| Summary: | The debate regarding the advantages and disadvantages of using DDT for IRS has divided the scientific community. The health benefits of reducing malaria spreading are weighed against the potential health and environmental consequences of the chemical, and opinions also differ regarding the cost-effectiveness of the use of DDT. Global recommendations regarding use of DDT for IRS have been issued by the WHO, and the receipt of these on the local level is determined by the intended beneficiaries’ perception of legitimacy of the organisation. The WHO recommendations on DDT as well as interviews conducted with residents of a South African village and representatives for two South African NGOs have been reviewed using qualitative content analysis. This method was used to highlight different perceptions of and views on DDT use, as well as for examining the potential effect that the interviewees’ perception of international institutions’ legitimacy has on their views on DDT. This study shows that the controversy regarding DDT is not as prominent on the local level as on the global level, and that the perceptions of IRS with DDT differ between the WHO, the NGOs and the residents of the village. Further, this study shows that assessing legitimacy is dependent on a definition of “the people” in question, and that the accountability of authoritative actors on different levels needs to be evaluated further.
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