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Proposal for the Establishment of Thematic Groups of the Global Alliance for alternatives to ddt cost-effectiveness of alternatives to ddt

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Proposal for the Establishment of Thematic Groups of the Global Alliance for alternatives to DDT

Cost-effectiveness of alternatives to DDT

November 2009

Stockholm Convention Secretariat


Background and approach 4


ANVR: African Network for Vector Resistance

COP: Conference of the Parties of the Stockholm Convention

DDD: Dichloro-diphenyl-dichloroethane

DDE: Dichloro-diphenyl-ethane

DDT: Dichloro-diphenyl-tricholoroethane

DSSA: Demonstrating and Scaling-up of Sustainable Alternatives

EMRO: WHO regional office for the Eastern Mediterranean countries

GCDPP: Global Collaboration for Development of Pesticides for Public Health

GEF: The Global Environment Facility

GFATM: Global Fund to fight Aids, Tuberculosis and Malaria

ICIPE: International Centre of Insect Physiology and Ecology

IGO: Inter-Governmental Organizations

IPEN: International POPs Elimination Network

IRS: Indoor Residual Spraying

ITNs: Insecticides Treated Nets

IVCC: Innovative Vector Control Consortium

IVM: Integrated Vector Management

LLINs: Long-lasting insecticidal-treated nets

LSHTM: London School of Hygiene & Tropical Medicine

MTC: Malaria Transmission Consortium

NGO: Non-Governmental Organizations

PDP: Product Development Partnership

PHP: Public Health Pesticides

PMI: United States of America President’s Malaria Initiative

POPs: Persistent Organic Pollutants

RBM: Roll Back Malaria

UNEP: United Nations Environment Programme

WHO: World Health Organization

WHOPES: WHO Pesticides Evaluation Scheme

Background and approach

DDT is one of the Persistent Organic Pollutant (POP) pesticides regulated by the Stockholm Convention. The Conference of the Parties (COP) to the Convention allows the use of DDT for public health interventions for disease vector control as recommended by the World Health Organization (WHO). At its fourth meeting, the COP endorsed the establishment of Global Alliance for the development and deployment of products, methods and strategies as alternatives to DDT for disease vector control and requested the Secretariat to lead its implementation. The need to develop and deploy alternatives to DDT is not only driven by the demand to reduce reliance on DDT in the context of the Stockholm Convention but should also be considered in the context of a sustainable approach to effective malaria vector control. Therefore it is needed to;

  • Bring together key organizations and stakeholders to enhance their collaboration and effectiveness for achieving agreed goals;

  • Facilitate the identification of gaps in existing programmes and catalyze complementary action;

  • Raise awareness of all stakeholders involved in disease vector control;

  • Monitor and share the progress towards the development and deployment of alternatives to DDT

There are nine major challenges associated with developing and deploying alternatives to DDT for disease vector control and grouped around four main goals as outlined below:

Goal 1

Strengthen the base of knowledge available to inform policy formulation and decision making

  1. Understand and establish the full cost-effectiveness of alternatives compared to DDT (including direct alternatives to IRS interventions as well as other vector control interventions such as ITNs or environmental management)

  2. Monitor vector resistance patterns across regions and understand vector resistance mechanisms

Goal 2

Overcome the complexity and cost of deploying alternatives to DDT

  1. Cover the potential additional cost of using alternatives rather than DDT for disease vector control

  2. Support in-country decisions regarding the choice of alternatives for disease vector control through the development and implementation of specific tools, guidelines and strategies

  3. Develop in-country capacity to implement Integrated Vector Management programmes and support cross-sector coordination in deploying alternatives to DDT

Goal 3

Make available new alternative vector control chemicals

  1. Bring to market new formulations of existing pesticide classes equally effective as DDT in vector control

  2. Address the issue of barriers to discovery and commercialization and bring to market new active ingredient classes to counter vector resistance in the long term

Goal 4

Develop non-chemical products and approaches for vector control

  1. Demonstrate the impact of environmental management across differing locations and set the agenda for further research

  2. Address the issue of barriers to discovery and development of non-chemical alternatives to DDT and set the agenda for further research

The Thematic Groups established under the Global Alliance for alternatives to DDT work as implementing instruments of the strategies developed by the Alliance Assembly through the steering committee. Each Thematic Group addresses a set of challenges to achieve a particular goal.

For effective interventions in addressing the challenges to reach the four goals, the thematic groups should formulate the strategies taking into consideration, all related elements and conditions prevailing in developing countries. Therefore the expertise of each thematic group should be carefully identified to ensure that required competency is possessed to effectively and comprehensively achieve the desired goal. Due consideration should be given to the knowledge and experience relating to developing country conditions in identifying the relevant experts.
A Thematic Group may take a number of organizational forms: it may be built upon existing networks, hosted and led by an established organization within the UN system, by a recognized public body with a development mission, by an academic/ research institution or a private organization. It will seek to leverage the existing and on-going work within the relevant domain and will seek to identify and address gaps in existing work rather than duplicate it.
Currently, there are five areas that have been selected to establish thematic groups. While these cover the four goals of the Global Alliance, it is feasible that other challenges could warrant the introduction of other thematic groups to tackle emerging issues. The five proposed thematic groups are:

  • Cost-effectiveness of alternatives to DDT;

  • Strengthening of in-country decision-making on IVM;

  • Malaria vector resistance patterns and mechanisms;

  • Reduce barriers to bring new chemicals and products to market;

  • Reduce barriers to bring new non-chemical products to market.

The details of the Thematic Group on Cost-effectiveness of alternatives to DDT, including the scope, expertise needed and possible activities to undertake are examined below.


Analysis on the costs associated with adverse health, environment and social effects is usually not available for products in use and little is done to obtain such data for new products. Therefore, policy formulation and decision making on disease vector control programmes are often biased towards financial components of the available options in relation to their effectiveness in controlling the disease vectors.

The alternatives to DDT include new active ingredients, new pesticide products, alternative methods and non-chemical options. The lifecycle cost of deploying any option for disease vector control in developing countries needs to be addressed for countries to make an informed decision on the mix of interventions to use from the range available. The elements for consideration include among others:

  • Cost of acquisition;

  • Cost of deployment;

  • Cost of acute and long-term health and environmental effects;

  • Cost of disposal of unwanted related material; and

  • Cost to cross-sector profitability (e.g. marketing of agricultural products,, fisheries, etc.)

The assessment of cost-effectiveness should also take into consideration the complexities due to influence from factors of actual field conditions such as varying durations of residual effects of Indoor Residual Spray (IRS) on different surfaces and pricing structure of pesticides used in IRS in different countries.

Often the cost-effectiveness is incorporated as a component in study programmes at research and development stage of new vector control tools and in vector control initiatives implemented in the field. Scopes of effectiveness of these different interventions are often not comparable. Therefore the information on cost-effectiveness available from such studies at country level may not provide proper basis for assessment of the cost-effectiveness of individual vector control tools as against that of DDT in disease endemic countries in a national vector control programme.
The sectors involved in assessment of cost of vector control tools include academia, industry, research, national governments, NGOs, donors and project implementing agencies. These stakeholder entities should forms the basis for establishing this Thematic Group.


The Cost-effectiveness of alternative pesticides to DDT in Indoor Residual Stray (IRS) in disease endemic countries is considered for informed decision making in national vector control programmes.


A comprehensive assessment of the cost-effectiveness of DDT and its alternatives in disease vector control under the conditions prevailing in malaria disease endemic countries to facilitate the achievement of goal 1 of the Global Alliance; Strengthen the base of knowledge available to inform policy formulation and decision making.
Extending the scope of this initiative to all possible vector control methods and strategies would make it complicated in the first instance and require extensive resource inputs. Therefore, the scope of the activities of this thematic group is limited, at the initial phase, to the cost-effectiveness of alternative pesticides to DDT in indoor residual spray.

Ongoing Initiatives

The WHO has already developed guidelines for the assessment of cost-effectiveness of pesticides including principles and methods of cost-effectiveness analysis and its application to decisions about the control of vector-borne diseases. However, there is no record of any activities being undertaken on a large scale basis among disease endemic countries. The chemical industry is expected to play a key role in assessment of cost-effectiveness of any new interventions in relation to existing measures.
Limited exercises are carried out to study the cost-effectiveness under the alternatives project of the Global Environmental Facility (GEF) through the World Health Organization regional office for the Eastern Mediterranean (EMRO). This initiative needs strengthening to fulfil the information gap. Among the other entities involved in cost-effectiveness studies include President’s Malaria Initiative, and the Goteburg University, Sweden.
Possible sources of funding should be explored for expanding these initiatives to generate more data covering all key components of total cost estimation and within reasonably shorter time duration. Prospective partners who are currently involved in related disciplines of this Thematic Group include:

  • The WHO IVM, Pesticide evaluation scheme (WHOPES)

  • Global malaria Programme (GMP)

  • CropLife

  • Pesticide Action Network (PAN)

  • Gates Foundation

  • Selected Disease Endemic Countries (DECs)

  • Stockholm Convention developed country Parties

  • Global Environmental Facility (GEF)

  • National malaria control programmes

  • International POPs Elimination Network (IPEN)

  • Presidents’ malaria Initiative (PMI)

  • Malaria Consortium

  • Malaria Emergency Technical and Operational Response (MENTOR)

  • AVIMA (manufacturer and distributor of public health pesticides and equipments)

  • Swiss tropical research institute, Basel

Main target audience

The outcomes of this Thematic Group should target the national policy makers and public health officers responsible for implementing the disease vector control programme and pesticide regulators in developing countries to facilitate informed decision making related to cost-effectiveness. The other key stakeholders include the Industry, NGOs and donor community.


The key activities of this Thematic Group to achieve the goals of the Global Alliance are given in Table 1. It should be noted that the activities listed in this table are identified based on the available information and should be periodically reviewed as the work progresses to optimize the outcome based on new and updated information.
Table 1: Proposed activities of the Thematic Group on Cost-effectiveness of alternatives to DDT



Organizational Activities

Programme establishment and launching


1st meeting of the group:

  • Identify a lead organization or individual;

  • Establish the terms of reference for the group;

  • Determine the working mode and meeting schedule in conjunction with the Coordinating Team;

  • Establish a core group for coordination, cross group discussions and exchange of information with relevant entities and stakeholders;

  • Develop a work progamme, set priorities and targets;

  • Establish sub committees where necessary;

  • Identify funding mechanisms and programme implementing opportunities.

2nd meeting of the group:

  • Review the progress related to the agreed targets;

  • Identify the gaps and accordingly review the programme of work;

  • Prepare and adopt the initial progress report;

  • Identify opportunities for strengthening the funding.

3rd meeting of the group:

  • Review the outcomes of the programme of work to assess the extent of the achievement of the targets;

  • Revise the programme and identify new activities, where necessary, to facilitate effectively achieving the objectives of the theme within the timeframe;

  • Update the progress report.

4th meeting of the group:

  • Establishment of a programme to ensure the sustainability of the status reached on the theme;

  • Recommendations for the next step;

  • Adoption of the thematic group report.


Acquisition of donor funding for the implementation of activities under the programme;

2010 - 2013

Preparation of progress reports to the Alliance Assembly and interim reports to the Steering Committee on a regular basis

2010 - 2013

Substantive Activities

Compile existing information related to the disciplines , including:

  • Ongoing initiatives and their study scopes

  • Entities involved and expertise available at national and regional level

  • Established guidelines

March- Dec. 2010

Establish a contact group towards developing a human resource pool

March- Sept. 2010

Establish information sharing mechanism and resource base for real time technical support

Dec 2010

Field surveys and studies to establish the information gaps

Sept.2010- March 2011

Review the current status of guidelines for assessment of cost-effectiveness

Sept.2010-June 2011

Establish standard templates for the assessment of cost-effectiveness under disease endemic country conditions

Jan. – May 2011

Capacity building to utilize the template for cost-effectiveness at country level

2011- 2012

Key agencies to lead the theme

There are many entities involved in activities related to this thematic group. It is important that all these entities find optimum synergy and opportunities on a global platform to extend and expand their scopes as global partners of the theme towards achieving the goals of the Global Alliance. To provide such flexible environment, the theme should lead by institutions covering broader and international scopes such as;

  • Global Malaria Programme;

  • CropLife;

  • National Malaria Programmes;

  • President’s Malaria Initiative;

  • International POPs Elimination Network (IPEN).

Major areas of expertise of the core group

The core group, while coordinating its members to ensure efficient implementation of the programme, shall represent the interests of the theme with other Thematic Groups, initiatives and fora for collaboration, cooperation and momentum. Therefore it is vital that the core group consists all major areas of expertise related to this theme including;

  • Knowledge on credible cost effective alternatives to DDT;

  • Efficacy;

  • Economics in vector control products

  • Deployment cost of alternatives in disease endemic countries.


The main output of the Thematic Group is cost-effectiveness measured for decision-making by vector control programmes, facilitated by the following outcomes:

  • Compilation of existing information related to the disciplines;

  • Establishment of a human resource pool;

  • Establishment of information sharing mechanism and resource base for real time technical support;

  • Updated guidelines on cost-effectiveness;

  • Establishment of standard templates for the assessment of cost-effectiveness under disease endemic country conditions;

  • Capacity building to utilize the template for cost-effectiveness at country level;

Promotion of the initiatives

Promotion of the Thematic Group on its objectives, expected outcome and benefits to the society is important for effective participation and collaboration of stakeholders on its initiatives. Promotion also facilitates synergy and collaboration in parallel initiatives and sensitising the donor community for effective investments towards the achievement of the objective of the Global Alliance.
Possible opportunities for promotion of this initiative include:

  • Roll Back Malaria (RBM) board meeting (March 2010);

  • CropLife vector control meeting;

  • Extraordinary meeting of the Conference of the Parties to Basel, Stockholm and Rotterdam Conventions;

  • United Nations Environment Programme(UNEP) Governing Council meeting (Feb. 2010);

  • Sub-regional RBM meetings.

Options for promotional activities include:

  • Link to all malaria vector control managers for in-country political support and involvement;

  • Media press releases;

  • Stockholm Convention and other related websites;

  • News letters;

  • Information leaflets and posters;

  • Internet fora.


The budget reflects the initial establishment and operational costs associated with related thematic group. The total cost for the work of the thematic group is estimated at USD 227,200.00 for the period 2010 – 2013. The details of the budget are outlined in the Table 2 below.
Table 2: Estimated cost for the activities of the Thematic Group on Cost-effectiveness of alternatives to DDT



Cost (USD)

Programme establishment and launching



Meeting of the group (X4)



Acquisition of donor funding

2010 – 2013


Preparation of progress reports

2010 – 2013


Compilation of existing information related to the disciplines



Establishment of a human resource pool



Establishment of information sharing mechanism



Field surveys to establish the information gaps

2010- 2011


Reviewing of guidelines



Establishment of standard templates (30 consultant days)



Capacity building (Regional workshop X 4)

2012- 2013





List of members:



Contact Details

Dr. R.S. Sharma


Joint Director, Department of Entomology

National Vector Borne Disease Control Programme

Ministry of Health and Family Welfare

Nvbdcp, 22 Sham Nath Marg

Delhi 110054


Tel.: +91 9958678110 / +91 1292428298

Fax: +91 (11) 23968329 / +91 (11) 23972884


Mme. Fagamou Sy


Chef de la Division Régionale de l'Environnement de Saint-Louis

Département de l'Environnment

Direction de l'Environnement et des Etablissements Classés

23 Rue Calmette

BP 6557



Tel.: +221 (33) 9611963 / +221 (33) 9611170

Fax: +221 (33) 9612303


Artak Khachatryan


Head of Risk Assessment Division

Waste Research Center

Ministry of Nature Protection

46 Chazents Street

0025 Yerevan


Tel.: +374 (494) 049955 / +374 (410) 273466

Fax: +374 (10) 538838

Email: /

Abdullah Naeem


Head Of Pesticides Residue Lab; Pesticides Department

Ministry of Agriculture

26 Sanaa


Tel.: +967 (711) 613311

Fax: +967 (1) 426273 / +967 (1) 228064


Egon Weinmueller


Director, Global Strategic Marketing

Global Strategic Marketing / Public Health Products

BASF SE, D-67117 Limburgerhof

D-67117 Limburgerhof


Tel.: +49 (621) 6028165 / +49 (621) 60 28403

Fax: +49 (621) 606628165 / +49 (621) 60 27014

Email: /



International Chemicals Safety, Sustainable Chemistry

Federal Ministry for the Environment, Nature Conservation

53175 Bonn


Tel.: +49 (228) 993052740

Fax: +49 (228) 3053524

Email: /

Stéphanie Guillaneux


Technical Officer, Vector Control and Prevention

Global Malaria Programme (GMP)

World Health Organization (WHO)

20, Avenue Appia

1211 Geneva 27


Tel.: +41 (22) 791 1088 / +41 (22) 791 3419

Fax: +41 (22) 791 4824

Email: /

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