There is the real risk of an increase in the incidence of malaria in regions affected by the tsunami tragedy in Asia. The capacity of aid organisations to response to this threat will be influenced not only by how much money these organisations have at their disposal but access to effective control strategies.
DDT has over many decades proven the most effective chemical for malaria (mosquito) control but its use is often restricted on environmental grounds.
Indeed, the continued use of DDT for malaria control has become a contentious international environmental issue.
DDT was once used extensively by Australian farmers but banned in Australia in 1987 as part of a world wide push to outlaw its use because it was bio-accumulating in the food chain and, it was claimed, caused cancer and was harming bird reproduction by thinning egg shells.
The modern environment movement is considered by many to have its origins with Rachel Carson's attack on DDT in her best seller Silent Spring, published in 1962.
The book and the campaign against DDT that followed resulted in the US Court of Appeals ordering the head of the US Environment Protection Agency William Ruckeshaus, to start the process of suspending DDT registration.
After an initial 60-day review process Rauckeshaus concluded that there was no good reason to ban DDT. But under mounting public pressure changed his position and banned DDT in the USA in June, 1972.
Ms Carson's campaign had effectively highlighted environmental concern but failed to acknowledge DDT's important role in malaria prevention particularly in the Third World.
According to the World Health Organisation (WHO) more than 1 million people die each year from malaria -- mostly small children in Africa. Malaria is estimated to cause up to 30,000 deaths a year in Indonesia.
There has been an increase in deaths due to malaria over the last decade which some have attributed to the international campaign against the use of DDT.
For example, in response to international pressure, South Africa stopped using DDT for malaria control in 1996. The number of deaths from malaria increased from less than 50 per year over the period 1971 to 1995, to 450 in 2000. The South African Health Department switched back to DDT with an 85 per cent reduction in malaria cases within 18 months -- the DDT spraying is believed to have controlled the case load to such an extent that all malaria patients could be treated with a new drug, Coartem.
In this and other current malaria control program, spraying with DDT is restricted to the inside of homes.
As part of a worldwide eradication program that started in the late 1950s, however, DDT was once sprayed over vast areas including from airplanes over US cities. This world-wide campaign was spectacularly successful in some regions with malaria eradicated from the US and in Europe.
In developing countries the incidence of malaria was dramatically reduced. In 1948 in Sri Lanka, for example, 7,300 deaths were attributed to malaria, in 1963 none.
In 1970 the National Academy of Sciences wrote in a report that "to only a few chemicals does man owe as great a debt as to DDT" and credited the insecticide with saving half a billion lives.
As part of the negotiations leading to the United Nation's Stockholm Convention on Persistent Organic Pollutants (POPs) coming into effect in May 2004, organisations like the World Wildlife Fund (WWF) campaigned hard to extend what has been a worldwide ban on the agricultural use of DDT to include malaria control.
But just before the Convention took effect, the WHO stated that it "proposed and supports the continued use of DDT for disease vector control" and that "DDT, if restricted to indoor residual spraying, will form a minuscule portion of past usage levels, and will address (concern over) the uncontrolled release of the pesticide in the environment".
Malaria is not an issue in Australia though we have the malaria mosquito. Malaria is considered both a disease of poverty and a cause of poverty in Africa, Asia and Latin America.
In the aftermath of the tsunami tragedy, communities in South Asia are particularly susceptible to water borne diseases including malaria.
How might aid organisations balance legitimate environmental concerns, like the funding of programs that include the use of DDT, against the need to save human lives?
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