I have been struck down by malaria dozens of
times. The vomiting, high fevers, dehydration, headaches, joint pain
and disorientation were beyond belief.
If doctors hadn't helped me even when I couldn't pay, I would
have been dead long ago - like my son, two sisters and three nephews,
all victims of this vicious disease. Like the husbands and children of
women who work with me, making beautiful purses to earn money for
malaria medicines. Like 50 of the 500 orphan children who attended the
school that my husband and I help sponsor - all dead in a single year!
It is an unspeakable tragedy. Malaria infects 400 million
Africans every year, leaving them unable to work, attend school,
cultivate fields, care for their families or build our nations. It
costs Uganda over US$700 million annually in lost productivity,
millions of hours spent caring for sick children and parents, countless
potential Einsteins, Beethovens and Martin Luther Kings.
We could end this suffering and death, if we use every
available weapon - not just insecticide-treated bednets, but
insecticides, too, especially DDT. Unfortunately, too many politicians,
environmental activists and bureaucrats promote programs that don't
work and tell Africans they can't use DDT, which keeps deadly anopheles
mosquitoes out of our homes for six months or more, with just one
spraying on their inside walls.
Thankfully, President Bush and the U.S. Congress and Agency
for International Development have begun spending more money - and
using DDT and other insecticides in Uganda, Tanzania and Angola. Other
agencies are also revising their policies and programs. But one is
dragging its feet.
Six years ago, the World Bank promised to spend $300-500
million on malaria control in Africa. However, according to a study in
The Lancet, the Bank has bungled the job.
The malaria experts who conducted the study said the Bank
actually spent perhaps $100 million worldwide, and cut the number of
recipient countries in half, and claimed progress where there was none.
By counting eight months as a year, the Bank made it look like its
programs had suddenly slashed malaria cases by 60% in Brazil. Refusing
to provide evidence to support claims that are sharply contradicted by
other data, it also said Bank programs had "dramatically" reduced
India's malaria deaths in just one year.
It refuses to spend Bank money on DDT in Eritrea, where
thousands die from malaria every year, even though this chemical has
reduced malaria by 75% in at least four African countries.
The Bank bought 100 million doses of chloroquine for use in
India, where this drug fails to work 15-45% of the time - and children
die as a result. Just imagine the malpractice charges and criminal
indictments that would result if doctors did something like that in the
United States. World Bank staff then argued that "chloroquine is 10-20
times cheaper" than Artemisia-based combination drugs - when even Bank
documents specifically acknowledge that "artemisinin-based drugs are
the only first-line anti-malarial drugs appropriate for widespread use
that still work against chloroquine-resistant malaria parasites."
The study also states that the Bank eliminated its entire
malaria staff, but says it now has "three full-time professionals
working on malaria" - for all of sub-Saharan Africa! This is completely
inadequate and does nothing to alter the incompetent policies that
continue to sicken and kill Africans.
Another study found that indoor spraying with DDT slashed
malaria rates by nearly 75% in just a few years in Madagascar's
highlands. Indoor DDT spraying, combined with insecticide-treated
curtains had similar results elsewhere in the country. Despite this
life-saving success, the World Bank and Roll Back Malaria have
pressured Madagascar to "progressively phase out DDT" and replace it
with an "environmentally friendly" insecticide, even though no chemical
has yet been found that is nearly as effective as DDT. I can only
conclude that, in their minds, environmental considerations and
"international criticism" about DDT take precedence over African lives.
Against all this and more damning evidence, the Bank's Lancet
response asserts that its "approach is driven by results." Just imagine
what would happen to doctors and corporate CEOs who got such "results."
The Bank's Lancet response did get one thing right. It said
that, compared to the Global Fund for the Prevention of Malaria,
Tuberculosis and HIV/AIDS, the Bank has a "comparative advantage in
development economics, financing ... capacity building and ...
Put another way, the Global Fund is more competent than the
Bank in disease control, and more transparent about its funding and
results. It has superior staff, policies, programs and therapies. And
it gives grants, which are attractive to African countries already
saddled with debt - instead of loans like the Bank does.
Instead of pretending to be a disease expert, the Bank should
focus on its comparative advantages. It should build new hospitals and
clinics, get them electricity and clean water, support Global Fund
malaria programs, and provide stipends for doctors and nurses, to keep
them from leaving Africa for countries where salaries are higher, and
obstacles less overwhelming. Let the Global Fund handle malaria
World Bank president Paul Wolfowitz has an opportunity to
change this dismal situation, end the Bank's shamefully defective
malaria programs, refocus it to what it does best, improve healthcare
delivery, and save lives.
I'm not a doctor or politician. I'm just an African woman with
a dream: that we finally end a disease that is wiping out the future of
Africa - our precious children. I truly hope Mr. Wolfowitz will rise to