Regional Program of Action and Demonstration of Sustainable Alternatives to DDT for Malaria Vector Control in Mexico and Central America
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This project aims to demonstrate sustainable and cost-effective alternatives to DDT for malaria control in Mexico and Central America. It will help eliminate stockpiles of DDT and other pesticides, implement demonstration projects of alternative control methods, and strengthen national capacity for DDT-free malaria control. The project is funded by GEF, national governments, and PAHO over three years and involves inventorying DDT stockpiles, community-based control models, and disseminating information through a technical manual and GIS systems.
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Regional Program of Action and Demonstration of Sustainable Alternatives to DDT for Malaria Vector Control in Mexico and Central America
- 1. Regional Program of Action and Demonstration of Sustainable Alternatives to DDT for Malaria Vector Control in Mexico and Central America Third Biennial International Waters Conference Salvador, Bahia, Brazil. 20-25 June 2005
- 2. Focal Areas This Project conforms with the Contaminant-based Operational Program No. 10 and will help demonstrate ways of overcoming barriers to the adoption of best practices that limit contamination of the international waters environment. The proposed activities are also consistent with several provisions with the adopted Stockholm Convention on POPs. DDT is one of the POPs in the Stockholm Convention.
- 3. M While Maallaarriiaa iiss IInnccrreeaassiinngg iinn TThhee AAmmeerriiccaass PP.. VViivvaaxx yy PP.. FFaallcciippaarruumm 11995599 -- 11999999 PAHO/WHO Year Number of cases (thousand)
- 4. Financing iinn MMaallaarriiaa CCaammppaaiiggnnss iinn TThhee AAmmeerriiccaass iiss DDeeccrreeaassiinngg 300 250 US$ millions Year 200 150 100 50 0 58 60 62 64 66 58 70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 PAHO/WHO 11995588 -- 11999999
- 5. DDT in the Environment, Including International Waters and Human Bodies.
- 6. Facts on the Course of DDT • DDT was Used for Public Health Malaria and other Vector Born Disease Control. • Central America and Mexico Stopped DDT Use in the 1990’s and 2000. • DDT is Still found in the Environment and Human Bodies.
- 7. Dispersion of DDT in Mexico Levels of DDT found on sediments in the Lagoons of Zempoala, Morelos and its comparison with DDT used for malaria control in Mexico Decades DDT applied (t) Year DDT used in Mexico
- 8. Impact in Biota Concentration of DDT (ng/g) in species of the food chain in “La Cigüeña”, Chiapas (2002) Birds = 232.50 Fish = 24.08 Crabs = 23.84 Sediment = 138.37
- 9. Impact in the Environment Total DDT (mg/kg) in superficial soil in malaria communities in 2002 La Ventanilla La Cigüeña Lacandona 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 Total DDT Average (μg/kg) Total DDT interior Total DDT exterior Ventanilla Cigüeña Lacandona
- 10. Impact in Humans DDT blood concentration in children (mg/L) 80 70 60 50 40 30 20 10 0 DDT in blood in children "La Cigüeña", Chiapas 2000 2001 2002 2003 2004 Years DDD (μg/L) DDE (μg/L) DDT (μg/L) Mean concentration (mg/L)
- 11. Impact in Humans DDT, DDE and DDEms levels in breast milk of 30 Mexican mothers (ng/g lipid) Substance Sweden 1992 Mexico 2004 DDT 22 366 DDE 227 1683 DDEms 0.4 3.4
- 12. UNEP/ GEF/ PAHO Project to Demonstrate DDT Alternatives for Malaria Control. Participating countries Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama Implementing agency •United Nations Environment Programme Executing agency •Pan American Health Organization (PAHO) •National Governments Funding Partners •Global Environment Facility •National Governments •PAHO •CEC Total 7.165 5.865 0.654 0.200 US$ 13.884 Duration Three years: August 2003- July 2006
- 13. Overall Objective • To demonstrate that methods for malaria vector control without DDT or other persistent pesticides are replicable, cost-effective and sustainable thus preventing the reintroduction of DDT in the Region. Components • Elimination of DDT stockpiles • Implementation of demonstration projects on alternatives to DDT for Malaria Control and dissemination • Strengthening of national institutional capacity to control malaria without DDT • Coordination and management
- 14. Inventory of DDT and Other POPs Country DDT Other POPs Belize 13.000 0.008 Costa Rica 8.621 0.122 El Salvador 4.672 46.252 Guatemala 15.058 Honduras 3.539 12.490 Mexico 87.000 Nicaragua 0.003 5.647 Panama 4.545 Total 136.438 64.519
- 15. Implementation Strategy • To integrate epidemiology with socio-economic issues, entomology, public health, environment, water and provision of health care. – Epidemiological stratification with risk approach – Elimination of the persistent parasite – Ecological larvae control with social participation – Control of the adult mosquito with inexpensive techniques and low environmental impact – Sustained sanitation educational program aimed at the community
- 16. MMooddeell ffoorr MMaallaarriiaa CCoonnttrrooll 1. Community participation can provide mosquito control management by regulating or modifying the breeding sites in water bodies and areas surrounding houses. 2. Hygiene seems to play a great roll in malaria transmission. Good sanitation and familiar hygiene can reduce mosquito attraction. 3. If malaria concentrates in only a few households, then suitable drug treatment can reduce infection sources and the risk for the community.
- 17. AAqquuaattiicc HHaabbiittaatt ooff LLaarrvvaall SSttaaggeess The breeding sites are influenced by the presence of water in streams and rivers. The breeding sites are characterized by the presence of low flux of streams and green algae.
- 19. Technical Manual on Demonstration Activities Guide for the implementation and demonstration of sustainable alternatives for the integrated control of malaria in Mexico and Central America
- 20. Collection, Discussion and Dissemination of Information http://shp.paho.org/sde/ddtgef/default.aspx
- 21. Geographic Information System Models used in the Project Tropical rainforest distribution (red) CONABIO map Mex. 1999 and CIESIN satellite image, 1995 Areas below 800 meters above average sea level. Digital Elevation Model (DEM), USGS, 2001. API by first sub-national level in Mesoamerica (Central America Basic Indicators 2001) and Mexico Rates x 1000 inhabitants by second administrative level (SUAVE, Mex, 2001) The SIGEpi perspective has the purpose of standardizing, integrating, compiling and facilitate the interchange of digital cartographic infrastructure ( data, methods and software) as a foundation for analyzing geographically the data about malaria vector control and DDT residuals.
- 22. Costa Rica’ s GIS Local Scale Observation Level for Malaria Control Mosquito breeding sites and surrounding positive houses to malaria Progress in the GPS dwellings survey in localities along the border corridor between Costa Rica and Panama Paper map The same map in vector and raster digital format in SIGEpi GPS demonstration Panama Costa Rica
- 23. From Sketch to Digital Maps in Panama Showing Malaria Houses (red houses) Calculating the number of preventive treatments in the 200 meters surroundings
- 24. Organizational Chart Steering Committee 8 Ministers of Health PAHO UNEP CEC CCAD Observers: World Bank, UNDP, NGOs, other cooperation agencies Regional Operational Committee 1 Regional Coordinator 8 Focal Points (Health) 8 National Coordinators Representatives from NGOs and the Civil Society National Committee National Focal Point (Health) National Coordinator Environment Representative Agriculture Representative Customs or Immigration Representative 9 Working Groups Demonstration Projects National Coordinator Focal Point Environment Representative Agriculture representative UNEP/GEF Implementing/Donor Agencies PAHO Executing Agency CEC Cooperation Agency Advisory Committee Universities, Research Institutions Civil Society, Organizations and NGOs with activities related to the project Advisory Committee One representative from each governmental unit Representatives from NGOs and the Civil Society
Notes de l'éditeur
- Thank you mister chairman. I am Emilio Ramirez Pinto, regional coordinator of the Regional Program of Action and Demonstration of Sustainable Alternatives to DDT for Malaria Vector Control in Mexico and Central America, and on behalf of all the professionals involved in this project I would like to share with you in the following minutes the progresses achieved so far in this project. DDT was used in the region for much of the second half of the twentieth century, raising the concern on the effects to human and environmental exposure in the areas sprayed with DDT. However, 35 percent of the Mexican and Central American population lives in malaria endemic areas or are at risk of developing this disease. But successful experiences developed in Mexico and Central America during the last years has showed that it is possible to control the malaria vector without using DDT. Next slide please.
- This concern shared by the governments of Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico Nicaragua and Panama prompted the implementation of this three-year project of regional scope, implemented by the United Nations Environment Programme, executed by the Pan American Health Organization and the national governments and funded by the Global Environment Fund, cash and in kind cooperation from the participating governments, PAHO in kind input and the contribution from the Commission for Environmental Cooperation of North America. Next slide please.
- This project seeks to demonstrate that the methods used to control malaria without DDT or other persistent organic pollutants are replicable, effective and sustainable, thus preventing the reintroduction of DDT in the region. There are four different groups of action necessary to address the countries’ needs to lower their vulnerability to using DDT for malaria control. First, the development of nine demonstration projects under specific environmental and socio-economic conditions, with detailed monitoring and evaluation with the participation of environment and health national services and the local communities. Second, to improve the analytical capacity of the national laboratories for the evaluation of exposure to plaguicides; to strengthen the regional and national malaria surveillance systems; to strengthen the institutions providing care for malaria and to implement the geographic information system. Third, update of the national inventories of DDT and other POPs, repackage, shipment and final disposal according to the Stockholm and Basel Conventions and raise political willingness to prevent recurrence of DDT stockpiles. And fourth, Coordination and management. Next slide please.
- The standardized form for the inventory of DDT and other POPs was made through and agreement with the Regional Institute of Toxicology in Costa Rica and seven countries have concluded data collection, which include information on location, type of pesticide, storage conditions and others. A total of 136.438 metric tons of DDT were found in the region (data from Mexico is preliminary and its based on the PDF-B assessment). Also 64.519 metric tons of other persisntes pollutants were found in the region. Thank you for your attention.
- The strategy for the successful implementation of the project is to integrate epidemiology with social sciences, entomology, public health, environment, health care services and other scientific fields of a model validated by Mexico and enriched by the other countries. The model is based on the epidemiological stratification with a risk approach; the elimination of the persistent parasite; ecological larval control with social participation; control of the adult anopheles with inexpensive techniques and with the lowest impact to the ecosystem; and a sustained program of sanitary education at the community level. Next slide please.
- Also it was recently published the Guide for the implementation and demonstration of sustainable alternatives for the integrated control of malaria in Mexico and Central America as a joint effort of the Mexican health authorities, CEC, PAHO, and the representatives from the ministries of health of the participating countries. This manual is a standardized guide for the development of the demonstration projects, yet aware and taking into account the particularities of each country. Next slide please.
- In relation to dissemination, the project’s webpage is an important tool of communication among stakeholders and a source of information for visitors. Next slide please.
- The highest organ of the project is the Steering Committee, which is composed by representatives of the ministries of health, PAHO, UNEP/GEF, CEC, CCAD and observers such as the World Bank, UNDP, NGOs and other relevant cooperation agencies. Meet once a year to approve the work plans of the countries, the terms of reference of the demonstration projects and provide advisory functions. Then, the Regional Operational Committee responsible for overseeing the implementation of the project and composed by the Regional Coordinator, the 8 Focal Points (from the health sector), the 8 National Coordinators and representatives from NGOs and the Civil Society. The next level of organization is the National Committee, composed by the National Focal Point, the National Coordinator and representatives from the ministries of the Environment and Agriculture, as well as a representative from Customs or Immigration Representative. With an Advisory Committee composed by Universities, Research Institutions, the Civil Society, Organizations and NGOs with activities related to the project. The organization at the local level is the Working Groups for each Demonstration Projects, composed by the National Coordinator, the Focal Point and representatives from the ministries of the Environment and Agriculture. With an Advisory Committee with representatives from the local government, NGOs and the Civil Society. Next slide please.