DECLARATION OF THE REGIONAL WORKSHOP ON PERSISTENT ORGANIC POLLUTANTS WITH SPECIAL EMPHASIS ON DDT: IS DDT THE ONLY VIABLE SOLUTION TO MALARIA IN AFRICA?
We, the scientists and other stakeholders meeting at the Hotel Africana, Kampala, Uganda on 26th to 27th of April 2004 after discussing the workshop theme "Is DDT the only viable solution to malaria in Africa?Ó having noted that:
á Malaria is the leading cause of preventable deaths in Sub-Saharan Africa. It places a huge burden on, and restricts the development potential of, especially the poor of Africa. This places a huge responsibility on the governments of the region, to apply the best possible interventions available, without compromising the health, economy or environment.
á The Minister for Health, Republic of Uganda, and Honourable Brigadier Jim Muhwezi clearly documented the human and economic cost dilemmas of Uganda government due to malaria.
á Countries at war with malaria need to involve communities by informing and educating them using various media, so that the communities, as key stakeholders, are involved in the planning and implementation of any adaptation methods. The impact and the inherent dangers of any synthetic or natural pesticide used, needs to be communicated in a balanced manner. This will bring scientific findings to the level of communities that will then be able to use them.
á Uganda has a unique agricultural set up. Smallholders account for 94 percent of all agricultural production and the majority keep their produce within their houses. Uganda is also in the process of establishing a niche among organic farmers in the region. The proposed method of use of DDT (indoor spraying) is likely to introduce DDT residues, which will hurt and disrupt the export potential of the country.
á The concessions regarding DDT, won during the negotiations for the Stockholm Convention (SC), were hard won. This legitimisation however, comes with a strong responsibility on the parties that are using, or planning to use DDT. Even non-parties will be bound by the narrow use restrictions imposed by the SC.
á DDT is one of the many weapons that can be used successfully against malaria. However, the use of such a weapon, or any other insecticide used for public health, can only be wielded by a well-trained corps of applicators. If the use of DDT in the context of malaria control is not implemented in a sustainable and effective fashion, then the strong possibility exists that the weapon, which Africa has fought so hard to get, will become compromised on a political level, and hard to motivate continued use.
Hereby resolve that:
1. The control of malaria must be approached from a holistic point of view including Integrated Vector Management (IVM). This involves inter alia, the additional support from a well-organised health service, including active surveillance and case management, as may be deemed appropriate for the conditions of the country or regions, taking into account local, regional and global climate patterns.
2. The control of malaria is possible without the application of DDT if research and awareness on the alternatives can be intensified.
3. In view of the security and urgency of UgandaÕs malaria burden, the responsible and well regulated use of DDT in malaria control is one of the practicable and proven means of interruption of malaria transmission. However, there are other means of control that can be used in combination, but their practicability under local conditions needs more planning, research and testing.
4. Resistance management, both of the vector, as well as the parasite to DDT, needs urgent and coordinated attention from the Health, Agricultural and Environmental departments within countries, as well as amongst countries due to cross-border implications.
5. Improper and non-monitored use of DDT may harm existing, potential and future international trade (especially in apiculture, horticulture, agriculture and fishing). The DDT intervention does not remove the onus of countries to actively pursue the various alternative measures
6. Scientific work worldwide reveals a concern for human and environmental health attributable to the use of DDT. This was the original reason for the inclusion of DDT in the original 12 Persistent Organic Pollutants (POPs) of the SC. Further more, African scientists, amongst others, have found that the persistence of DDT (including DDE) is not as high in tropical environments, when compared with temperate ones. No studies have been done under local conditions on the persistence of DDT when used for indoor spraying in grass thatched and mud and wattle houses.
7. The very useful recommendations that the workshop came up with should be taken up by ANCAP and other scientists through fundable proposals for studies and implementation.
8. That governments collaborate with ANCAP / SETAC Africa as a scientific resource, for coordinating, advice, consultation and project management, regarding research. ANCAP / SETAC Africa should also work in close collaborations with the main stakeholders of the DDT issue (UNEP, WHO, GEF etc).
9. The workshop was very useful and all efforts should be made to promote a next phase, awaiting the comments of this document.
The workshop has identified a number of specific issues, which will be presented in the executive summary of the workshop proceedings.