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Alternatives to DDT Janice Jensen, USEPA LRTAP POPs Task Force March 1, 2004 3/15/2018 Alternatives to DDT Janice Jensen, USEPA LRTAP POPs Task Force March 1, 2004 3/15/2018 1

Purpose Ø Review availability & feasibility of safer and economically viable alternatives to DDT Purpose Ø Review availability & feasibility of safer and economically viable alternatives to DDT Ø Coordinate with WHO, UNEP, FAO Ø Final review due by one year after EIF 3/15/2018 2

DDT Global Production & Use Intend to produce - Stockholm Convention ü China ü DDT Global Production & Use Intend to produce - Stockholm Convention ü China ü India ü Russian Federation Indicated the need to use - Stockholm Conv ü Disease vector control (32 countries) ü Intermediate to produce dicofol (Brazil, China) ü As contaminant in dicofol (Korea) 3/15/2018 3

World Health Organization ü Action Plan to reduce reliance on DDT ü Component of World Health Organization ü Action Plan to reduce reliance on DDT ü Component of Roll Back Malaria ü WHO will assist countries to reduce reliance on DDT ü Concerned about re-emergence of malaria in areas considered “eradicated” 3/15/2018 4

Alternative Vector Control Strategies Factors that contribute to DDT use: ü Malaria transmission intensity Alternative Vector Control Strategies Factors that contribute to DDT use: ü Malaria transmission intensity ü Vector biology and ecology ü Health and vector control services ü Available resources ü Insufficient knowledge base ü Lack of safe, cost-effective alternatives 3/15/2018 5

Instead of DDT, countries rely on… • Other residual insecticides • Biological control • Instead of DDT, countries rely on… • Other residual insecticides • Biological control • Personal protective measures such as impregnated bed nets • Environmental management 3/15/2018 6

Chemical Pesticides • WHO pesticide evaluation scheme • Evaluates new products • Identifies pesticides Chemical Pesticides • WHO pesticide evaluation scheme • Evaluates new products • Identifies pesticides that meet WHO standards and guidelines for malaria control • Assesses pesticide cost effectiveness-case by case • DDT may be least expensive-cost per house 3/15/2018 7

1990 Cost Comparison of Insecticides Insecticide Cost (US$) per house per 6 mo 1. 1990 Cost Comparison of Insecticides Insecticide Cost (US$) per house per 6 mo 1. 60 Cost ratio (DDT=1) 3. 36 2. 1 5 -5. 60 3. 1 Permethrin 6. 00 3. 8 Fentrothion 12. 00 7. 5 Propoxur 37. 20 23. 3 DDT Malathion Deltamethrin 1 Reference: K. Walker, Medical and Veterinary Entomology (2000) 8 14, 3/15/2018 345 -354.

WHO Insecticides Suitable for Indoor Spraying Organochlorines Organophosphates Pyrethroids 3/15/2018 DDT Chlorpyrifos-methyl Fenitrothion Malathion WHO Insecticides Suitable for Indoor Spraying Organochlorines Organophosphates Pyrethroids 3/15/2018 DDT Chlorpyrifos-methyl Fenitrothion Malathion Primiphos-methyl Alpha-cypermethrin Cyfluthrin Cypermethrin Deltamethrin Etofenprox Lamda-cyhalothrin Permethrin 9

Conclusions • DDT is not produced or used by most countries in the UNECE Conclusions • DDT is not produced or used by most countries in the UNECE region • Malaria is not a significant health problem in the region • However, malaria is re-emerging in areas where it was considered “eradicated” • Several pesticides are routinely used for vector control in place of DDT • Cost data indicate that DDT may be the least expensive pesticide on a cost per house basis • Insect resistance, high cost, and market access may limit insecticide choice • Other interventions (early diagnosis and 3/15/2018 treatment) may be more cost effective than VC 10