- The Washington Times - Sunday, February 27, 2005

Experts on malaria testifying on Capitol Hill this month found hope in the recent scientific advances against the disease, but they said eradicating it is now a question of money.

Malaria, a life-threatening parasitic disease transmitted by mosquitoes, is responsible for the deaths of more than 1 million people every year, mostly in sub-Saharan Africa. Ninety percent of the victims are children under 5, according to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Melinda Moree, director of the Malaria Vaccine Initiative, a nonprofit group seeking to accelerate the development of promising vaccines, said if children were dying at the same rate in the United States, in a high school enrolling 500 children, 81 would die before finishing high school, and there would be funerals every three weeks.

“This is a completely unnecessary child holocaust,” Richard Feachem, executive director of the Global Fund, told lawmakers, arguing that these deaths are preventable.

Ways to avoid infection

Mr. Feachem said there are three well-established ways malaria infection can be prevented.

The first is to reduce the mosquito population by spraying insecticides. Another way — and the least costly — is to use mosquito bed nets impregnated with long-lasting insecticide. Most malaria-carrying mosquitoes bite at night and bed nets, if treated with insecticide, generate a chemical halo.

The third way to fight malaria is to promptly diagnose infected people and treat them with effective drugs. A new combination therapy uses Artemisinin, a Chinese plant that is more expensive than older treatments, but more effective. Mr. Feachem also urged the automatic treatment of pregnant women.

“We know that, where those interventions are applied on a serious scale, malaria collapses,” he said.

During the Feb. 15 congressional briefing, Mr. Feachem discussed the Lubombo region, a 38,610-square-mile swath of Mozambique, South Africa and Swaziland, where the prevalence of children’s malaria has dropped from 64 percent to less than 8 percent since 1999.

88 percent reduction

According to the private group Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, 820,000 dwellings in the Lubombo region were sprayed in 2003 through 2004, and the use of Artemisinin-based combination therapy is one reason for the 88 percent drop in malaria prevalence in targeted areas of southern Mozambique and the 90 percent drop in some parts of South Africa in the last five years.

“It’s all very achievable,” Mr. Feachem said. “If it can be done in southern Mozambique or Swaziland, it can be done in all African countries. We need to do it, and we need to do it quickly.”

Another promising new development in the fight against malaria is an experimental vaccine developed by GlaxoSmithKline that proved effective in clinical trials last year in Africa that involved 2,000 children ages 1 to 4. The vaccine cut the risk of malaria in immunized children by 30 percent, and cut life-threatening cases by more than one-half.

Eradicating malaria could greatly benefit African economies.

Susumu Yoshida is the senior coordinator of Sumitomo Chemical Co. Ltd., which manufactures insecticide-impregnated bed nets that last more than five years. “Africa is a vital region and has enormous potential for economic development in the 21st century,” he said. “The World Bank estimates that malaria reduces Africa’s gross domestic product by $12 billion every year.”

Malaria hurts economy

According to the World Health Organization, the direct costs of malaria are tremendous in terms of private and public spending to prevent and treat the disease. Malaria also impairs children’s development and schooling through absenteeism and neurological damage. Malaria in a country also affects national prosperity, in part because of the reluctance of travelers to visit malaria-infested areas.

But there is hope. Ms. Moree said science is no longer the major obstacle to progress against malaria.

“The obstacle in the past has been science: [the malaria] parasite, it is very difficult. We don’t have any vaccine against parasites,” she said. “But … now what really is the obstacle is the resources and the political will to move things forward and make them happen.”

Ms. Moree called for more U.S. funding of efforts to combat malaria worldwide, and said efforts against the disease could be hurt seriously because it has much less priority in the United Stated than does AIDS or bioterrorism.

But Roger Bate, a resident fellow at the American Enterprise Institute (AEI) and a specialist in health policy and endemic diseases in developing countries, said fighting malaria is not just a question of money.

“What tends to happen is the money that is being spent on malaria control often goes to U.S. contractors, and a lot of the money never even leaves the United States. The money goes on studies, it goes on consultative exercises, it goes on research programs, it goes on technical advice and technical assistance,” he said.

Mr. Bate said he is working on a paper for AEI analyzing the malaria program of the U.S. Agency for International Development. “The [Government Accountability Office] is doing an investigation of how [USAID is] spending the money, which gives you an indication that it probably isn’t being spent very well,” he concluded.

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