Jeffrey D. Sachs Calls
for Renewed Global Effort to Reduce the Scourge of Malaria
Global Initiatives Rely on Recent Advances in Genomic Mapping of Malaria Parasite and Mosquito, as well as Major Investment in Prevention, Control and New Technologies
With the stunning completion of the mapping of the genomes of the main malaria parasite and the mosquito that spreads it, Earth Institute Director Jeffrey D. Sachs renews his call for a worldwide effort to control malaria in the October 4, 2002 issue of Science.
Sachs says a marked surge of disease and deaths due to malaria, the possibility of using existing technologies more effectively to control malaria, and striking advances in genomics that will lead to new drug and vaccine development all signal the urgency of a global effort. Funding, he says, is critical to the effort's success. "Much of the required international machinery has been put in place in the past four years, though the gears of the new machinery have barely begun to move, mainly for lack of funds."
"The urgent global task," he writes, "is to throw the new machinery of malaria control into gear, with adequate leadership and financing." In the article, Sachs outlines four principles that must guide a global campaign to fight the malaria scourge:
1. Focus on the world's most afflicted regions -- overwhelmingly
those in the sub-Saharan Africa
2. Recognize that, unlike other epidemic diseases, malaria control is uniquely site specific and depends on climate patterns, vector ecology and biology, and human activity, requiring active local expertise
3. Pursue increased control (both prevention and treatment) with existing technologies and spur major investment in R&D for new and promising technologies
4. Fund the global campaign adequately and consistently for at least two to three decades
Sachs notes that current worldwide spending for anti-malaria prevention and treatment is likely below $500 million annually, whereas actual needs exceed $2 billion per year, and likely more to fund a replacement for chloroquine, the principal drug used to combat malaria that has lost its effectiveness against resistant strains of the disease. Longer-term solutions, based on recent genomic advances, will come from new drug discovery and especially vaccine development. However, "no major pharmaceutical company reports a major malaria research effort," and donor governments have not adequately backed recent research initiatives from the private philanthropic community.
According to Sachs, the human and economic costs are horrendous, especially in sub-Saharan Africa, where malaria may claim in excess of 2 million lives and one percentage point of economic growth per year. Malaria, like other epidemic diseases, tears at sub-Saharan African societies, drawing them into a downward spiral of increasing poverty, environmental degradation and greater ecological instability. "The annual outlays by donors will surely have to reach several billion dollars per year for a generation or so to get malaria under controlÉ but this will be a very small price to pay for millions of lives saved per year and hundreds of millions of people given a chance to escape from the vicious circle of impoverishment and disease."
The Earth Institute at Columbia University is the world's pioneer academic center for mobilizing the sciences and public policy in pursuit of a sustainable future, especially for the world's poor. More than 800 scientists with strength in Earth science, ecology, health, social science or engineering are working together to reduce poverty, hunger, disease, and environmental degradation. The Institute brings their creative knowledge to bear through teaching, research and outreach in dozens of countries around the world.