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We need to learn from our mistakes, take a hard look at the science and use DDT where and when it is needed: to save lives.
"Silent Spring," probably the most influential book ever written, “caused serious problems in terms of reluctance of people to use insecticides for public health value,” said Durland Fish, director of the Yale Institute for Biospheric Studies Center for EcoEpidemiology. To be sure, he said, we’ve made it very difficult for an honest use of pesticides. “There has been quite a bit of regulation, sometimes over-regulation of pesticides but some effort needs to be made to bring some rationale back to the whole story of pesticides.” He pointed to a U.S. Centers for Disease Control-funded Lyme disease study he did in Westchester County, N.Y., that showed that a single application of a commonly used insecticide reduced the risk of Lyme disease 97 percent but the county health department recommended against spraying.
This complicated global juggling (how much of the chemicals and where) has been played out in the press as fierce debates between environmentalists, who, rightly so, worry about the long-lasting impact of these poisons and public health experts, who, rightly so, worry about the millions of children dying from infectious diseases. In the real world, though, the issue is not so much about narrow-minded experts hollering at each other as it is about a network of do-gooders who have different sets of priorities. If you spend your life studying how high doses of organophosphates may impair children’s cognition, you’ll come into this debate with a different category of worries than if you take care of kids who are brain-damaged from malaria.
The environmentalists see the downside of chemicals. They read studies such as the recent ones in The Journal of Epidemiology suggesting that DDT exposure may increase rates of miscarriage or reduce fertility. A South Africa study suggested DDT affects sperm physiology.
Public Health officials focus on the immediate dangers of the mosquito-carrying diseases. Every day 2,200 Africans die from malaria, the vast majority are children younger than 5, according to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Put another way, every 30 seconds, malaria kills one African child. Those who survive are often left weak — physically and mentally. It is a disease that is clobbering entire nations.
The real solution, according to the experts, is to do what I always nag my kids about: Use common sense, learn from mistakes and get along with the other players. That means that we have to look at the science, not the politics of pesticides and use them judiciously and only when needed.
We have to learn, for the first time, to use restraint when we discover a new poison for the bugs. Alternating a few chemicals in limited use will prolong resistance. And we have to realize that we’ll never control these diseases simply. These bugs are clever creatures, always one step ahead of us. If we want to make any advance, it will take a sustained, labor-intensive effort incorporating low doses of pesticides along with surveillance and prevention. For malaria, this also means impregnated bednets and good diagnostic techniques so we only treat people who truly have malaria.
And lastly, the environmentalists and the health folks should sit down together, a peace conference of sorts. Or, as Yale’s Fish said, “the public health funding agencies are not responsible for the environment and the Environmental Protection Agency is not responsible for health. We need to engage each other in outcomes so there won’t be conflicts.”