Articles for March 2005

Zimbabwe 'threat to health of region'  - Tamar Kahn
The collapse of health-care services in Zimbabwe poses a serious threat to its neighbours and may worsen the HIV crisis in the region, advocacy group Africa Fighting Malaria has warned.

Despotism and Disease  - Richard Tren & Roger Bate
Africa Fighting Malaria releases a new report on the healthcare situation in Zimbabwe and its impact on the region.

The forgotten killer  - Steve Connor
The new figures are the result of detailed research that gives the most accurate assessment yet of the disease that kills at least a million people a year. Scientists now believe there are about 515 million cases of malaria out of 2.2 billion people who are at risk - about a third of the world's population.

Rakai to Spray DDT  - Ali Mabule - New Vision, Kampala
Let's hope they actually do spray and that the donors and UN agencies in Uganda gives Rakai the support it needs to spray DDT, and therefore to save lives.

Win over malaria 'achievable'  - Marion Baillot
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.

Taiwan helps Sao Tome eradicate malaria  - Owen Chu
An island help islands in this story about the effective use of aid dollars. Taiwan helps Sao Tome and Principe control its malaria problems by supporting an indoor residual spraying program. It's a shame about the prejudice against DDT. DDT properly used in an indoor residual spray program is one of the most effective anti-malarial insecticides there is and it does not harm the environment. Taiwan should know this, as DDT was the insecticide that eradicated malaria from its borders.

However, in it's decision to not use DDT, Taiwan shows that a responsible aid donor listen to the concerns of the country it's helping. Do you think aid donors will show similar courtesy to Uganda, which wants to use DDT in its IRS program?

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Fact and Comment
Steve Forbes, 02.28.05, 12:00 AM ET

Deadly Prejudice

Nearly every month almost as many people die from malaria as were killed by the tsunami waves in the Indian Ocean. Most of malaria's victims, some 2 million a year, are children under the age of 5. More than 300 million annually suffer from this debilitating disease that drains survivors of their mental and physical energies. Incredibly, there's an easy, proven and cheap way to eradicate most of the globe's malaria--DDT. Yet in one of history's more murderously myopic ongoing actions, most advanced countries and international agencies discourage its use. Why? Blame Rachel Carson's seismically influential--and now largely discredited--book, Silent Spring, first published in 1962. In it she blames DDT for imperiling birds and people, portraying it as a blight of almost biblical proportions. It ain't so. As Dr. Elizabeth Whelan of the American Council on Science & Health once put it, there "has never been a documented case of human illness or death in the U.S. as a result of the standard and accepted use of pesticides." The British medical journal The

Lancet similarly notes that after 40 years ofresearch no significant health threat from DDT has been found.

Indiscriminate use of DDT will indeed have a deleterious impact on certain birds. But we're not advocating that. The use of tiny amounts inside a house or hut is all that's needed. As Nicholas Kristof observed in one of his New York Times columns, "Four hundred fifty thousand people can be protected [from malaria] with the same amount [of DDT] that was applied in the 1960s to a single 1,000-acre American cotton farm. Humans are far better offexposed to DDT than exposed to malaria."

Yet Carson's book has made DDT taboo--with ghastly results. Some 30 million to 60 million people have perished unnecessarily. In 1996, for example, South Africa stopped using DDT, and its malaria cases increased tenfold. Four years later South Africa reversed itself and employed DDT again. The result: The incidence of malaria promptly dropped almost 80%. Nevertheless, too many health officials cling to alternatives that are only fractionally as effective. That various agencies, governments, health officials and environmentalists have deliberately dissuaded the world from using DDT is one of the most immoral moves of modern times.

Soviet-Style Pricing

California has a new law on its books requiring hospitals to disclose prices for goods and services. One immediate, eye-opening result is being able to see the Grand Canyon-esque gaps in what hospitals charge for similar treatments and medications. A head/brain CT scan, for instance, can range in price from a little less than $900 to as much as $6,600. In short, the hospitals' pricing seems to have little to do with supply and demand and no real rationale.

At some of these institutions consumers must make special appointments in order to see the hospital's price list. Can you imagine, say, a hotel not letting you know how much a room costs?

This just further demonstrates the need for promoting the new Health Savings Accounts. HSAs are like IRAs--the money goes in tax-free, grows tax-free and can be spent for health care purposes tax-free. HSAs enable companies to buy high-deductible health care insurance policies at low prices, and most of the deductible is covered by the contributions to the HSAs. These accounts are owned by the individual employees, so if you lose your job, you take the HSA with you. The money is yours.

We've used a variation of HSAs here at Forbes for a number of years. Each year our employees get $2,000 to use for medical expenses. What they don't use gets rolled over. If your medical outlays exceed $2,000, then--and only then--the deductible kicks in. Go above the deductible and the plan's catastrophic insurance comes into play. We're now also offering HSAs themselves--they have the advantage of being easily, fully portable. Bottom line: Our health care costs have gone up less than those of our peers. Individual workers search out better values for the health care money that belongs to them.

Injecting consumerism into health care would give us the best of all worlds: more health care for less money. The most vivid example is laser eye surgery. Today the procedure that enables people to do away with glasses costs about a third of what it did a decade ago. Why? Because it's not covered by insurance; therefore, those performing the laser surgery have every incentive to make the procedure better and more affordable. HSAs will have the same effect: You, the consumer (i.e., the patient), will get full value for your health care dollars precisely because they are your dollars.

Band of Buyers

Instead of bellyaching over the increase in the number of people who don't have health insurance, Congress should immediately pass the Small Business Health Fairness Act. This piece of legislation would make insurance affordable for as many as 8.5 million people by allowing small businesses to band together through trade and professional associations to purchase health insurance for their employees. Currently these outfits must buy policies on their own, often at prohibitively high prices. These businesses lack the buying clout of big companies, and they fall under state regulations whose mandated benefits enormously increase insurance costs.

With so-called Association Health Plans (AHPs), small businesses would gain the bargaining power of large corporations and, in being put under federal jurisdiction, would avoid costly state mandates, just as big companies do today. Fewer small businesses would be forced out of the health care market altogether.

The Congressional Budget Office estimates that AHPs would cut small business insurance premiums 13% on average, and in some cases, up to 25%. The bill passed the House last year but was stalled in the Senate. The White House and congressional leaders should push enactment of this bill as soon as possible.

Congress should also permit individuals and companies to buy health insurance through the Internet. Buyers could then choose from policies around the country. Thus a person in New Jersey could purchase a policy issued by a company in Oklahoma, thereby avoiding the costly, onerous regulations that make health insurance in New Jersey so unnecessarily expensive--and unaffordable.

True Titan

Walter B. Wriston, former chairman and CEO of Citi-corp/Citibank, was a founding director of, serving until last year. Our dot-com revenues would never have equaled those that Citicorp took in every few minutes, but to Walt that mattered not at all.

He was, at heart, an innovator, an entrepreneur, an original thinker and a man who delighted in getting things done. He quickly grasped the promise of the Internet and never lost faith in its possibilities, even in the aftermath of the high-tech bubble. The fact that there were setbacks and excesses in the field was to him part of the normal course of events in a free market. That never made Walt lose sight of how powerful an instrument the Internet is. He understood, as few do, how fundamentally vital is the spread of information.

The willingness to pioneer by pursuing and investing in new technologies and venturing into areas where others feared to tread--or had tread and faltered--was how this man truly revolutionized American and global banking. The word "revolution" has been grossly overused, but what Wriston did for finance was just that--a revolution.

Until the 1960s banking had been a backwater. A handful of hours each day was more than sufficient to handle one's responsibilities. Commercial bankers were risk averse, stodgy. They didn't want to be bothered with consumers--that was for savings banks, not commercial banks. And the government told banks what interest rates they were allowed to pay on deposits.

Before Walt was through, however, he had almost singlehandedly turned banking from the equivalent of a small, sleepy town into a hyperenergetic New York-like metropolis. Under his leadership Citibank pioneered automated teller machines. It pursued the credit card business in a way that no other bank was doing at the time. He constantly battered government regulations. He expanded internationally at a dizzying pace. Old constraints on banks were consigned to the dustbin of history. Walt made what is now known as Citigroup the world's leading financial institution. Because he was not risk averse, Walt made his share of mistakes. But these were minute compared with his monumental achievements.

Walt was a delight to be around. He believed passionately in free markets. His insights were almost always original and profound, and our board meetings were always productive and stimulating.

My only regret is that he was never given the reins to run the Treasury Department or the Federal Reserve. Now that would have been something to behold! Ultimately, however, Walt Wriston achieved far, far more than those who have held these kinds of public-sector posts. We have lost a truly remarkable man.