The Corner

‘Target: Malaria’

Tomorrow is World Malaria Day. In this morning Wall Street Journal, Peter Chernin, the chairman of Malaria No More, writes about the danger to reduce the funding to fighting malaria — even in times of economic downturns. He reminds us how murderous and economically costly malaria is. But it doesn’t have to be, he says:

We have the tools today to cure an illness that kills one child every 30 seconds. Besides the human toll, its economic and social impacts are also devastating: Sick children miss school, parents miss work to care for them, and development is stifled. In Africa, malaria eats up 40% of all hospital expenditures and costs economies there $12 billion annually in lost productivity. That’s a crippling 1.3% annual loss in GDP growth in countries where it is endemic. Malaria is a self-perpetuating problem — the disease wipes out the human and economic capital necessary to bring the disease under control.

His proposal:

The tools we need to protect people from malaria are some of the simplest and most cost-effective of any disease: protective nets, diagnostic tests, antimalarial drugs and indoor spraying of recommended insecticides. Effective malaria treatment costs just $2 per recipient.

As for me, when I read an article about malaria, I always wonder what my friend, and director of Africa Fighting Malaria, Richard Tren would think of it. So I asked him. I thought I would share his insights with you. He wrote:

Peter Chernin is right that malaria is a good public health investment – that $1 in malaria control goes a long way.  And yes, the US has been a leader in the fight against malaria – doing much more than Europe and being much bolder – For instance, after many years of refusing to use the great public health insecticide DDT and even trying to force some countries to not use DDT, the US Government is now spraying DDT.  DDT is cheap and incredibly effective – compared to other insecticides, you can spray many more houses, save many more lives.

But – overwhelmingly donors and the Global Fund, even Malaria No More focus primarily on bednets.  It isn’t that bednets don’t work – it is just that they are only one of several methods used to control malaria.  If you compare the efficacy of bednets with indoor residual spraying with an insecticide like DDT – the spraying is more effective.  One important reason is that once a house is sprayed, that’s it; the residents can get on with their lives.  With nets – you have to remember every night to sleep under the net.  In a hot, tropical area with no air conditioning, the nets are uncomfortable, restrict air flow – I can’t tell you how many people I talk to who say that they never sleep under nets because it is so uncomfortable.  So we need support for all tools. 

Now we really need new insecticides.  DDT is a wonderful chemical, but it is very old.  There has been almost no investment from any private or public group in an alternative.  And we won’t get it because there is opposition to the use of insecticides – stupid legislation that makes it very expensive to develop these chemicals. In addition, enviromentalists want everything to be natural and oppose any ‘man made chemical’ no matter how many lives we could save with these products. If Chernin really wanted to do something useful, he would use his celebrity contacts to make the point that Chemicals Save LIVES.  If we had all his celebrity friends calling for new insecticides and man made chemicals – many more lives would be saved than just his bednet campaigns.

 Lastly, he really gets it wrong on the economics.  Yes, malaria is an economic drain, it costs people money to pay for medicines, look after children, they can’t work – it all hurts productivity.  But if you get rid of malaria, you won’t suddenly grow your economy.  The Communist countries mostly did a great job of controlling malaria and other diseases like this – they stayed poor.  It is just fanciful and stupid and possibly dangerous to assume that if you give all this money for malaria control, suddenly these countries will grow.  Most malarial countries are economically unfree and rank poorly on the World Bank’s Doing Business report.  Historically, reduced malaria has FOLLOWED economic growth – it hasn’t caused it. (There may be one or two localized exceptions).

For other examples of misguided malaria policies and their consequences read this great piece by Reason’s Katherine Mangu-Ward here.

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