there is an ordinance regarding storage of agricultural produce which stipulates that crops/produce shall not be stored in the same environment with man and other animals. This is why in the past, every household was compelled to have granaries.

The ordinance still holds and we should invoke it to protect our agro-exports from vermin and other contaminants. This falls within the mandate of Bundibugyo district council and others.

While the district council implored the Government to use "less toxic" alternatives, such alternatives have been used at one time or another and will continue to be used where and whenever applicable.

However, the cost benefit analysis of such alternatives, including the insecticide-treated nets, has been on the lower compared to DDT. Indeed, malaria remains the number one killer in Bundibugyo yet the district has benefited from alternative prevention programmes.

This does not mean that DDT is a magic bullet solution in the fight against malaria. Rather, it is part of a combination of strategies such as case management, Intermittent Preventive Treatment in pregnancy, use of insecticide-treated nets, good environmental management, behavioural change, communication and information, communication and education, and use of other insecticides such as Iconare.

Fourthly, the Public Health Act alludes to mosquitoes as a nuisance and failure to have the environment in which the mosquitoes live disinfected is in itself an offence. Wana inchi should be reminded of this act in order to have healthy people who will grow more cocoa and fight poverty, thus addressing government programmes like Poverty Eradication Action Plan and Bonna bagagawale.

*Dr. Myers Lugemwa is the international health specialist with the National Malaria Control Programme in the Ministry of Health

New Vision

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