A fierce debate is underway in Uganda about whether to return to the effective but environmentally suspect chemical DDT to kill the mosquitoes that transmit malaria.

On 21 July, according to the Kaiser Network, itself reporting other sources, Uganda’s Parliamentary Committee on Social Services approved the use of DDT for indoor spraying, claiming support from the US Presidential Malaria Initiative.

However Ugandan farmers have expressed concern that exports to Europe and other regions that ban DDT would be affected, and the Kampala Monitor newspaper on 26 July said the Ministry of Health was “ready to go to court to sue” the National Environment Management Authority (NEMA) if it failed to approve use of the chemical.

Most recently, Uganda’s New Vision newspaper reported the Minister of Health, Stephen Malinga, as saying “We are still waiting for NEMA to get back to us, but in the meantime we are informing and teaching the public about indoor residual spraying. There is, therefore, no government position on this issue yet. When NEMA presents its findings, we shall then put them to the Cabinet, which will deliberate before taking an official position.”

Recently Brian Greenwood, malaria expert at the London School of Hygiene and Tropical Medicine, writing in Nature on a book reporting the history of Italy’s successful use of DDT – among other tools – to eliminate severe endemic malaria after the Second World War, drew the main lesson of Italy’s experience.

It was, said Greenwood, that “malaria can be controlled successfully, even in the most extreme circumstances. What’s needed is an integrated approach – rather than reliance on a single tool – based on sound epidemiological knowledge, supported by effective rural healthcare and educational programmes, and with a high level of political and financial support.”

“These are demanding requirements” he said “but the Italian story shows what will be needed in malaria is to be controlled effectively in Africa today”.