Future Challenges

Rethinking Malaria Control

Previous attempts at malaria control have relied heavily on the use of DDT, a non-biodegradable insecticide. Use of this substance was banned in the United States in 1972 because of its accumulation in the envi-

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ronment and its damaging effects on fowl, notably the peregrine falcon and the bald eagle. Many other concerns have been raised about its possible carcinogenicity and potential effects on human fetuses. Although not generally used in agriculture, more than 20 countries still use it for malaria control, and more would use it if they could afford it. Biodegradable insecticides are available, but they are more expensive than DDT, and they are not without toxicity. With children dying of malaria every minute worldwide, the options for rapid relief from malaria all seem bad, and a choice has to be made of which ones are the least bad. While insecticides may be necessary short term, other options including education, economic development, vaccines, biological control of the Anopheles vectors, and mosquito habitat alteration may prove more important in achieving sustained relief from the disease.

The challenge for the future is to better understand the ecology of malaria as it applies in each location, with the aim of minimizing insecticide use and discovering new options for maintaining long-term control.

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