Cooperative actions to achieve malaria control without the use of DDT.

The success of regional networks to provide incentives and mechanisms for sharing information is illustrated through the North American Regional Action Plan on DDT (NARAP). This NARAP was designed to reduce human and environmental exposure to DDT and its metabolites in North America through cooperative efforts. The increasing role of environmental concerns in the planning and design of Mexico's DDT phase-out program motivated the Mexican Ministry of Health to undertake an alternative program for malaria control maximizing community participation without negatively affecting human and ecosystem health. This program relies on: 1) elimination of parasites in people, 2) improvement of personal and household hygiene, and 3) use of environmental management practices to eliminate mosquito breeding sites. This new strategy resulted in the elimination of DDT for malaria control in Mexico in the year 2000. While malaria and its corresponding vectors show considerable variability within a single country and certainly around the globe, the case example of Mexico provides a methodology for developing alternatives to DDT.