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Commentary

The G8 and Health: The Wrong Target
Andrew Farlow, Straits Times — Singapore, 7-15-06

Andrew Farlow calls on the G–8 to turn towards more practical initiatives to end infectious diseases in poverty-stricken nations, and away from media grabbing programs that don't accomplish any real results. He argues that in order to reduce suffering from preventable diseases in poor nations, the G–8 leaders need to focus on reforming corrupt governments and encouraging free markets.

First off, before we go pouring millions of dollars into new schemes, we should examine whether we are using properly what we know already works.

Two–thirds of all African children who die under the age of five could be saved by low–cost treatments such as vitamin A supplements, oral rehydration salts and existing combination–therapy drugs against malaria. Better water management and spraying inexpensive insecticides inside dwellings have been proven to reduce malaria significantly.

But basic vaccinations and drugs are still not getting to a majority of people in sub–Saharan Africa and poor nutrition contributes to over half of all deaths associated with infectious diseases in children under five.

The problem is distribution, hampered by poverty, few clinics, bad roads and, above all, bad governance: inept state monopolies, tariffs on medicines, refusing foreign certification and holding back the economic freedoms that would make people better off and therefore healthier.

These facts are well known. If existing drugs, technologies and methods were properly distributed, the benefits for the world's poorest people would be immense. But the kind of sustained, low–profile effort needed, like the Rotary Club's worldwide success against polio, brings little reward for politicians whose nearest vista is the next election.

As a result, resources and political attention get shifted away from these bread–and–butter issues towards grandiose schemes. This has the knock–on effect of constantly tying up global health organizations in exploring the very latest novel proposals, while funding for tried and tested approaches gets put on the back burner.

Worse, these superficially attractive big schemes are doomed to failure. It is wishful thinking that the private sector will risk its own capital on developing a vaccine under APC, as it is most unlikely that bureaucrats would have the knowledge of current or future demand, or of development costs, to give the right level of reward to a successful product. But even if a vaccine were invented, how would it ever reach those who need it?



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