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Bilateral Malaria Assistance: Progress and Prognosis

January 19, 2006

The Subcommittee's hearing on USAID's malaria assistance in May 2005 led to the discovery that less than 8 percent of the USAID malaria budget went toward life-saving commodities. USAID’s approach had been talking about the malaria problem—not investing in results. 

Since that hearing the President proposed a $1.2 billion commodity-based initiative to cut malaria mortality in focus countries by half. USAID recently announced radical program reforms to save lives which includes indoor residual spraying with DDT. Rich, western nations, as well as many others, which used to be endemic for malaria eliminated their malaria problems decades ago by spraying DDT indoors to kill mosquitos and prevent malaria infection. Africans in developing countries deserve to use the same solution. Unfortunately, after solving their *own* malaria problems with DDT, these same nations came together at the Stockholm convention in 2000 and banned the use of DDT worldwide. Fortunately, Secretary of State Colin Powell insisted on a public health exemption to this ban, allowing poor countries to use DDT to eradicate malaria. But the stigma of the convention meant that DDT use was discouraged and defunded by rich donor nations when the poor countries asked for funding to use it. Thanks to Republicans in Congress and President Bush, this is beginning to change. 

The reforms announced last year by President Bush and USAID mean that malaria money will now go directly to those who are suffering or are most at risk, and not primarily to American and European advice-givers as has been the case for too many years. USAID reported at the hearing that a public web site with detailed funding and progress/outcomes information will go live soon.

Related hearing.

• View webcast now

• Chairman's Statement (27.5 KBs)

Major Findings:

• Historically, indoor residual spraying with DDT eradicated malaria in all endemic developed nations.
•  Despite the unfair and life-threatening stigma, DDT is STILL the cheapest (by far!) and most effective (by far!) insecticide for indoor spraying programs.
• No scientific evidence suggests it is unsafe for humans or the environment when used for indoor spraying programs.
• Evidence was presented that demonstrates DDT is still effective through its repellency action even when resistance to its mosquito-killing action is present.
• A public web site with detailed funding and progress/outcomes information is not yet launched, despite previous assurances from the agency. However, the site will go live soon.

Impact on Taxpayers:

• Taxpayer money will now go directly to those who are suffering and not primarily to American and European advice-givers.
• Americans will be able to see malaria rates go down in countries receiving U.S. foreign assistance.
• Taxpayers, activists, host nations, and other stakeholders will be able to track the American investment in malaria on a public website.
• This hearing proves that Congressional oversight can work, in concert with political will at the Executive branch. As stories of success increase, Congress might engage in more oversight.

These Findings Demand a Response:

• Congratulations are due to President G.W. Bush for making life-saving policy changes.
• Careful Congressional oversight of the implementation of the new policies will be critical in the coming year.
• What the U.S. says and buys MATTERS. Past refusal to support commodities and spraying programs has generated a worldwide stigma that has cost millions of lives.
• USAID needs to reverse that damage by now aggressively, verbally and enthusiastically supporting indoor spraying programs generally and DDT specifically.
• The President must appoint a Malaria Coordinator for his program whose vision is consistent with this new approach to fighting malaria, and not someone entrenched in the failing attitudes and programmatic approaches of the past.
• Appropriation language may be necessary if a comprehensive website transparently publishing all funding and outcomes/progress measures is not launched in timely manner.
• Encourage USAID to streamline unnecessary regulatory barriers to implementing indoor residual spraying programs.