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Tuesday, January 13, 2015

"Soft Power" in Action: Saving generations in the fight against malaria

If there were a disease that affected over 200 million people annually and its most vulnerable populations were pregnant women and children under five years of age - of over 600,000 deaths, 80% (480,000) are children under 5 - wouldn't the fight against it be big news?

On last weekend's Midrats, I spoke with Tim Ziemer, coordinator of the President's Malaria Initiative about the important "soft power" effort of the U.S. to reduce the impact of malaria in Africa.

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We struggle with so many other "wars" around the world - cyber war, jihad, drug cartels, human traffickers, local actual or wanna-be hegemons, international looney tunes (PDRK, anyone), etc - that it is easy to forget the great battles against diseases that have been fought in the past and those which are on-going. Measles, small pox and yellow fever are mostly gone (yellow fever now strikes about 200,000 a year, mostly in Africa). Tuberculosis still kills about 1.5 million a year, "Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent." But we are fighting them.

As RADM Ziemer says during our conversation, reducing the incidence of malaria frees up local medical services to deal with other issues and also frees up populations to engage in productive work to improve their lot in life. I think he said something like, "Malaria is a disease of poverty."

A recurrent question in the show chat room during the live broadcast was whether the U.S. was getting "credit" for pouring $4 billion into this fight against malaria? Without asking some of the people whose lives have changed (or been saved) as a result of theses efforts, how do we measure "credit"?

I am reminded of the Aesop's fable of the lion and the mouse:
A Lion lay asleep in the forest, his great head resting on his paws. A timid little Mouse came upon him unexpectedly, and in her fright and haste to get away, ran across the Lion's nose. Roused from his nap, the Lion laid his huge paw angrily on the tiny creature to kill her.

"Spare me!" begged the poor Mouse. "Please let me go and some day I will surely repay you."

The Lion was much amused to think that a Mouse could ever help him. But he was generous and finally let the Mouse go.

Some days later, while stalking his prey in the forest, the Lion was caught in the toils of a hunter's net. Unable to free himself, he filled the forest with his angry roaring. The Mouse knew the voice and quickly found the Lion struggling in the net. Running to one of the great ropes that bound him, she gnawed it until it parted, and soon the Lion was free.

"You laughed when I said I would repay you," said the Mouse. "Now you see that even a Mouse can help a Lion."

A kindness is never wasted.
 How much is sparing several generations from malaria worth down the road?

The U.S. taxpayers are not alone in this fight. The World Health Orgaization (WHO) (U.S. taxpayers also contribute heavily to WHO (about 20% of WHO funding) and private foundations (again, mostly American like Bill and Melinda Gates Foundation). The United Kingdom is a large contributor. China is a player - see here:
To combat malaria, drugs are of vital importance. When a delegation of senior African government officials visited a Shanghai-based pharmaceutical company in 2005, they called on Chinese companies to set up branches in Africa for medicine production. DihydroArtemisinin, or “Cotecxin,” was first developed by Beijing Holley-Cotec in 1993. It was approved by the World Health Organization (WHO) as an effective anti-malaria drug. In 1996, China’s Ministry of Health designated Cotecxin as the required medicine for CMTs. It is also chosen many times as aid materials to Africa, either by governments or pharmaceutical companies. Another important measure is the set-up of anti-malaria centers in Africa, a direct result of 2006 Summit.

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