Malaria rates underscore need to set aside costly taboos

This research paper by the South African Institute of International Affairs argues that international donor agencies and UN bodies are hindering malaria control in Africa by resisting the use of Indoor Residual Spraying (IRS) and DDT in favor of less effective measures. The author contends that a 'vertical' health program approach, combining DDT-based IRS and Artemisinin-based combination therapy (ACT), is the most effective strategy, citing successful implementations in South Africa and India.

• The author asserts that effective malaria control requires a 'vertical programme'—a coordinated plan with a clear chain of command and dedicated budget—rather than decentralized, horizontal health systems. Countries like South Africa, Swaziland, Namibia, and Botswana that maintained vertical structures have seen more success, whereas Ethiopia, which outlawed such programs, has failed to control the disease.
• Indoor Residual Spraying (IRS) using DDT was highly successful in eradicating malaria in Europe and the US and reducing it in Africa, Asia, and Latin America following its use in 1944. A 1955 WHO eradication program protected approximately 650 million people by 1961 at a cost of 11 to 42 US cents per capita.
• The document claims that the global environmental movement, specifically Rachel Carson's 1962 book Silent Spring, led to the banning of DDT for agricultural use in 1972 by the US Environmental Protection Agency, which the author argues lacked a scientific basis and contributed to the rise of malaria.
• India provides a case study of the effectiveness of DDT; after implementing it as the core of its IRS program in 1953, the annual incidence of malaria dropped from 75 million cases to around 2 million cases, with deaths in the low thousands.
• South Africa experienced a severe malaria epidemic after deciding to drop DDT in 1996, with cases increasing more than 6-fold. The reintroduction of DDT in 2000, combined with Artemisinin-based combination therapy (ACT), resulted in an 80% reduction in cases in one year.
• The author criticizes the WHO's Roll Back Malaria (RBM) program, noting that malaria deaths increased by approximately 12% halfway through its life. The author attributes this to the refusal of partners like the WHO, World Bank, UNICEF, and USAID to support IRS, preferring insecticide-treated nets which are described as having 'much more limited success'.
• USAID is criticized for its $80 million annual malaria budget, which the author claims is not spent on insecticides or drugs, but is instead directed toward US-based consultants.

APA

South African Institute of International Affairs (2008). Malaria rates underscore need to set aside costly taboos. https://saiia.org.za/research/malaria-rates-underscore-need-to-set-aside-costly-taboos/

Chicago

South African Institute of International Affairs. Malaria rates underscore need to set aside costly taboos. 2008. https://saiia.org.za/research/malaria-rates-underscore-need-to-set-aside-costly-taboos/.

Wikipedia

{{cite report |author=South African Institute of International Affairs |title=Malaria rates underscore need to set aside costly taboos |date=25 April 2008 |url=https://saiia.org.za/research/malaria-rates-underscore-need-to-set-aside-costly-taboos/ |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{southafricaninstituteofinternationalaffairs2008malaria, author = {{South African Institute of International Affairs}}, title = {{Malaria rates underscore need to set aside costly taboos}}, institution = {South African Institute of International Affairs}, year = {2008}, month = apr, url = {https://saiia.org.za/research/malaria-rates-underscore-need-to-set-aside-costly-taboos/}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }