DDT: last mile in the global phase-out of its use for disease vector control?

Dichlorodiphenyltrichloroethane (DDT), one of the persistent organic pollutants to be phased out globally under the Stockholm Convention, still continues to be used in some countries as an insecticide for malaria vector control. The global production and use of DDT has reduced substantially over the last 8 years, and the number of alternative insecticides for vector control has increased steadily, suggesting that a global phase-out of DDT is within reach. Only three countries, India, South Africa, and Zimbabwe, were still using DDT in 2023, and a few other countries are keeping the option open of using DDT for emergency response. The main challenges in the global elimination of DDT are that most of the alternative insecticides are less affordable compared with DDT and that the global progress in malaria control and elimination has stagnated. Consultation meetings with countries that intend to use DDT have enabled a sharing of experiences and challenges in phasing out DDT. This Personal View provides recommendations to attain a global phase-out of DDT and to address the problem of disposal of obsolete stocks.