I’ve had a number of friends ask me to tackle the topic of possibly bringing back DDT. These requests go back months, and I’ve been hesitant to tackle the topic because of the politics surrounding this issue. I’ve also been hesitant, because if I tackle this topic, I want to do it right…which means this will probably be the longest article I’ve written on AaE to date. I hope that it will be the longest article, as well.
This comes on the heels of a pair of articles which had widespread press back in Feburary. One is by a blogger popular in the Skeptic community, SkepticalRaptor. The other is from one of my idols working in public health, a vaccine expert named Paul Offit. I initially wanted to tackle this in February, but ultimately decided to wait until Earth Day and World Malaria day to post these articles.
The story of the failed malaria eradication program is far more complicated than either Offit or Raptor let on. They leave out huge chunks of the story, and many of those chunks completely change the narrative. Specifically, they leave out any serious discussion of the role of insecticide and antimalarial drug resistance. They do not discuss the many administrative failures of the campaign, and neither of them seriously consider the role of economic development in malaria epidemiology.
Instead of laying out the standard DDT story most are familiar with, I’d like to discuss why the WHO’s Global Malaria Eradication Program failed, while the US campaign succeeded. Comparing and contrasting these stories is very productive, because it demonstrates why vector control is really hard.