Why tobacco companies shouldn’t make health policy

If there were ever a chemical with a branding problem, it’s DDT. Used in vast quantities in the US as an insecticide on cotton crops, it became common to detect DDT throughout the ecosystem, especially in fish and bird populations. (DDT is insolulable in water, but collects in fats, which makes it dangerous for predators within a food chain.) Rachel Carson’s “Silent Spring” called attention to carcinogenic properties of DDT and its role in weakening the shells of raptor eggs. Interest in Carson’s book led to a ban on DDT in the US by the Environmental Protection Agency, and strong pressure in international organizations not to sponsor DDT use. As Tina Rosenberg, writing in the New York Times Sunday Magazine observes, “Ask Americans over 40 to name the most dangerous chemical they know, and chances are that they will say DDT.”

Spraying huge quantities of DDT on crops is A Bad Thing. But eliminating DDT entirely as a tool of mosquito control is an even worse thing. Malaria’s not just a deadly disease for 2 million people a year – the major killer in Africa before the rise of AIDS; it’s economically devestating for nations where a large portion of the population fight to keep working while suffering through flu-like symptoms multiple times a year. A World Health Organization commission estimates that nations where malaria is endemic suffer 20% economic shrinkage over 15 years from malaria alone.

And DDT is really good at killing mosquitoes, especially when sprayed in low concentrations in the interior of homes in malarial areas. South Africa used this technique for years and saw malaria deaths decline sharply. They discontinued the policy in 1996 and “almost immediately plummeted into one of its worst ever malaria epidemics — from around 6,000 cases in 1995 to over 60,000 in 2000,” according to an article in the Johannesburg Observer. USAID, for many years, refused to fund mosquito control programs based around DDT, favoring pyrethin-treated bednets. But bednets, even subsidized by international aid programs, are expensive, inconvenient, and in tropical weather, extremely uncomfortable. The new malaria chief of the WHO endorses indoor spraying of DDT as the most cost-effective form of mosquito eradication.

But not everyone is on the right side of this debate. British American Tobacco, the second largest tobacco company in the world, is leading a campaign in Uganda against the use of DDT. Insisting that the weak solution of DDT that the government plans to spray in houses to try to combat the 110,000 annual deaths from malaria might affect crops grown in the country, potentially costing 600,000 jobs.

Richard Tren, the director of Africa Fighting Malaria, isn’t applauding BAT’s concern for the environment or the economy.. “That BAT would oppose DDT in this way is not only foolish, it is deadly and represents a truly shameful episode in the company’s history.” And hey, BAT’s had more than a few truly shameful episodes, like the long campaign required to get BAT to pull out of a cigarette factory they co-ran in Burma in partnership with the military junta. Or their lobbying against health warnings on cigarettes in developing nations… or support for tobacco smuggling efforts to allow un-warned cigarettes into countries with warning legislation.

The Gates Foundation is supporting research on DDT alternatives, and at a future date, there may be cost-effective alternatives to spraying low concentrations of DDT in malarial households. In the meantime, it’s worth asking why shareholders allow companies like BAT to support such counterproductive and dangerous campaigns as encouraging poor farmers to stop using a chemical likely to prevent their children from dying from malaria. After all, if they die before you can sell them cigarettes, you’re losing a potential market, BAT – think it through…

Thanks to FP Passport – one of my very favorite daily reads – for pointing to the DDT Uganda story yesterday…