The regulation of DDT: a choice between evils.

• Author: Martin, Ashley K.

ABSTRACT

DDT has the potential for great benefit and great harm. It is currently the most efficient method for controlling malaria, particularly for those countries the disease affects most. However, it also causes global pollution and damages the health of humans and wildlife. These characteristics of DDT make regulating DDT difficult because they create a need for the continued use of DDT to prevent the debilitating effects of malaria, but also a need to ban the use of DDT in order to prevent its negative environmental and health effects. These conflicting needs correlate to diverging interests of developing and developed countries. The Stockholm Convention is an international attempt to regulate DDT use while recognizing this tension. It permits DDT use for public health purposes, though ultimately pursues an objective of total elimination of the chemical. After examining malaria, DDT, and the Convention in some detail, this Note suggests several reforms to the Stockholm Convention in order to more effectively reconcile the need for DDT with the need to eliminate DDT from manufacture or use.

TABLE OF CONTENTS I. INTRODUCTION II. BACKGROUND A. Malaria: A Global Killer B. DDT: A Global Pollutant C. The Stockholm Convention: A Global Attempt to Regulate DDT III. ANALYSIS A. Disparate Interests B. Uncertainty of the Harm of DDT C. Ineffectiveness of the Alternatives to DDT D. Critique of the Stockholm Convention 1. Inadequate Recognition of Developing Countries' Unique Public Health Needs 2. Objective of Total Elimination 3. Inappropriate Use of Precautionary Principles 4. Requirements for Exemption 5. Lack of Consequences for Non-Compliance IV. PROPOSED REFORM V. CONCLUSION I. INTRODUCTION

Every thirty seconds, a child dies from malaria. (1) And while children are most susceptible to the disease--experiencing the highest rates of mortality from infection--they are not its only victims. Today malaria kills approximately one million people per year and infects hundreds of millions more, often to the point of incapacitation. (2) Although malaria infects populations around the world, (3) its "tragedy is most pronounced among the poor" in developing countries. (4) Developing countries lack the financial and technological resources to combat the disease, and thus are not able to thwart its spread; poverty, indeed, breeds disease--malaria included. (5) However, disease also breeds poverty; malaria's effects extend beyond those on human health, inhibiting economic production. (6) As the disease sweeps across a population, it incapacitates or kills individuals, making them unable to contribute to the workforce. The aggregate effect of this decline in workers is an economy incapable of any significant advancement. However, the deleterious effects of malaria are almost entirely preventable. (7) The solution: a chemical called Dichloro-diphenyl-trichloroethane (DDT).

DDT has proven to be a very effective means to prevent the spread of malaria. It has a successful, albeit short, history of use to combat the disease. It facilitated the U.S. military's invasions during World War II by protecting them from various diseases, (8) and it all but eliminated malaria from the United States and most of Europe. (9) Even small quantities of DDT have successfully reduced the number of malaria victims in many countries. (10) Unfortunately, the use of DDT has been banned in most countries, (11) and it suffers from a stigma that discourages its use, even for the most pressing of epidemics. That stigma is not undeserved; it stems from the harmful effects of the chemical on the environment, wildlife, and human health. (12)

The problem of DDT and its relationship to malaria presents a choice between two evils. When used, DDT causes irreparable harm to the environment and human health. When not used, malaria sweeps across countries, killing hundreds of millions of people. The choice, therefore, involves two inevitable harms--from malaria or from the derivative effects of DDT. Neither option is ideal, and both necessitate prioritizing inherently invaluable alternatives. The issue becomes how to reconcile the need for DDT, primarily a need of developing countries (those that malaria most affects), with the need to eliminate DDT, primarily a need of developed countries (those more concerned with the harm to the environment). The issues raised by this reconciliation and the continued use of DDT are international in scope. Because of its ability to travel long distances, the effects of DDT span the globe and reach populations and environments even where the chemical is neither used nor produced. (13) Thus, its treatment is a matter of international concern.

The existence of these international concerns prompted an attempt to address the problem of DDT using international law; in 2004, countries came together and ratified an international treaty called the Stockholm Convention. (14) The Convention calls for the elimination of a classification of chemicals known as persistent organic pollutants (POPs), a category which includes DDT. (15) The treaty, however, created an exception for DDT, in an attempt to resolve the tension between the need for DDT and the need to eliminate it. (16) Rather than completely banning DDT, as the treaty does for other POPs, it allows for the continued use of DDT for limited public health purposes. (17)

Although the Stockholm Convention acknowledges the need to treat DDT differently, it does not adequately resolve the problem of DDT use due to the disparate and concomitant interests of countries involved in the dilemma. Part II of this Note discusses the history and characteristics of malaria and DDT in order to present the difficulty of choosing between banning DDT and allowing its use. It also explains the Stockholm Convention's attempt to resolve the problem. Part III analyzes the choice more critically and then evaluates the Stockholm Convention. Part IV proposes a solution for how to regulate the use of DDT while reconciling the need for, and desire to eliminate, both the chemical and malaria.

If. BACKGROUND

1. Malaria. A Global Killer

   Malaria is a global disease; in 1995, it affected more than forty percent of the world's population. (18) Moreover, the disease is an ongoing threat; the number of malaria cases is increasing around the world (and the rate of increase is accelerating), (19) it is reappearing in areas where it had previously been eradicated, and it is emerging more often in industrialized countries. (20) Malaria is as fatal as it is pervasive, second only to the HIV/AIDS pandemic among infectious diseases in deadliness. (21) Indeed, the disease kills approximately one to two million people per year, and infects another 650-750 million. (22) Its ravaging effects are due in part to the fact that it is extremely communicable. The basic reproduction number for malaria--the number of people one ill person can infect with the contagious disease--is 100, meaning that one malarious person can be responsible for making 100 others sick. (23) The death toll from malaria is most readily appreciated by way of illustration: every day, malaria kills the same number of persons as would die from loading up seven Boeing 747 airliners and deliberately crashing them. (24)

   Although malaria affects individuals across the globe, people in poor, developing countries in warm climates are particularly susceptible. (25) Mosquitoes, the carriers of the disease, breed easily in warm climates, and developing countries often lack the financial and technological resources to combat the problem. (26) Indeed, almost 60% of malaria cases occur in the poorest 20% of the world's population, (27) and "about ninety percent" of the deaths malaria causes occur in sub-Saharan Africa, one of the poorest and warmest regions of the world. (28) Malaria indisputably affects poorer nations, as countries with a high rate of malaria have economic growth rates 1.3% lower than nonmalarious nations, (29) and the GNP of malarious countries is reduced by more than half as compared to nonmalarious countries. (30) The disease presents a cause-and-effect quandary with respect to its economic implications. In part, the malaria epidemic is the effect of the nations' poor economic situations; they have fewer financial resources to devote to the prevention and treatment of malaria, and so the disease continues to spread. Malarious countries often spend as much as 40% of public health expenditures on the disease. (31) However, malaria also contributes as a partial cause of the economic problems. (32) Those individuals who are infected are often incapacitated (if not killed), and thus cannot contribute to the economy of the household or of the nation. (33) Africa, for example, "loses about $12 billion a year due to the drop in economic productivity due to malaria." (34) What limited finances these developing countries do have are spent fighting the disease rather than for other purposes, further stagnating the economies. Moreover, the disease poses a risk to the public, depresses tourism, and prevents sustainable use of the land, all of which have further prohibitive effects on the development of the economies. (35)

   Malaria is caused by the Plasmodium protozoan parasite, which is transmitted by the bite of an Anopheles mosquito. (36) The nature of the disease generates two possible methods for preventing it: attacking the parasite itself or attacking the carrier mosquito. (37) Attacking the parasite is accomplished through the use of prophylactic drugs. (38) The drugs slow the parasite's replication, which allows the body's natural immune system to better respond to the intrusion and prevent the parasite from taking over. A more common way to prevent the spread of malaria is through an attack on the carrier-mosquito (vector-control). (39) Because vector-control does not depend on individualized treatment, it is a cheaper, longer-lasting, and more...