Thank you, Chairman Inhofe, and distinguished members of the Committee on Environment and Public Works for the opportunity to present my views on the misuse of science in public policy. My testimony focuses on misrepresentations of science during decades of environmental campaigning against DDT
Before discussing how and why DDT science has been misrepresented, you first must understand why this misrepresentation has not helped, but rather harmed, millions of people every year all over the world. Specifically you need to understand why the misrepresentation of DDT science has been and continues to be deadly. By way of explanation, I will tell you something of my experience.
I conducted malaria research in the Amazon Basin in the 1970s. My Brazilian colleague—who is now the Secretary of Health for Amazonas State—and I worked out of Manaus, the capitol of Amazonas State. From Manaus we traveled two days to a study site where we had sufficient numbers of cases for epidemiological studies. There were no cases in Manaus, or anywhere near Manaus. For years before my time there and for years thereafter, there were essentially no cases of malaria in Manaus. However in the late 1980s, environmentalists and international guidelines forced Brazilians to reduce and then stop spraying small amounts of DDT inside houses for malaria control. As a result, in 2002 and 2003 there were over 100,000 malaria cases in Manaus alone.
Brazil does not stand as the single example of this phenomenon. A similar pattern of declining use of DDT and reemerging malaria occurs in other countries as well, Peru for example. Similar resurgences of malaria have occurred in rural communities, villages, towns, cities, and countries around the world. As illustrated by the return of malaria in Russia, South Korea, urban areas of the Amazon Basin, and increasing frequencies of outbreaks in the United States, our malaria problems are growing worse. Today there are 1 to 2 million malaria deaths each year and hundreds of millions of cases. The poorest of the world's people are at greatest risk. Of these, children and pregnant women are the ones most likely to die.
We have long known about DDT’s effectiveness in curbing insect borne disease. Othmar Zeidler, a German chemistry student, first synthesized DDT in 1874. Over sixty years later in Switzerland, Paul Muller discovered the insecticidal property of DDT. Allied forces used DDT during WWII, and the new insecticide gained fame in 1943 by successfully stopping an epidemic of typhus in Naples, an unprecedented achievement. By the end of the war, British, Italian, and American scientists had also demonstrated the effectiveness of DDT in controlling malaria-carrying mosquitoes. DDT's proven efficacy against insect-borne diseases, diseases that had long reigned unchecked throughout the world, won Müller the Nobel Prize for Medicine in 1948. After WWII, the United States conducted a National Malaria Eradication Program, commencing operations on July 1, 1947. The spraying of DDT on internal walls of rural homes in malaria endemic counties was a key component of the program. By the end of 1949, the program had sprayed over 4,650, 000 houses. This spraying broke the cycle of malaria transmission, and in 1949 the United States was declared free of malaria as a significant public health problem. Other countries had already adopted DDT to eradicate or control malaria, because wherever malaria control programs sprayed DDT on house walls, the malaria rates dropped precipitously. The effectiveness of DDT stimulated some countries to create, for the first time, a national malaria control program. Countries with pre-existing programs expanded them to accommodate the spraying of houses in rural areas with DDT. Those program expansions highlight what DDT offered then, and still offers now, to the malaria endemic countries. As a 1945 U.S. Public Health Service manual explained about the control of malaria: “Drainage and larviciding are the methods of choice in towns of 2,500 or more people. But malaria is a rural disease. Heretofore there has been no economically feasible method of carrying malaria control to the individual tenant farmer or sharecropper. Now, for the first time, a method is available—the application of DDT residual spray to walls and ceilings of homes.” Health workers in the United States were not the only ones to recognize the particular value of DDT. The head of malaria control in Brazil characterized the changes that DDT offered in the following statement: “Until 1945-1946, preventive methods employed against malaria in Brazil, as in the rest of the world, were generally directed against the aquatic phases of the vectors (draining, larvicides, destruction of bromeliads, etc….). These methods, however, were only applied in the principal cities of each state and the only measure available for rural populations exposed to malaria was free distribution of specific drugs.”
DDT was a new, effective, and exciting weapon in the battle against malaria. It was cheap, easy to apply, long-lasting once sprayed on house walls, and safe for humans. Wherever and whenever malaria control programs sprayed it on house walls, they achieved rapid and large reductions in malaria rates. Just as there was a rush to quickly make use of DDT to control disease, there was also a rush to judge how DDT actually functioned to control malaria. That rush to judgment turned out to be a disaster. At the heart of the debate—to the extent there was a debate—was a broadly accepted model that established a mathematical framework for using DDT to kill mosquitoes and eradicate malaria. Instead of studying real data to see how DDT actually worked in controlling malaria, some scientists settled upon what they thought was a logical conclusion: DDT worked solely by killing mosquitoes. This conclusion was based on their belief in the model. Scientists who showed that DDT did not function by killing mosquitoes were ignored. Broad acceptance of the mathematical model led to strong convictions about DDT's toxic actions. Since they were convinced that DDT worked only by killing mosquitoes, malaria control specialists became very alarmed when a mosquito was reported to be resistant to DDT's toxic actions. As a result of concern about DDT resistance, officials decided to make rapid use of DDT before problems of resistance could eliminate their option to use DDT to eradicate malaria. This decision led to creation of the global malaria eradication program. The active years of the global malaria eradication program were from 1959 to 1969. Before, during, and after the many years of this program, malaria workers and researchers carried out their responsibilities to conduct studies and report their research. Through those studies, they commonly found that DDT was functioning in ways other than by killing mosquitoes. In essence, they found that DDT was functioning through mechanisms of repellency and irritancy. Eventually, as people forgot early observations of DDT's repellent actions, some erroneously interpreted new findings of repellent actions as the mosquitoes’ adaptation to avoid DDT toxicity, even coining a term, "behavioral resistance," to explain what they saw. This new term accommodated their view that toxicity was DDT's primary mode of action and categorized behavioral responses of mosquitoes as mere adaptations to toxic affects. However this interpretation depended upon a highly selective use of scientific data. The truth is that toxicity is not DDT's primary mode of action when sprayed on house walls. Throughout the history of DDT use in malaria control programs there has always been clear and persuasive data that DDT functioned primarily as a spatial repellent. Today we know that there is no insecticide recommended for malaria control that rivals, much less equals, DDT's spatial repellent actions, or that is as long-acting, as cheap, as easy to apply, as safe for human exposure, or as efficacious in the control of malaria as DDT. Attached as Annex 1 is a more technical explanation of how DDT functions to control Malaria. The 30 years of data from control programs of the Americas plotted in Figure 1 illustrate just how effective DDT is in malaria control. The period 1960s through 1979 displays a pattern of malaria controlled through house spraying. In 1979 the World Health Organization (WHO) changed its strategy for malaria control, switching emphasis from spraying houses to case detection and treatment. In other words, the WHO changed emphasis from malaria prevention to malaria treatment. Countries complied with WHO guidelines and started to dismantle their spray programs over the next several years. The line graph in Figure 1 illustrates the progress of the dismantling. As you can see, fewer and fewer houses were sprayed. The bar graph illustrates the cumulative increase in cases over the baseline of cases that occurred during years when adequate numbers of houses were being sprayed (1965-1979). As you can also see, as countries reduced numbers of houses sprayed, the number of malaria cases continually increased. Figure 1. Impact of the World Health Organization’s malaria control strategy in 1979 to de-emphasize indoor spraying of house walls and adoption of World Health Assembly resolution in 1985 to decentralize malaria control programs in the Americas. The x-axis is years and the y-axis is cumulative numbers of malaria cases above the baseline. Baseline is defined as the average number of malaria cases each year from 1965 to 1979.
With data such as this, I find it amazing that many who oppose the use of DDT describe its earlier use as a failure. Our own citizens who suffered under the burden of malaria, especially in the rural south, would hardly describe it thus.
Malaria was a serious problem in the United States and for some localities, such as Dunklin County, Missouri, it was a very serious problem indeed. For four counties in Missouri, the average malaria mortality from 1910 to 1914 was 168.8 per 100,000 population. For Dunklin County, it was 296.7 per 100,000, a rate almost equal to malaria deaths in Venezuela and actually greater than the mortality rate for Freetown, Sierra Leone. Other localities in other states were equally as malarious. Growing wealth and improved living conditions were gradually reducing malaria rates, but cases resurged during WWII. The advent of DDT, however, quickly eradicated malaria from the United States.
DDT routed malaria from many other countries as well. The Europeans who were freed of malaria would hardly describe its use as a failure. After DDT was introduced to malaria control in Sri Lanka (then Ceylon), the number of malaria cases fell from 2.8 million in 1946 to just 110 in 1961. Similar spectacular decreases in malaria cases and deaths were seen in all the regions that began to use DDT. The newly formed Republic of China (Taiwan) adopted DDT use in malaria control shortly after World War II. In 1945 there were over 1 million cases of malaria on the island. By 1969 there were only 9 cases and shortly thereafter the disease was eradicated from the island and remains so to this day. Some countries were less fortunate. South Korea used DDT to eradicate malaria, but without house spray programs, malaria has returned across the demilitarized zone with North Korea. As DDT was eliminated and control programs reduced, malaria has returned to other countries such as Russia and Argentina. Small outbreaks of malaria are even beginning to appear more frequently in the United States.
These observations have been offered in testimony to document first that there were fundamental misunderstandings about how DDT functioned to exert control over malaria. Second, that regardless of systematic misunderstandings on the part of those who had influence over malaria control strategies and policies, there was an enduring understanding that DDT was the most cost-effective compound yet discovered for protecting poor rural populations from insect-borne diseases like malaria, dengue, yellow fever, and leishmaniasis. I want to emphasize that misunderstanding the mode of DDT action did not lead to the wholesale abandonment of DDT. It took an entirely new dimension in the misuse of science to bring us to the current humanitarian disaster represented by DDT elimination.
The misuse of science to which I refer has found fullest expression in the collection of movements within the environmental movement that seek to stop production and use of specific man-made chemicals. Operatives within these movements employ particular strategies to achieve their objectives. By characterizing and understanding the strategies these operatives use, we can identify their impact in the scientific literature or in the popular press.
The first strategy is to develop and then distribute as widely as possible a broad list of claims of chemical harm. This is a sound strategy because individual scientists can seldom rebut the scientific foundations of multiple and diverse claims. Scientists generally develop expertise in a single, narrow field and are disinclined to engage issues beyond their area of expertise. Even if an authoritative rebuttal of one claim occurs, the other claims still progress. A broad list of claims also allows operatives to tailor platforms for constituencies, advancing one set of claims with one constituency and a different combination for another. Clever though this technique is, a list of multiple claims of harm is hardly sufficient to achieve the objective of a ban. The second strategy then is to mount an argument that the chemical is not needed and propose that alternative chemicals or methods can be used instead. The third strategy is to predict that grave harm will occur if the chemical continues to be used.
The success of Rachel Carson’s Silent Spring serves as a model for this tricky triad. In Silent Spring, Rachel Carson used all three strategies on her primary target, DDT. She described a very large list of potential adverse effects of insecticides, DDT in particular. She argued that insecticides were not really needed and that the use of insecticides produces insects that are insecticide resistant, which only exacerbates the insect control problems. She predicted scary scenarios of severe harm with continued use of DDT and other insecticides. Many have written rebuttals to Rachel Carson and others who have, without scientific justification, broadcast long lists of potential harms of insecticides. One such rebuttal is attached to my testimony (Annex 1). It is a paper by Dr. J. Gordon Edwards entitled "DDT: A case study in scientific fraud."
As shown in Annex 2, time and science have discredited most of Carson’s claims. Rachel Carson’s descriptions of inappropriate uses of insecticides that harmed wildlife are more plausible. However harm from an inappropriate use does not meet the requirements of anti-pesticide activists. They can hardly lobby for eliminating a chemical because someone used it wrongly. No, success requires that even the proper use of an insecticide will cause a large and systematic adverse effect. However, the proper uses of DDT yield no large and systematic adverse effects. Absent such adverse actions, the activists must then rely on claims about insidious effects, particularly insidious effects that scientists will find difficult to prove one way or the other and that activists can use to predict a future catastrophe.
Rachel Carson relied heavily on possible insidious chemical actions to alarm and frighten the public. Many of those who joined her campaign to ban DDT and other insecticides made extensive use of claims of insidious effects. These claims were amplified by the popular press and became part of the public perception about modern uses of chemicals. For example, four well-publicized claims about DDT were:
1. DDT will cause the obliteration of higher trophic levels. If not obliterated, populations will undergo reproductive failure. Authors of this claim speculated that, even if the use of DDT were stopped, systematic and ongoing obliterations would still occur.
2. DDT causes the death of algae. This report led to speculations that use of DDT could result in global depletion of oxygen.
3. DDT pushed the Bermuda Petrel to the verge of extinction and that full extinction might happen by 1978.
4. DDT was a cause of premature births in California sea lions.
Science magazine, the most prestigious science journal in the United States, published these and other phantasmagorical allegations and/or predictions of DDT harm. Nonetheless, history has shown that each and every one of these claims and predictions were false.
1.) The obliteration of higher trophic levels did not occur; no species became extinct; and levels of DDT in all living organisms declined precipitously after DDT was de-listed for use in agriculture. How could the prediction have been so wrong? Perhaps it was so wrong because the paper touting this view used a predictive model based on an assumption of no DDT degradation. This was a startling assertion even at the time as Science and other journals had previously published papers that showed DDT was ubiquitously degraded in the environment and in living creatures. It was even more startling that Science published a paper that flew so comprehensively in the face of previous data and analysis.
2.) DDT’s action against algae reportedly occurred at concentrations of 500 parts per billion. But DDT cannot reach concentrations in water higher than about 1.2 parts per billion, the saturation point of DDT in water.
3.) Data on the Bermuda petrel did not show a cause and effect relationship between low numbers of birds and DDT concentrations. DDT had no affect on population numbers, for populations increased before DDT was de-listed for use in agriculture and after DDT was delisted as well. 4.) Data gathered in subsequent years showed that
“despite relatively high concentrations [of DDT], no evidence that population growth or the health of individual California sea lions have been compromised. The population has increased throughout the century, including the period when DDT was being manufactured, used, and its wastes discharged off southern California.”
If time and science have refuted all these catastrophic predictions, why do many scientists and the public not know these predictions were false? In part, we do not know the predictions were false because the refutations of such claims rarely appear in the literature.
When scientists hear the kinds of claims described above, they initiate research to confirm or refute the claims. After Charles Wurster published his claim that DDT kills algae and impacts photosynthesis, I initiated research on planktonic algae to quantify DDT’s effects. From 1968-1969, I spent a year of honest and demanding research effort to discover that not enough DDT would even go into solution for a measurable adverse effect on planktonic algae. In essence, I conducted a confirmatory study that failed to confirm an expected result. I had negative data, and journals rarely accept negative data for publication. My year was practically wasted. Without a doubt, hundreds of other scientists around the world have conducted similar studies and obtained negative results, and they too were unable to publish their experimental findings. Much in the environmental science literature during the last 20-30 years indicates that an enormous research effort went into proving specific insidious effects of DDT and other insecticides. Sadly, the true magnitude of such efforts will never be known because while the positive results of research find their way into the scientific literature, the negative results rarely do. Research on insidious actions that produce negative results all too often ends up only in laboratory and field notebooks and is forgotten. For this reason, I place considerable weight on a published confirmatory study that fails to confirm an expected result.
The use of the tricky triad continues. A copy of a recent paper (Annex 3) published in The Lancet illustrates the triad's modern application. Two scientists at the National Institute of Environmental Health Sciences, Walter Rogan and Aimin Chen, wrote this paper, entitled "Health risks and benefits of bis(4-chlorophenyl)-1,1,1-trichloroethane (DDT)." It is interesting to see how this single paper spins all three strategies that gained prominence in Rachel Carson’s Silent Spring.
The journal Emerging Infectious Diseases had already published a slim version of this paper, which international colleagues and I promptly rebutted. The authors then filled in some parts, added to the claims of harm, and republished the paper in the British journal, The Lancet. To get the paper accepted by editors, the authors described studies that support (positive results) as well as studies that do not support (negative results) each claim. Complying with strategy number 1 of the triad, Rogan and Chen produce a long list of possible harms, including the charge that DDT causes cancer in nonhuman primates. The literature reference for Rogan and Chen's claim that DDT causes cancer in nonhuman primates was a paper by Takayama et al. Takayama and coauthors actually concluded from their research on the carcinogenic effect of DDT in nonhuman primates that “the two cases involving malignant tumors of different types are inconclusive with respect to a carcinogenic effect of DDT in nonhuman primates.” Clearly, the people who made the link of DDT with cancer were not the scientists who actually conducted the research.
The authors enacted strategy number two of the triad by conducting a superficial review of the role of DDT in malaria control with the goal of discrediting DDT's value in modern malaria control programs. The authors admitted that DDT had been very effective in the past, but then argued that malaria control programs no longer needed it and should use alternative methods of control. Their use of the second strategy reveals, in my opinion, the greatest danger of granting authority to anti-pesticide activists and their writings. As The Lancet paper reveals, the NIEHS scientists assert great authority over the topic of DDT, yet they assume no responsibility for the harm that might result from their erroneous conclusions. After many malaria control specialists have expressed the necessity for DDT in malaria control, it is possible for Rogan and Chen to conclude that DDT is not necessary in malaria control only if they have no sense of responsibility for levels of disease and death that will occur if DDT is not used.
Rogan and Chen also employ the third strategy of environmentalism. Their list of potential harms caused by DDT includes toxic effects, neurobehavior effects, cancers, decrements in various facets of reproductive health, decrements in infant and child development, and immunology and DNA damage. After providing balanced coverage of diverse claims of harm, the authors had no option but to conclude they could not prove that DDT caused harm. However, they then promptly negated this honest conclusion by asserting that if DDT is used for malaria control then great harm might occur. So, in an amazing turn, they conclude they cannot prove DDT causes harm, but still predict severe harm if it is used.
Rogan and Chen end their paper with a call for more research. One could conclude that the intent of the whole paper is merely to lobby for research to better define DDT harm, and what’s the harm in that? Surely increasing knowledge is a fine goal. However, if you look at the specific issue of the relative need for research, you will see that the harm of this technique is great. Millions of children and pregnant women die from malaria every year, and the disease sickens hundreds of millions more. This is an indisputable fact: impoverished people engage in real life and death struggles every day with malaria. This also is a fact: not one death or illness can be attributed to an environmental exposure to DDT. Yet, a National Library of Medicine literature search on DDT reveals over 1,300 published papers from the year 2000 to the present, almost all in the environmental literature and many on potential adverse effects of DDT. A search on malaria and DDT reveals only 159 papers. DDT is a spatial repellent and hardly an insecticide at all, but a search on DDT and repellents will reveal only 7 papers. Is this not an egregiously disproportionate research emphasis on non-sources of harm compared to the enormous harm of malaria? Does not this inequity contribute to the continued suffering of those who struggle with malaria? Is it possibly even more than an inequity? Is it not an active wrong?
Public health officials and scientists should not be silent about enormous investments into the research of theoretical risks while millions die of preventable diseases. We should seriously consider our motivations in apportioning research money as we do. For consider this: the U.S. used DDT to eradicate malaria. After malaria disappeared as an endemic disease in the United States, we became richer. We built better and more enclosed houses. We screened our windows and doors. We air conditioned our homes. We also developed an immense arsenal of mosquito control tools and chemicals. Today, when we have a risk of mosquito borne disease, we can bring this arsenal to bear and quickly eliminate risks. And, as illustrated by aerial spray missions in the aftermath of hurricane Katrina, we can afford to do so. Yet, our modern and very expensive chemicals are not what protect us from introductions of the old diseases. Our arsenal responds to the threat; it does not prevent the appearance of old diseases in our midst. What protects us is our enclosed, screened, air-conditioned housing, the physical representation of our wealth. Our wealth is the factor that stops dengue at the border with Mexico, not our arsenal of new chemicals. Stopping mosquitoes from entering and biting us inside our homes is critical in the prevention of malaria and many other insect-borne diseases. This is what DDT does for poor people in poor countries. It stops large proportions of mosquitoes from entering houses. It is, in fact, a form of chemical screening, and until these people can afford physical screening or it is provided for them, this is the only kind of screening they have.
DDT is a protective tool that has been taken away from countries around the world, mostly due to governments acceding to the whims of the anti-pesticide wing of environmentalism, but it is not only the anti-pesticide wing that lobbies against DDT. The activists have a sympathetic lobbying ally in the pesticide industry. As evidence of insecticide industry working to stop countries from using DDT, I am attaching an email message dated 23rd September and authored by a Bayer official (Annex 4). The Bayer official states
"[I speak] Not only as the responsible manager for the vector control business in Bayer, being the market leader in vector control and pointing out by that we know what we are talking about and have decades of experiences in the evolution of this very particular market. [but] Also as one of the private sector representatives in the RBM Partnership Board and being confronted with that discussion about DDT in the various WHO, RBM et al circles. So you can take it as a view from the field, from the operational commercial level - but our comapnies point of view. I know that all of my colleagues from other primary manufacturers and internationally operating companies are sharing my view."
The official goes on to say that
“DDT use is for us a commercial threat (which is clear, but it is not that dramatical because of limited use), it is mainly a public image threat.”
However the most damming part of this message was the statement that
"we fully support EU to ban imports of agricultural products coming from countries using DDT"
Annex 4 provides clear evidence of international and developed country pressures to stop poor countries from using DDT to control malaria. This message also shows the complicity of the insecticide industry in those internationally orchestrated efforts.
Pressures to eliminate spray programs, and DDT in particular, are wrong. I say this not based on some projection of what might theoretically happen in the future according to some model, or some projection of theoretical harms, I say this based firmly on what has already occurred. The track record of the anti-pesticide lobby is well documented, the pressures on developing countries to abandon their spray programs are well documented, and the struggles of developing countries to maintain their programs or restart their uses of DDT for malaria control are well documented. The tragic results of pressures against the use of DDT, in terms of increasing disease and death, are quantified and well documented. How long will scientists, public health officials, the voting public, and the politicians who lead us continue policies, regulations and funding that have led us to the current state of a global humanitarian disaster? How long will support continue for policies and programs that favor phantoms over facts?