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Anti-malarial bed nets: the $10 insult

Giving nets rather than DDT to Africans sends a powerfully paternalistic message: ‘You can hide from disease, but you cannot eradicate it.’

Emily Hill

Topics Politics

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These days there is a special ‘day’ for just about everything. So you can be forgiven if you missed that yesterday was Africa Malaria Day. Not Malaria Day, you will notice, but Africa Malaria Day.

The reason it is called Africa Malaria Day is because in the developed West malaria no longer poses much of a problem. Southern Mediterranean countries, such as Italy, where hot and humid conditions would normally be a fertile breeding ground for malarial mosquitoes, have been malaria-free for more than 60 years (1). Yet the tool that rooted out malaria in the developed world – the mosquito-bashing pesticide DDT – is not considered fit for Africa today. So this Africa Malaria Day we were all encouraged to buy an African a bed net as the next best (environmentally-friendly) thing.

Buying a bed net might make you – and the celebrities who endorse the bed net campaign – feel good about yourselves. But it also sends a powerful message to Africans about their place in the scheme of things: that is, at the bottom, where the most they can hope for is to put a charity-donated flimsy shield between them and their harsh environment, rather than to transform their environment.

In America, Africa Malaria Day was big this year. The First Lady, Laura Bush, has been heading a campaign to encourage every American to donate $10 to buy an anti-malarial bed net for an African child through the charities Nothing But Nets and Malaria No More. International celebrities have also been marshalled to help spread awareness about the cause. At the suggestion of screenwriter Richard Curtis (of Comic Relief and Love, Actually fame), music mogul Simon Fuller allowed campaigners to ask for contributions on two episodes of his hit show American Idol. Titled ‘Idol Gives Back’, the shows featured celebrities such as pop star Gwen Stefani and comedian Sacha Baron Cohen pleading for money to help charities supporting the victims of Hurricane Katrina and to purchase anti-malarial nets for African kids.

The economist Professor Jeffrey Sachs outlined his own case for anti-malarial nets in a poetic article for Time magazine titled ‘The $10 solution’: ‘Listen for a moment to the beautiful and dignified voices of Africa’s mothers. Despite their burdens of poverty and hunger, they will tell you not of their endless toil but of their hopes for their children. But softly, ever so softly, they will also recount the children they have lost, claimed by a sudden fever, children who died in their arms as they were carried in a desperate half-day’s journey by foot from the village to the nearest clinic.’ This, says Sachs, is ‘the ineffable sadness of malaria’. ‘Another African child has died of malaria since you started reading this article’, he writes. ‘Perhaps two million children in all will succumb this year.’ (2)

That millions die from malaria in the developing world every year is an obscenity – especially when we know that DDT has a very high success rate in obliterating mosquitoes. Will bed nets stop the scourge of malaria? Sachs, like Laura Bush, like Richard Curtis (whose ‘Red Nose Day’ appeals on British TV earlier this year were also saturated with calls from celebs for more anti-malarial nets for Africa), argues that in order to cure Africa’s malaria problem, ‘We should bring forth armies of Red Cross volunteers to distribute bed nets and to offer village-based training for tens of thousands of villages across Africa.’

Many in the developed world are no doubt greatly concerned about disease in Africa. But if we did swamp Africa with nets, how many children (not to mention adults) would be saved? According to Sachs, every 100 nets save the life of one African child a year. However, every net has to be replaced after four years, because the pesticides wear out, rendering the net useless. So sending a net to Africa is a $10 dollar ‘solution’ that eventually wears out and which doesn’t actually kill off malarial mosquitoes, instead just keeping them at bay (hopefully).

There is a reason why the West is no longer infested with malarial insects and why deaths from malaria are virtually zero. It’s because over half a century ago we sprayed everything down with DDT. DDT is not very popular nowadays; it has become an anathema to environmentalists. In the Sixties and Seventies, various environmentalists raised concerns about the impact of DDT on wildlife. In her 1962 book Silent Spring, Rachel Carson claimed that DDT harmed birds of prey and their eggs. Following intense lobbying, DDT was banned in America in 1972 by the Environment Protection Agency and its use was severely restricted in Europe. This had a big impact on its use in countries in Latin America and Africa. And all of this happened despite the fact that, as the campaign group Africa Fighting Malaria (AFM) points out, where heavy use of DDT in agricultural settings did occasionally cause harm to birds of prey, that harm subsequently ‘proved reversible’, and ‘after 50 years of study there is not one replicated study that shows any harm to humans at all’.

Indeed, last year the World Health Organisation (WHO) ‘reversed a 30-year policy by endorsing the use of DDT for malaria control’ (3). WHO explained that there is no health risk for humans from DDT. Dennis Avery of AFM estimates that, ‘The absence of DDT has led to the needless deaths of at least 30million people from malaria and yellow fever in the tropics’ (4). Dr Roger Bate, resident fellow at the American Enterprise Institute for Public Policy Research and former chairman of AFM, tells me that although bed nets can help in combating malaria, ‘if they rip or if you don’t go to bed early enough or if you get up in the night, you can get bitten’. Bate favours Indoor Residual Spraying (IRS) with DDT. ‘The fixation on nets stems from opposition to IRS’, he says.

Although African countries tended to make DDT their first choice in fighting malaria, many of them discontinued DDT-use because some aid agency funding was made contingent on their adoption of other, more environmentally friendly sprays. According to BBC News: ‘South Africa was one country that switched, but it had to return to DDT at the beginning of [the 2000s] after mosquitoes developed resistance to the substitute compounds.’ Arata Kochi, director of WHO’s Global Malaria Programme, says that ‘of the dozen insecticides WHO has approved as safe for house-spraying, the most effective is DDT’ (5).

Put in blunt terms, DDT is proven to be successful in the fight against malarial mosquitoes, and the environmentalist campaign against DDT has proved disastrous for millions of Africans. And now some of the same campaigners are telling Africans that they should combat malaria with bed nets instead. However, as well as being far more unreliable than a large-scale and targeted pesticide-spraying campaign – because, as Bate points out, people in Africa do not spend all their time in bed hiding from the world – the whole concept of using pesticide-soaked nineteenth-century colonial-style net curtains is regressive. What it effectively says to Africans is that you cannot eradicate disease, you can only protect yourself from it. You cannot change the world outside your front door – a world that consists of far too much disease and poverty – but you can put up a barrier, albeit a sometimes unreliable one, between you and that world.

The symbolism of the bed nets is striking – the focus is on protection from hardship rather than on getting rid of that hardship, as many of us in the developed world have done. The idea that Africans must hide behind a charity-bought veil for their whole lives, rather than buying a tank full of DDT and killing the pests that threaten to kill them, is inherently patronising. Like the buy-a-goat-for-Christmas schemes, the ‘insecticide-impregnated bed net’ scheme is helping to ensure that Africa’s development remains retarded, while allowing we in the comfortable West to feel good about having Done Something.

Fundamentally, the net-based scheme to save the children of Africa won’t work. DDT, on the other hand, might. The charity nets are not a $10 solution; they’re a $10 insult.

Emily Hill is staff writer at spiked and a blogger for Dazed and Confused.

Previously on spiked

Brendan O’Neill interviewed activist Roy Innis on the eco-imperialism threatening Africa. On the fortieth anniversary of Rachel Carson’s Silent Spring, Dave Hallsworth explained why we need DDT; and Roger Bate showed that without it the Malaria virus is biting back. James Heartfield wondered why those supposedly committed to saving the planet are off snorkelling in the Pacific. Or read more at: spiked issue Environment

(1) Net effects, Mark Honigsbaum, Comment is Free, 24 April 2007

(2) The $10 solution, Jeffrey Sachs, Time, 4 January 2007

(3) WHO backs DDT for malaria control, BBC, 15 September 2006

(4) Rachel Carson and the malaria tragedy, Dennis Avery, 16 April 2007

(5) WHO backs DDT for malaria control, BBC, 15 September 2006

To enquire about republishing spiked’s content, a right to reply or to request a correction, please contact the managing editor, Viv Regan.

Topics Politics

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