STATEMENT

of

Roy Innis, National Chairman

Congress of Racial Equality

before the

U.S. Senate Committee on Homeland Security and Governmental Affairs

on

Bilateral Malaria Assistance: Progress and Prognosis

January 19, 2006

I want to thank this Committee and Subcommittee for giving CORE the opportunity to submit a statement on progress in the fight against one of the greatest killers in human history.

One of America’s oldest civil rights organizations, the Congress of Racial Equality helped lead the marches, sit-ins, voter registration drives and other civil rights actions of the 1960s. When three courageous civil rights workers – James Chaney, Andrew Goodman and Michael Schwerner – were brutally murdered in Mississippi in June 1964, they were working for CORE.

Today, we continue to be deeply involved in the struggle for rights, freedoms and equal opportunities for all, regardless of race, creed, color or nationality. We especially believe that with rights come responsibilities … that all individuals must strive to take full advantage of the opportunities available to them … and that the struggle for civil and human rights continues, but takes new forms and must confront new opponents on new battlegrounds.

Just a few decades ago, the struggle was over whether black Americans could vote, go to the school of our choice, enjoy a drink or meal at a lunch counter, and sit at the front of the bus. Two years ago, at our annual Martin Luther King dinner, we honored Rosa Parks, whose refusal to give up her bus seat in 1955 sparked the modern US civil rights movement. This year, just three days ago, we honored Governor Haley Barbour and the state of Mississippi for the enormous strides they have made in race relations since that dark day four decades ago.

Today, at least one struggle for civil and human rights is even more urgent. It is the self-evident and fundamental right of people to life itself. For without life, it is impossible to enjoy liberty, pursue happiness or benefit from any of the other rights with which we have been endowed by our Creator.

But all too often, government policies deny this fundamental right to billions of the world’s poorest people. The struggle to safeguard that basic human right is the topic of today’s hearing.

We have come here today to help people secure the right to control, reduce and eventually eradicate the terrible killer known as malaria. We have come to undo and reverse the effects of well-intended but woefully misguided policies, rules and restrictions that for too long have prevented communities and nations from taking effective action against this disease.

Carried by mosquitoes, malaria brings on repeated surges of fevers, chills, vomiting, delirium and unconsciousness. It leaves victims unable to work, cultivate fields, attend school or care for their families, for weeks or months on end. It especially targets children and pregnant women, robs people of their health and earning capacity, leaves many with permanent brain damage – and kills millions.

Few of us, even in this room, remember that malaria still killed 10,000 Americans a year in the first quarter of the twentieth century. It killed 5,000 people a year in the Tennessee River Valley alone during the 1930s. It thrived from New York to Florida, from East Coast to West.

Throughout much of US history, malaria reigned and killed in Oklahoma and Virginia, Kansas and Texas, the Ohio and Mississippi River Valleys, California’s Sacramento Valley … in Ohio, Michigan, New York, New Jersey, Delaware – and even Alaska. Three times, it stopped construction of the aqueduct that finally brought water from the Potomac River to Washington, DC. The disease’s first cousin, yellow fever, killed 9,000 people during the summer of 1878 in Memphis and New Orleans.

The United States had up to seven million cases of malaria every year during this time, and the disease delayed and frustrated progress and prosperity throughout our southern states, where it kept the average worker from working up to a month every year until 1940.

These facts prompted the United States to implement DDT spraying, wetland draining and other actions on a widespread, almost incredible scale after World War II. Even so, malaria was not eradicated in the United States until the 1960s.

However, we seem to have forgotten our own recent history. We have paid too little attention to the cold reality that many parts of the world are not nearly as fortunate as we Americans.

Today, malaria still kills 2,500 to 5,000 people EVERY DAY in Africa. Acute malaria still infects more Africans every year than there are people in the United States, Canada and Mexico combined. It costs this impoverished continent over $12 billion in lost productivity every year. It is still the biggest single killer of African children.

Malaria still sickens, kills and impoverishes countless people in Asia and Latin America.

That is why, like Martin Luther King, I have a dream. Of a day when parents and children everywhere can live as we do here in the United States – in good health, without fear of being struck down by malaria. Of a day when the Congress of Racial Equality can honor Congress, the U.S. Agency for International Development – and the World Bank, World Health Organization and Roll Back Malaria – for their roles in sending malaria to the ash heap of history.

But that day is not yet here.

It is not yet here because – while we have the knowledge, weapons and resources to dramatically reduce, or even eradicate, this horrible disease – we have lacked the moral clarity and political willpower to do so. We have spent vast sums on programs that do little to reduce malaria. We have placed such heavy emphasis on environmental considerations that human health, and the urgent need to prevent this readily preventable disease, have been a distant second tier priority.

For me, and perhaps for a few of you, malaria is a very personal matter. I have seen it up close, in all its horror, during many trips to Africa. I have watched helplessly, as little children died, and have spoken with their grief-stricken parents, not knowing how to ease their pain.

My wife is from Uganda. Her family has battled malaria for as many years as they can remember. They have lost aunts and uncles, parents and children, friends and siblings.

My nephew’s wife, Fiona Kobusingye, is also Ugandan. As she recounts in the moving testimony attached to this statement, she lost two sisters, two nephews and her own son to malaria. She has had malaria many times since she was a little girl, and almost died from it again just two months ago. She and my nephew sponsor a school for orphans in Uganda, and were heartbroken when they went back last Christmas to deliver presents – only to find that 50 of their 500 young students had died from malaria during the previous twelve months.

Their photographs are also attached to this statement. I cannot help getting choked up and teary-eyed every time I look at their images, and think of their promising lives cut short.      

That is why I have come before you today, in a spirit of bipartisanship – and in hope that we can begin right here, right now, to resolve together to do whatever is necessary to end malaria’s reign of terror on Africa and so many other developing countries.

Controlling malaria transcends all racial, ethnic, religious and political boundaries. Reducing disease and saving lives is a topic on which ALL people of good conscience and humanitarian commitment ought to agree. It is a cause that can and must unite us all.

The Congress of Racial Equality is committed to working with every person and organization that shares this vision, for it is truly a goal we can reach, if we work together.

If the United States had malaria rates akin to Africa’s, 100 million Americans would become acutely ill every year. Up to 200,000 of our children would die. Our hospitals and healthcare system would be overwhelmed. We would demand immediate action – with every available weapon – and any legislator, bureaucrat or activist who stood in our way would be run out of town on a rail.

We must respond with equal clarity, vigor and determination to Africa’s life-or-death situation – for surely their parents and children are as deserving of health, life and a better future as ours.

Unfortunately, for many years, USAID and other agencies failed unconscionably in their mission – and their duty – to be responsible care givers to the world’s least fortunate citizens. For years, they assured us that their bed net, capacity-building and educational programs would bring malaria under control, and we would not have to resort to insecticides. They were wrong.

Malaria disease and death rates have been soaring upward. Billions have been stricken, and millions have died. It was unnecessary. It was unconscionable. If the people running these programs had been physicians in private practice, they would have been indicted for gross medical malpractice, convicted and probably imprisoned.

CORE could not stand idly by. We have spoken out repeatedly. We have participated in conferences and meetings. We and our colleagues in this battle have testified before Congress, and written articles, commentaries, and letters to the President, Congress, United Nations, USAID, WHO and World Bank.

More recently, we helped launch the Kill Malarial Mosquitoes NOW! campaign – and issued a forceful Declaration, stating what we believe must be done to prevent this disease and save lives. It demands that US, EU and UN policies must henceforth permit, encourage and support the use of DDT, other insecticides and modern drugs. (A copy of the Declaration is attached, and further information can be found at www.FightingMalaria.org)

It makes it clear that these weapons are to be used in addition to – never instead of – all the other weapons we have in our arsenal to combat this serial killer. It presents in detail the reasons why DDT, other insecticides and new combination drug therapies are vital to controlling malaria. The Declaration recognizes that winning the war against trillions of malarial mosquitoes will require every bit of the innovation and dedication that stopped cholera and polio – the kind that one day could also stop malaria.

It will also require eliminating the obstacles and restrictions we have erected to using the weapons we have – and used so effectively to rid America, Europe, Australia, Canada and other nations of this killer disease.

The Declaration also recognizes that we can and must protect both human beings and the environment. Careful use of insecticides and other commodities and interventions will ensure this in Africa and other malaria epidemic countries, just as it has here in the United States.

The KMMN campaign has already gained the support of Nobel Peace Laureates Archbishop Desmond Tutu, former South African President F. W. de Klerk and Dr. Norman Borlaug, Greenpeace co-founder and forest ecologist Dr. Patrick Moore, and hundreds of infectious disease experts, physicians, human rights advocates, and religious, political, business and intellectual leaders from all over the world.

It has already helped persuade Congress to enact appropriations language strongly recommending that the USAID revamp its policies. 

CORE is pleased to say that USAID is responding and appears to be making progress. It appears to be revising its policies, to make them more accurately reflect the realities of malaria, malaria control, and effective drug and insecticide use. It appears to be taking steps to ensure that USAID’s policies and programs save far more lives than they have in the past, and actually begin to roll back malaria in Africa and all over the developing world.

We intend to watch the Agency and its programs very closely over the coming months and years – not as meddling interlopers, but as committed partners – to ensure that progress continues. We stand shoulder-to-shoulder with USAID, this Committee and Congress. We endorse your efforts wholeheartedly, and will vigorously defend your decisions to support the use of insecticides. With equal fervor, we will defend the primacy of developing country health ministers in determining which interventions should be used under given circumstances, with encouragement, instead of delays or threats of reprisals for using insecticides.

America has been a world leader in conquering disease and aiding poor countries’ efforts to break the shackles of disease, poverty and early death. With your support, we will again stand tall in defending people’s health, lives, economic well-being and rights of self-determination.

I firmly believe that opposing DDT and other insecticides is equivalent to signing a death warrant for millions of children and mothers. The dangers of DDT and other insecticides – properly used – are minimal. Those risks, moreover, must be judged against their clear benefits, just as we balance the dangers and benefits of chemotherapy drugs – or of spraying Dade County, FL and the entire Gulf of Mexico coast with insecticides to prevent West Nile virus.

For us here in what are now the malaria-free United States to tell malaria endemic or epidemic African, Asian or Latin American nations that we will not enable them to use DDT and other insecticides – and sometimes have even threatened them with penalties if they do so – is scientifically indefensible and morally wrong. It means putting minimal, speculative risks of using these chemicals far above the very real and immediate risks of illness, brain damage and death from the diseases that will result from not using them.  

The realities of malaria and malaria control programs are simple and straightforward

Billions are at risk.

Over 2 billion people worldwide remain at risk of getting acute malaria. A half billion actually get it, and 1 to 3 million die from it – year after year – in poor developing countries where doctors, nurses, medical facilities, and even roads and electricity are minimal to nonexistent.

The death toll is equivalent of a Rwanda or Cambodia every year, a Holocaust every 2-3 years.

Nets, conferences, capacity building, education and treatment programs are simply not enough. Vaccines are years or even decades away. Malaria-threatened nations need every single weapon in the world’s arsenal. They cannot and must not be prevented from using any or all of them to prevent disease and save lives.

Government aid agencies too often spend their malaria control money on the wrong things.  

The USAID, World Bank, WHO and Roll Back Malaria all want to slash malaria rates. But the programs they insist on following will never accomplish this vital, and clearly achievable goal. They spend far too much money on consultants, conferences, education, “capacity building,” training, bed nets, and drugs like Chloroquine that no longer work.

They spend almost no money on DDT, other insecticides or ACT drugs. In fact, their funding, environmental and other policies often make it virtually impossible for countries to get or use DDT to control disease. Until they begin spending significant money on weapons that actually reduce malaria and save lives, people will continue to die needlessly, in huge numbers.

A few years ago, several organizations provided loans to Eritrea, where malaria is responsible for 50 percent of all deaths. But the UNICEF money could be spent only on insecticide-treated bed nets, while USAID funds went for “environmental assessments.” The World Bank required Eritrea to develop a program and schedule to replace DDT house spraying with “chemicals or techniques that are safer for the environment and human health.” As a result, malaria rates have remained unconscionably high.

In February 2005, a European Union bureaucrat warned Uganda that the country’s export of fish, flowers and cereals to Europe could be disrupted if it used DDT to reduce a malaria epidemic that kills 70,000 to 100,000 Ugandans every year. Even barely detectable traces of DDT on these products could trigger an import ban. Others repeated the threat later in the year.

DDT is the best single malaria control weapon known to man. 

DDT certainly does kill mosquitoes. However, it is most valuable as the world’s most powerful and long-lasting insect repellant. Sprayed in small quantities, just once or twice a year on the walls and eaves of mud-and-thatch or cinder-block homes, via indoor residual spraying (IRS), it keeps 90% of mosquitoes from entering. It irritates any that do enter, so they rarely bite, and kills those that land on walls.

Using IRS programs, South Africa slashed its malaria disease and death rates by 80 percent in just 18 months. It was then able to provide modern artemisinin-based combination drugs to the much smaller number of people who still got malaria – and cut disease and death rates by 96 percent in three years!

Madagascar cut its rates by 90 percent after just two spraying cycles with DDT. Mozambique and Zambia slashed malaria rates by 75 percent in less than two years through the use of DDT. Ecuador cut its malaria incidence by 60 percent by using DDT. Other countries could do likewise, if we would help, encourage, facilitate and support them.

No other insecticide, and no bed net – at ANY price – is this effective.

And yet, for years the USAID opposed the use of DDT or other insecticides in spraying programs. The World Bank continues to impose similar ideologies and policies. The World Health Organization claims to support DDT and other insecticides – but imposes expensive and cumbersome rules and procedures, and does all it can to discourage actual DDT use.

Of course, DDT is neither a panacea nor the only weapon needed in our war on disease. We still need larvacides and other insecticides for outdoor spraying, to kill mosquitoes – and we need bed nets and modern ACT drugs, window screens, hygiene, education and other interventions.

DDT is safe to use. 

Tens of millions of people, of all ages and ethnicities, were sprayed with DDT directly on their bodies during and after World War II. No significant ill effects were ever recorded. Sprayed on the walls of houses, there is virtually no chance that DDT will enter or harm the environment.

Humans are at little or no risk from DDT either, especially when it is used in tiny amounts for indoor residual spraying. The worst thing anti-pesticide activists now say about DDT is this:

“Researchers think DDE could be inhibiting lactation because of its estrogen-like effects and may therefore be contributing to lactation failure throughout the world,” says a 2001 Greenpeace International report [emphasis added].

Studies “suggest that DDE and possibly other organochlorines can weaken the immune systems of children, increasing their risk of developing asthma and certain infections,” Physicians for Social Responsibility argues [emphasis added].

Compared to the risks of malaria, these risks from DDT are laughably small. That they have been used to justify opposition to DDT and other insecticides for malaria control is almost criminal.

Continuing to rely primarily on bed nets means millions will die unnecessarily.  

The World Bank says bed nets “could” reduce childhood malaria deaths “by as much as one-fifth.” If one million are dying each year, getting bed nets to vastly more people could mean perhaps 200,000 fewer deaths annually.

However, South Africa and other countries have proven that DDT reduces malaria deaths by 75 percent. That means 750,000 fewer deaths each year. In other words –

DDT can save 500,000 more lives every year than insecticide-treated nets.

Why? Because people rarely have enough nets for an entire family, cannot use them when they are working around the house after dusk, forget to use them, use them even when they are torn, use them as fishing nets (which poisons lakes and rivers, and renders the nets far less effective), or refuse to use them when it’s 90 degrees at night but 100 degrees under the nets.

Stopping malaria is the most critical human rights issue facing Africa today.

Without good health, without life, other human rights mean nothing. People with malaria cannot work, go to school, care for their families or enjoy other basic rights. People with malaria are more likely to die from AIDS, typhus, dysentery, tuberculosis and other diseases.

Access to every anti-malaria weapon is a basic human right. Policies that preclude countries from getting DDT, other insecticides and modern drugs violate basic human rights.

We used DDT to stop malaria in the United States, and now use aerial insecticide spraying regularly to prevent West Nile virus, which kills about 100 Americans annually. That is less than 1/10,000th of the death toll from malaria. We must no longer deny those weapons to African and other countries that are wracked by malaria.

We must no longer spend millions on malaria – but not on weapons that reduce disease and save lives. We must no longer permit aid agencies or the European Union to threaten aid cutoffs or trade embargoes against countries that want to use DDT to reduce disease and save lives.

We must get our priorities straight.

Too many agencies emphasize ultra-precaution about alleged risks from pesticides, at the expense of millions of deaths from diseases that pesticides could prevent.

Health ministers need the power, authority and weapons to safeguard families from real, immediate, life-threatening risks – instead of condemning them to poverty, disease and premature death, to prevent conjectural risks from pesticides. Decisions about which weapons to use should be made by those health ministers – not by anti-pesticide politicians, activists and bureaucrats in air-conditioned, malaria-free offices in Washington, Geneva or Brussels.

USAID should spend 2/3 of its future malaria control funds on insecticides and drugs.

For years, virtually no USAID funds were spent on these commodities. If the agency continues spending money on conferences, consultants and bed nets – or delaying the use of DDT and other insecticides by requiring extensive environmental studies – it will ensure that malaria, yellow fever, trypanosomiasis and other diseases are not brought under control, and millions of mothers, fathers and children will continue to die unnecessarily.

TOTAL funds devoted to malaria control by ALL agencies worldwide are far below what experts agree are needed to reduce preventable insect-borne diseases. Of the three worst diseases killing Africans (the others are TB and HIV/AIDS), malaria is the easiest to control – if we take the proper measures.

Therefore, available funds must allocated to interventions that will reduce disease and save lives. Even if funding is ultimately or temporarily less than two-thirds, as much money as possible should go to DDT and modern artemisinin-based drugs. Nothing else works as well.

Firm, determined, moral actions by Congress and USAID will be likely be followed by the World Health Organization and World Bank. Millions of lives will be saved. Billions of people will be spared the ravages of malaria. Countless communities and nations will become healthier, economically stronger and blessed with a much better future.

We therefore ask Congress to take the following actions.  

(1) Enact federal legislation in 2006, saying that a full two-thirds of anti-malaria monies MUST – not merely "should" – be used to purchase and deploy cost-effective insecticides (DDT) and ACT drugs. 

(2) Require that all agencies receiving US funds for malaria control have realistic programs for achieving their goals – and spend substantial sums on DDT and other insecticides, and on ACT and other modern drugs that are consistently effective against malaria parasites.

(3) Ensure that the World Health Organization does not move forward with plans to require that any country using DDT must: (a) set up an expensive new bureaucracy to regulate the purchase, import and use of DDT, and (b) conduct detailed environmental studies, based on the incorrect assumption that limited disease control uses are the same as massive agricultural uses.

(4) Ensure that all agencies receiving US funds are transparent, open to scrutiny, honest in reporting their accomplishments, and held accountable for their success or failure in reducing disease and death tolls.

(5) Support or require independent, scientific studies comparing how well bed nets actually work – compared to DDT, other insecticides and ACT drugs – in controlling malaria.

(6) Define success clearly and unequivocally. Insist on clear, scientifically sound baseline figures for malaria rates – and equally sound data on reductions in disease and death rates. Information on dollars spent, conferences held or nets distributed is misleading, useless and unacceptable.

(7) Ensure relentlessly tough Congressional and independent oversight of the implementation and success rates of malaria control programs by the USAID, WHO, World Bank, Roll Back Malaria and other agencies that receive US funding.

(8) Serve notice to the EU and aid agencies that we will no longer tolerate threats against countries wishing to use DDT, in accord with the Stockholm Convention, to control malaria and save lives.

CONCLUSION

The positive momentum that Congress and the U.S. Agency for International Development have generated has created a window of opportunity. We have it in our power to change disease control policies and practices, prevent diseases, save millions of lives, and bring greater health and prosperity to families, communities and nations in Africa, Asia and Latin America.

If we take firm action – rooted in moral, medical, scientific and human rights principles – to support the initiatives set forth in this statement and the Kill Malarial Mosquitoes NOW! Declaration, we can undo and reverse the effects of well-intended but woefully misguided policies, rules and restrictions that for too long have perpetuated malaria’s reign of terror.

Thank you for giving me this opportunity to present the Congress of Racial Equality’s position statement. If we join together in this vital bipartisan, humanitarian effort, millions will be alive in the coming years to thank us.