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Merrill Goozner

Merrill Goozner

Posted: April 25, 2007 02:24 PM

Where's Wolfowitz On World Malaria Day?


While Al Kamen of the Washington Post is reporting the latest emails emanating from Paul Wolfowitz's bunker at the World Bank, the Financial Times has uncovered evidence that the architect of the Iraq War has also been busy censoring reports on global warming.

For those not following this saga, the erstwhile Bush administration Middle East policymaker is enmeshed in a conflict-of-interest scandal that involves giving his companion a big raise and a prestigious job at that institution. If I'm reading between the lines properly, she didn't deserve the job, or at least didn't deserve it as much as some other long-time employees at the Bank.

Now that Wolfowitz is in the press' crosshairs, an enterprising reporter could tackle another major flaw in Wolfowitz's leadership at the Bank. It's especially relevant to raise this issue today, which has been designated as World Malaria Day.

Three years ago, an Institute of Medicine committee chaired by Nobel Prize-winning economist Kenneth Arrow issued a report called "Saving Lives, Buying Time." It outlined a strategy for bringing life-saving anti-malarials to the developing world. Nearly two million people, most of them children, die from the disease every year. In many parts of the world, the mosquito-born parasite has grown resistant to chloroquine, an extremely cheap drug that can be bought for pennies in most developing world pharmacies or local dispensaries. The parents who buy the drug for their children discover too late that it doesn't work.

There is a proven therapy for treating resistant malarial strains. It is a combination of drugs that includes artemisinin, a derivative of the sweet wormwood bush. For a history of its development and more background on this issue, you can click here to read my story that ran in last December's The Scientist magazine.

Despite the efforts of Doctors Without Borders to develop less expensive versions of this drug, the cheapest version now on the market still costs $1 a day, ten times the price of chloroquine. The IOM report came up with a plan for overcoming this problem: the global health agencies should get together, establish a centralized purchasing fund, and buy enough artemisinin-based combination treatments to treat everyone in the world who needs it. This would cost less than $500 million a year.

Then, the centralized authority could simply sell its supply into normal distribution channels as the same price as chloroquine (about 10 cents a dose) and let the market do its magic. The good drug would rapidly supplant the bad one.

The World Bank was given the job of bringing this plan to fruition. Last month, I spoke to the coordinator of public health programs at the World Bank "on background." (They always make you do that over there, especially if you're a lowly blogger.) He brought me up to date on the plan.

Netherlands and Tanzania are co-chairing a group that is creating the "mechanism" for implementing the plan. They still haven't raised the money. They've decided they can't create another bureaucracy but need to find a "partner" who can execute the plan. They're debating whether it should be direct purchase or a voucher system. They hope to launch by the end of the year.

Sound like typical bureaucratese to you? It sure did to me. Where was the sense of urgency, I kept asking. "The discussions are ongoing," he said. "They're intense."

Novartis, which makes the expensive formulation of the combination drug (theirs is called Coartem), announced a major charity program in Tanzania this morning. They'll deliver 4.7 million free doses of the drug to a country where malaria is the leading killer. My morning paper has large ads from ExxonMobil assuring me how much they are worried about the global malaria epidemic. Is there any problem on earth that their p.r. department can't address with a full page ad?

What I would like to see on World Malaria Day is Paul Wolfowitz come out of his bunker and announce the formation of a fully-financed global purchasing authority for artemisinin-combination therapy -- the best hope in the world for rapidly curbing the devastating impact of this disease.

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