Bush Renews Effort to Cut Malaria Deaths

South African pop star Yvonne Chaka Chaka, an activist in the fight against malaria, speaks at a White House summit in Washington last week.
South African pop star Yvonne Chaka Chaka, an activist in the fight against malaria, speaks at a White House summit in Washington last week. (By J. Scott Applewhite -- Associated Press)
By David Brown
Washington Post Staff Writer
Sunday, December 17, 2006

For an administration trying to solve problems such as the war in Iraq, illegal immigration and the potential meltdown of Social Security, cutting worldwide malaria deaths in half looks like low-hanging fruit -- and President Bush is intent on picking it.

Bush gathered a group of global health luminaries last week to give a second debut to one of his least-known foreign ventures, the $1.2 billion, five-year President's Malaria Initiative.

The PMI, as it is coming to be called, is a younger sibling to Bush's biggest global health project, the $15 billion, five-year President's Emergency Plan for AIDS Relief, known as PEPFAR. The malaria initiative targets many of the same countries and may help some of the same people. But the infection is virtually an "orphan disease" in the minds of Americans, who have not faced the threat of malaria, except through foreign travel, for three generations.

Bush launched the malaria program in June 2005, with the goal of reducing malaria-related deaths in 15 African countries by 50 percent. The disease kills more than 1 million people a year, most of them African children under age 5.

Both the AIDS and malaria initiatives seek to prevent infections and treat them with state-of-the-art therapy not widely available in places where the diseases take their greatest toll. Both harness grass-roots organizations -- many church-affiliated and first-timers in public health campaigns -- to do much of the work. Both involve public education and the distribution of consumer goods.

There are big differences, though. Malaria does not involve sex and drugs. It can be contracted by anyone, regardless of behavior. And the chief nonmedical means of preventing transmission is a mosquito net, not a condom or a clean needle.

Those distinctions are part of the reason that Bush's malaria initiative is inviting the private sector -- corporations, clubs, elementary schools -- to join the campaign against malaria in a way that he has not done in his fight against AIDS.

As with AIDS, but more dramatically so, the malaria initiative seeks to provide potential victims with resources that are certain to work.

"For many illnesses, there is no known relief," Bush said Thursday in a closing speech to the White House Summit on Malaria, held at the National Geographic Society headquarters. "Yet for malaria, we know exactly what it takes to prevent and treat the disease. The only question is whether we have the will to act."

Research has shown that five interventions, used together, can dramatically reduce malaria's toll.

The first is a combination of drugs that includes artemisinin, a substance first used in ancient Chinese herbal remedies that can often dramatically cure cerebral malaria, reviving children who are in a coma and close to death. The second is a hand-held blood test kit that can be used even in remote villages to diagnose falciparum malaria, by far the most dangerous subtype. The third is automatic treatment of pregnant women in infested areas.

The fourth is spraying the indoor walls of dwellings with long-lasting pesticides, including DDT, which is enjoying newfound acceptance for this one purpose. The fifth is sleeping under mosquito nets impregnated with insect repellents that remain active for years.

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