Wednesday, May 3

Malaria in the 21st century

Painting in Magdalen CollegeTonight's lectures on malaria, presented by the Oxford Global Health Group, demonstrated once more the kind of opportunity that is being missed with regards to global development. According to the World Health Organization (WHO), one million people per year die from the parasite. In addition, the direct economic costs imposed exceed $12B a year: a figure agreed upon by the two scientists and the representative from GlaxoSmithKline. By contrast, the WHO estimate for the cost of controlling malaria globally is just $3.2B a year. While money alone can't solve so complex a problem, the gap between what is possible and what is being done remains unacceptable.

Like HIV/AIDS, while efforts are being made to find an effective vaccine, the state of affairs at the moment includes treatment and prevention measures. As Adrian Hill - the Director of Oxford's Jenner Institute - discussed, there has never been an effective vaccine developed against any human parasitic illness, and the incredible complexity of the malarial life cycle and the long period of endemic coexistence between people, mosquitos, and parasites makes it a task of fiendish difficulty. That doesn't mean that a vaccine is impossible. Indeed, Dr. Hill stressed how two moderately effective vaccines based on different approaches could combine into a single highly effective treatment. What it does mean is that the existence of effective mitigation mechanisms like pesticide-coated bednets and combination anti-malarial therapies should be focused upon.

I was pleased to learn that Oxford is presently the only organization in the world that is carrying out any level of clinical trial for vaccines addressing tuberculosis, HIV/AIDS, and malaria. Each has an enormous global toll, in terms of lives lost and societies disrupted, and all are well within the present financial means of the world to reduce in significance enormously. When the constant refrain is that official development assistance gets spirited off by corrupt governments and into foreign bank accounts and BMWs, the case for funding large-scale research into the development and cost-reduction of medical responses to devastating illnesses of the poor world is clear and compelling.

The comparison everybody makes is with arms expenditures. That's fair enough. Discretionary spending on armaments in the 2004 American federal budget was $399B. Three times more was spent on just missile defence than would cover the WHO's estimated cost for global malarial control. $1.2B was allocated just for the V-22 Osprey aircraft: a design that many, even within the Air Force, consider hopelessly flawed and too dangerous to ever put into operation.

Though of another way, Canada's GDP is about $1000B. The WHO estimate is therefore just 0.32% of the GDP of a single, relatively unpopulous, member of the rich country club. If anything, the global experience of smallpox and polio has shown that bold and properly funded global health strategies can yield fantastic returns. The chance to capitalize on that potential for AIDS, malaria, and TB is sitting right there for us to grasp.
During the transition period from the Blogger version of this blog to the WordPress version, I would appreciate if people left comments on the latter. Those left here will probably be lost to the ages shortly.

Posted by Milan at 11:43 PM