The End of Poverty: How We Can Make It Happen in Our Lifetime by Jeffrey Sachs

Author:Jeffrey Sachs [Sachs, Jeffrey]
Language: eng
Format: epub
Tags: Political Science, History & Theory, Social Science, Poverty & Homelessness, Business & Economics, Economics, General
ISBN: 9780141018669
Google: DnoaoaPbBzQC
Amazon: B0063GJMPY
Publisher: Penguin
Published: 2011-11-24T00:00:00+00:00

The Malaria Mystery

I had a lot to learn about disease and public health. It took me a while to understand the dire state of affairs. I still remember asking, “What do you mean they are not going to doctors? They have AIDS but they are not seeing doctors? Their children suffer from malaria-induced anemia but are not treated? How can this be?” “You know, there are treatments for AIDS and malaria,” I sputtered. “What do you mean, there are no medicines here? What do you mean, there’s no treatment program? What do you mean, USAID is doing nothing? What do you mean that the World Bank hasn’t had an AIDS or malaria program in this country for years?” These were basic questions that I had never asked before coming to Africa. Strangely, neither had other economists, including those leading the IMF and World Bank missions to Africa.

Malaria became my first target of study. Malaria is a potentially fatal protozoan disease transmitted by a specific kind of mosquito, the genus anopheles. Malaria is utterly treatable, yet, incredibly, it still claims up to three million lives per year, mostly young children, about 90 percent of whom live in Africa. The rest of the deaths occur in tropical regions of the Americas and Asia. In fact, there are four types of human malaria. The malaria caused by the pathogen Plasmodium falciparum is by far the most lethal variant and is responsible for the vast proportion of malaria cases in Africa. The malaria due to P. vivax is very widely distributed in tropical and subtropical regions outside of Africa and is much less lethal. It is worth restating the central fact: malaria is utterly treatable, yet it still claims around three million lives per year, overwhelmingly in Africa. Low-cost treatments exist, but they do not reach the poor. These statistics boggled my mind, as does the current estimate that malaria causes up to five billion clinical cases per year. Virtually everybody in tropical Africa contracts the illness at least once a year. In some places, the entire population lives year-round with the malaria parasite in their bodies (although without clinical symptoms much of the time).

I overlaid two world maps, one of low GDP per capita and one that shows malaria transmission at three points in time: 1946,1966, and 1994 (one can see the areas where malaria has been eliminated during those fifty years). The poor regions were largely the same as malarious ones, as shown in maps 9 and 10. This prompted four questions: First, does malaria contribute to poverty, or does poverty cause higher malaria incidence, or is it both? Second, why was the malaria situation so much worse in Africa? Third, what was being done to break the malaria-poverty linkage? And fourth, of course, what more could be done? Addressing these questions opened my eyes to a host of issues that I had hardly imagined in the mid-1990s. They led me from malaria to AIDS to public health, and then to the Millennium Development Goals.

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