Can Wolfowitz change the culture of the World Bank which has up to date resisted the use of DDT in the control of malaria.
The World Bank is rightly concerned about malaria and the way it stifles development and exacerbates poverty. That is why, along with the World Health Organization, UNICEF, and various donor agencies such as USAID, it launched Roll Back Malaria (RBM) in 1998. The goal was to halve the burden of malaria by 2010. So far that goal remains a mirage. Malaria cases are actually increasing: According to the latest WHO data, they have probably risen by at least ten percent since the inception of RBM.
The failed RBM strategy has much to do with this public-health catastrophe. Almost all of the efforts to prevent malaria cases have focused on providing people with insecticide-treated nets. People, particularly pregnant women and young children–those most at risk–are encouraged to sleep under these nets in order to protect themselves from the Anopheles mosquito. The problem isn’t that these nets don’t work; it is simply that as a sole strategy they haven’t been shown to have any significant large-scale impact on malaria transmission.
Those countries that are making progress against the disease have ramped up their indoor insecticide-spraying programs. These programs entail spraying tiny amounts of insecticide, such as DDT, on the inside walls of houses to repel or kill (or both) the malaria-carrying mosquitoes. This method of control is safe and highly effective: Malaria rates have plummeted in the very poor northern parts of Zambia where this approach is currently employed. Yet RBM and the World Bank, always politically correct, have eschewed this method of control. The World Bank even went as far as to require that its of funding malaria control in Eritrea be conditional on non-use of DDT.