Malaria Vector Control
Malaria Treatment

Still Taxed to Death: An Analysis of Taxes and Tariffs on Medicines, Vaccines and Medical Devices  - Roger Bate, Richard Tren & Jasson Urbach
Bate, Tren & Urbach update their working paper on taxes and tariffs on medicines and medical devices - published by the AEI-Brookings Joint Centre.

The WTO and Access to Essential Medicines: Recent Agreements , New Assignments  - Dr Roger Bate & Richard Tren
Roger Bate and Richard Tren discuss the recent WTO agreement on TRIPS and public health and recommend that the WTO now turn its attention towards removing import tariffs on medicines and medical devices, which have been shown to reduce access to medicines and medical care.

Brazil's AIDS Program - A Costly Success  - Richard Tren & Roger Bate
Richard Tren & Roger Bate comment on Brazil's AIDS Treatment program which has achieved some notable successes, but potentially reduces research into new AIDS medicines and could result in large long term costs down the line.

AFM testimony to the US Senate Committee on Environment & Public Works  - Roger Bate & Richard Tren
Download the testimony given by AFM's Roger Bate and Richard Tren to the US Senate's Committee on Environment and Public Works. The hearing, chaired by Sen. Inhofe (R, OK) was set up to look at the role of science and environmental policy - what better case study than DDT?

An Immesurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured  - Prof. Amir Attaran
Prof. Amir Attaran evaluates the Millennium Development Goals and criticises them for being unmeasurable and therefore largely meaningless. He also criticises the UN for failing to discuss the measurement of these goals at the September 2005 UN meeting on the MDGs.

State in Fear - Zimbabwe's Tragedy is Africa's Shame  - Archbishop Pius Ncube, Dr Roger Bate & Richard Tren
Catholic Archbishop of Bulawayo Pius Ncube, Dr Roger Bate and Richard Tren report on the horrific abuses of human rights by Mugabe's police and military. The authors call on the G8 leaders to exert pressure on African leaders, such as President Mbeki, to condemn Mugabe's regime and support the return of peace and democracy in Zimbabwe.

AFM's Comment on the WHA Malaria Resolution  - AFM
The World Health Assembly recently passed a resolution on malaria control. The WHO and UNICEF also recently published their World Malaria Report. AFM comments here on some aspects of the resolution and report.

Senate Hearings on USAID  -
The Senate Hearings on USAID's involvement in malaria control led to significant challenges to the agency's activities. Download the testimonies from USAID, Senator Sam Brownback, Professor Amir Attaran and AFM's Dr Roger Bate here.

Eliminate Neglected Diseases Act of 2005  -
Senator Sam Brownback's Eliminate Neglected Diseases Act of 2005 has been dropped in the US Senate. Read the Act and supporting documents here.

Taxed to Death  - Roger Bate, Richard Tren and Jasson Urbach
AFM publishes a working paper on the degree to which import tariffs, taxes and bureaucratic procedures block access to essential medicines in poor countries. See the latest version of this ongoing study here.

Despotism & Disease  - Richard Tren & Roger Bate
Africa Fighting Malaria report on the destruction of the Zimbabwean healthcare sector and the probable impacts on the entire region. Download the pdf version of this report here.

Ugandan Study Highlights Best Drug Combinations for Treating Malaria in Africa  - The Lancet
Results of a randomised trial from Uganda in this week’s issue of THE LANCET suggest that the drug combination of amodiaquine and sulfadoxine-pyrimethamine might offer the optimal treatment for malaria in terms of efficacy and cost-effectiveness in this region. The study also shows that the drug combination of chloroquine and sulfadoxine-pyrimethamine—the recommended first-line treatment in Uganda—is far less effective than other drug combinations.

Climate Change and Malaria  - Indur Goklany - with response from Sir David King
Indur Goklany offers some fascinating insights into climate change, malaria, poverty and development. Sir David King, the UK Government's chief scientific adviser gives a predicable response.

The Real Obstacles to Sound Treatment of AIDS in Poor Countries  - Roger Bate & Richard Tren
Writing for the American Enterprise Institute's Health Policy Outlook, Bate and Tren explore some of the reasons for low drug access in poor countries. Despite promises of cheap or free antiretroviral drugs, Bate and Tren argue that access to treatment in poor countries is abysmally low because of a lack of infrastructure, political indifference, excessive bureaucracy and taxes and tariffs.

South Africa's War Against Malaria - Lessons for the Developing World  - Richard Tren & Roger Bate
The Cato Institute published Richard Tren and Roger Bate's analysis of South Africa's recent history with malaria control. They argue that its policy on DDT use and Artemesinin based combination therapy provide excellent examples for other malarial countries.

SA's Leading Malaria Researchers Support DDT Use  -
South Africa’s leading malaria control experts, researchers and doctors support and endorse the use of the insecticide DDT to control malaria. Their statement is released in light of recent claims that DDT is harmful to human health and should be removed from South Africa’s malaria control programme.

South African Malaria Data  - SA Dept of Health
November 2003 - the malaria statistics show that malaria is still well under control in South Africa. A recent epidemic in the Limpopo Province was primarily caused by late spraying and poor case management.

South Africa Malaria Data  - SA Dept of Health
The latest data on malaria cases and deaths from South Africa show that the country's policy of indoor residual spraying with DDT (among other insecticides) and the use of artemesinin based combination therapy is working. KwaZulu Natal, traditionally the province with the worst malaria and the centre of the recent epidemic has only recorded 1 malaria death this year!

South Africa Malaria Statistics  - Dept of Health
The 11th Dept of Health Malaria Update shows the latest number of confirmed cases and deaths from malaria in the three malarial provinces of South Africa.

Saving Lives Today and Tomorrow  - Dr. Roger Bate
This paper analyses trends in drug development using data from the drug industry association, the Pharmaceutical Research and Manufacturers of America (PhRMA). Worryingly, the findings suggest that far fewer AIDS drugs are in development compared to several years ago, and at a time when drug development for other communicable diseases is increasing. There are several probable explanations for this phenomenon, but the least benign is the likelihood that continual pressure group and media attacks on the industry over pricing of drugs in Africa has reduced incentives for development of new AIDS medicines

South African Malaria Update  - SA Dept of Health
The latest malaria update from the Directorate of Communicable Diseases.

Climate Change and Malaria

Sir David A. King's claim that "Climate change is the most severe problem that we are facing today--more serious even than the threat of terrorism" ("Climate change science: adapt, mitigate, or ignore?", Policy Forum, 9 Jan., p. 176) is based, in part, on UK government-sponsored impacts analyses (1, 2) that estimate that by the 2080s, because "of continued warming, millions more people around the world may in future be exposed to the risk of hunger, drought, flooding, and debilitating diseases such as malaria. Poor people in developing countries are likely to be most vulnerable" (p. 176). But the very studies underlying the latter quote, and which King cites, show that, for the most part, many more millions would be at risk in the absence of climate change (2). For instance, the population at risk of malaria (PAR-M) in the absence of climate change is projected to double between 1990 and the 2080s, to 8,820 million (2). However, unmitigated climate change would, by the 2080s, further increase PAR-M by another 257 to 323 million (2).

Thus, by the 2080s, halting further climate change would, at best, reduce total PAR-M by 3.5% [=100 x 323/(323 + 8,820)] (3). On the other hand, reducing carbon dioxide emissions with the goal of eventually stabilizing carbon dioxide at 550 ppm would reduce total PAR-M by 2.8% (2) at a cost to developed nations, according to King, of 1% of GDP in 2050 (p. 177), or about $280 billion in today's terms (4). But malaria's current annual death toll of about 1 million could be halved at an annual cost of $1.25 billion or less, according to the World Health Organization, through a combination of measures such as residual home spraying with insecticides, insecticide-treated bednets, improved case management, and more comprehensive antenatal care (5). Clearly, implementing such measures now would provide greater malaria benefits over the next few decades than would climate stabilization at any level. It would also reduce vulnerability to malaria from all causes--man-made or natural--now and in the future (3). Similarly, reducing present-day vulnerabilities to the other risk factors mentioned by King (i.e., hunger, water shortage, and flooding) could well provide larger benefits at lower costs over the next few decades than would climate change mitigation efforts that go beyond so-called "no-regret" actions, that is, actions that are worth undertaking on their own merits unrelated to any climate change-related concerns (e.g., elimination of subsidies for fossil fuel usage or land clearance) (3).

The World Bank estimates that with additional annual expenditures of $40 to $60 billion, the United Nation's Millennium Development Goals to advance sustainable development could be reached by 2015 (6, 7). Comparing these goals (e.g., at least halving poverty, hunger, illiteracy, child and maternal mortality, and the proportions of populations lacking safe water and sanitation) (6) against what can be expected from halting further climate change (2) indicates that no matter how serious climate change is compared to terrorism, it pales by comparison with the more mundane problems poor people in developing countries face today and over the next few decades. Even advancing halfway toward those goals would provide greater benefits for environmental and human well-being from now through the 2080s, and do so more economically than would heroic mitigation efforts (2, 6). Thus, it would be far more beneficial, and cost-effective, at least for the next several decades, to reduce vulnerabilities to current problems, especially if they might be exacerbated by climate change (e.g., hunger, malaria, drought, and flooding) (3). Even with a lagtime of 50 years to account for the inertia of the climate and energy system, the aforementioned analyses suggest we may have at least a quarter century window (2080s minus 50 years) before deciding on the depth and extent of mitigation. Meanwhile, we should focus on improving mitigation and adaptation technologies and our knowledge of climate change science, economics, and responses. This way we can advance sustainable development and solve the problems of today while furthering our ability to solve the problems of the day after tomorrow.

Indur M. Goklany*
Office of Policy Analysis,
U.S. Department of the Interior,
1849 C Street, NW,
Washington, DC 20240,

*Views expressed here are the author's and not necessarily those of any unit of the federal government.


  1. M. L. Parry et al., Global Environ. Change 9, S1 (1999).
  2. N. W. Arnell et al., Clim. Change 53, 413 (2002).
  3. I. M. Goklany, Energy Environ. 14, 797 (2003).
  4. World Bank, World Development Indicators (World Bank, Washington, DC, 2004).
  5. World Health Organization, World Health Report 1999 (WHO, Geneva, 1999).
  6. World Bank, "The Costs of Attaining the Millennium Development Goals," available at (accessed 25 June 2004).
  7. United Nations, "UN Millennium Development Goals," available at (accessed 8 July 2004).

There is no real choice between action on climate change and action on poverty, disease, hunger, and other millennium development goals. These are part of the same sustainable development agenda. Climate change is already affecting developing countries, and it is the poorest regions of the world--such as Africa and Southeast Asia--that are most at risk. The many people who have died and the millions now homeless through the monsoon flooding in Bangladesh will bear witness to that. This kind of event can be expected to become more frequent and more extreme as global warming accelerates, exacerbated by rising sea levels.

To meet the millennium development goals, serious investment is needed in areas such as public health and infrastructure for water and energy. The British government under Prime Minister Tony Blair's leadership is strongly committed to that. The total UK official development assistance (ODA) will rise to almost £6.5 billion by 2007/08, which will mean that our ODA will have risen from 0.26% of Gross National Income (GNI) in 1997 to 0.47% in 2007/08.

At the same time, the clock is ticking as concentrations of greenhouse gases mount in the atmosphere. At well over 370 ppm, we are already at 50% above preindustrial levels, unlikely to have been seen on Earth for around 20 million years. Global action is needed now if we are to retain the chance to stabilize emissions at a level to avoid even more dangerous climate change than that to which we are already committed. The work of the Intergovernmental Panel on Climate Change, representing the overwhelming majority of world scientific opinion, including in the United States, has shown that we are now on track to seeing average global temperatures rise by 1.5º to 5.8ºC this century as a result of human activities--burning of fossil fuels and deforestation. Failure to act will result in a price, both human and economic, that will be paid across the world for generations to come. Once CO2 is released into the atmosphere, it will remain there for centuries.

That is why real climate action is needed now at a global level. As Tony Blair has announced, during our G8 Presidency, we wish to deliver real progress on both climate change and African development.

Sir David A. King
Chief Scientific Adviser to Her Majesty's Government and Head of the Office of Science and Technology,
1 Victoria Street,
London SW1H 0ET,

The editors suggest these related resources at Science:

Climate Change Science: Adapt, Mitigate, or Ignore?

David A. King
Science 9 January 2004: 176-177
[Summary] [Full Text] [PDF]

Volume 306, Number 5693, Issue of 1 Oct 2004, pp. 55-57.
Copyright © 2004 by The American Association for the Advancement of Science. All rights reserved.