Regional Program of Action and Demonstration of Sustianable Alternatives to DDT for Malaria Vector Control in Mexico and Central America
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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: 1.Implementation of demonstration projects and dissemination 2.Strengthening of national institutional capacity to control malaria without DDT 3.Elimination of DDT stockpiles 4.Coordination and management.
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Regional Program of Action and Demonstration of Sustianable 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. WWHHOO oonn DDDDTT uussee iinn ddiisseeaassee vveeccttoorr ccoonnttrrooll uunnddeerr tthhee SSttoocckkhhoollmm CCoonnvveennttiioonn oonn PPOOPP’’ss ((MMaayy--22000044)) ““The Convention reconizes three iimmppoorrttaanntt ffaaccttss:: 11.. ...... TToo mmaannttaaiinn tthhiieerr rreelliiaannccee oonn tthhee uussee ooff DDDDTT ffoorr iinnddoooorr rreessiidduuaall sspprraayyiinngg ttoo ccoonnttrrooll iinnsseecctt vveeccttoorrss,, ppaarrttiiccuullaarrllyy mmaallaarriiaa vveeccttoorrss,, ...... 22.. AA nneeeedd ttoo aacceelleerraattee rreesseeaarrcchh aanndd ddeevveellooppmmeenntt ooff ssaaffee,, eeffffeeccttiivvee aanndd aaffffoorrddaabbllee aalltteerrnnaattiivveess ttoo DDDDTT,, ........ 33.. AA lloonnggeerr--tteerrmm ggooaall ooff rreedduucciinngg tthhee oovveerr--rreelliiaannccee ooff vveeccttoorr ccoonnttrrooll pprrooggrraammmmeess oonn ppeessttiicciiddeess iinn ggeenneerraall,, ttoo pprrootteecctt bbootthh tthhee eeccoossyysstteemm aanndd hhuummaann ffrroomm nneeggaattiivvee iimmppaaccttss ooff PPOOPP ppeessttiicciiddeess..””
- 3. 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
- 4. Impact in Biota Concentration of DDT (ng/g) in species of the food chain in “La Cigüeña”, Chiapas, Mexico (2002) Birds = 232.50 Fish = 24.08 Crabs = 23.84 Sediment = 138.37
- 5. Impact in the Environment Total DDT (mg/kg) in superficial soil in malaria communities Mexico, 2002 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 La Ventanilla La Cigüeña Lacandona
- 6. Impact in Humans DDT blood concentration in children, Mexico (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)
- 7. 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
- 8. General Information PPaarrttiicciippaattiinngg ccoouunnttrriieess Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama IImmpplleemmeennttiinngg aaggeennccyy •United Nations Environment Programme EExxeeccuuttiinngg aaggeennccyy •Pan American Health Organization (PAHO) •National Governments FFuunnddiinngg PPaarrttnneerrss •Global Environment Facility •National Governments •PAHO •CEC Total 7.165 5.865 0.654 0.200 US$ 13.884 DDuurraattiioonn Three years: August 2003- July 2006
- 9. 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 1. Implementation of demonstration projects and dissemination 2. Strengthening of national institutional capacity to control malaria without DDT 3. Elimination of DDT stockpiles 4. Coordination and management
- 10. 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 adopted Stockholm Convention on Pops.
- 11. Implementation Strategy • To integrate epidemiology with social sciences, entomology, public health, environment 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
- 12. Demonstration projects • Demonstration projects in sites selected • Baseline assessment concluded • Community participation attained
- 13. Technical Manual Guide for the implementation and demonstration of sustainable alternatives for the integrated control of malaria in Mexico and Central America
- 15. The Regional Perspective of Malaria in Mexico and Central America in the Context of Epidemiological Stratification 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.
- 16. GIS-DDT-GEF Demonstration areas in Central America, GPS survey progress and instrumentation of the SIGEpi Model up to May 2005 Tropical broad leaf rain forest Municipalities with malaria transmission in 2004 Municipalities with malaria transmission in 1960
- 17. 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
- 18. From Sketch to Digital Maps in Panama Showing Malaria Houses (red houses) Calculating the number of preventive treatments in the 200 meters surroundings
- 19. Malaria Stratification and Levels of Analysis in the GIS DDT Model for Honduras, May 2005 API, municipal level 2002 API, locality level 2005 Cases, intra-locality level cases 2005… in SIGEpi • Identification of malaria houses per week • Detection of houses on transmission risk •100 meters proximity • close to a mosquito breeding site • Intervention programming of community actions and focal control and preventive treatments
- 20. 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
- 21. 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
- 22. MMaallaarriiaa ccaasseess aanndd hhoouussee sspprraayyiinngg Cases MMééxxiiccoo 11995599 -- 22000044 Houses EERRAADDIICCAATTIIÓÓNN Y e a r DDT CCOONNTTRROOLL 160,000 140,000 120,000 100,000 80,000 60,000 40,000 20,000 0 59 61 63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93 95 97 99 01 03 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Houses Cases Piretroids
Editor's Notes
- Thank you mister chairman. 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 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.
- After a brief overview of the project, we will discuss the results of the project. Within the first component, demonstration projects and dissemination: The demonstration communities have been selected according to stratification criteria; organization of area and local technical teams; final phase of the baseline assessment, made with a standardized form and fine-tuning of the field interventions. The pillars of the community and education participation are the community leaders, families, vulnerable groups, NGOs, local governments and the environment, education and migration sector. Currently seven countries have organized the community groups and drafted the local work plans. 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 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 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.