Posts or Comments 21 May 2024

Health Systems Bill Brieger | 05 Jan 2009 09:39 am

Is there ‘enough’ government to eliminate malaria?

Fareed Zakaria in today’s Washington Post quoted, “Samuel P. Huntington, the greatest political scientist of the past half-century, who died on Christmas Eve,” as saying, “‘the most important political distinction among countries concerns not their form of government but their degree of government.'” The implication, therefore is that …

So many of the world’s problems — from terrorists in Waziristan to the AIDS epidemic to piracy in Somalia — are made worse by governments that are unable to exercise real authority over their lands or people.

Money does not solve the problem. Sue Lloyd-Roberts of the BBC reported that, “Oil has provided hundreds of billions of pounds in revenue for the government since it was discovered in the Nigerian Delta 50 years ago and yet the country boasts some of the poorest communities in West Africa. Elections are rigged by money and guns and corruption pervades society from the top down.” People she interviewed explained that it is not just the billions of dollars embezzeled by government leaders over time but that, “The idea that there is a huge pot of black gold out there for the taking has distorted everyone’s values.”

‘Smaller’ pots of money may have a similar effect. When it became likely that Kenya might not secure Round 8 Global Fund support, “A Kenyan official (said) the government will investigate allegations of corruption in programs funded by a U.N.-backed agency to treat patients with AIDS, malaria or tuberculosis.” The Medical Services Minister said that, “The Geneva-based Global Fund to fight AIDS, Tuberculosis and Malaria said it suspects that some lists of patients treated in earlier programs were fictitious.”

Larger trends may be at work. The Washington Post looked at the world’s demographic future and explained that, “Sub-Saharan Africa — which is afflicted with the world’s highest fertility rates and ravaged by AIDS — will still be racked by large youth bulges … In recent years, most of these countries have demonstrated the correlation between extreme youth and violence. If that correlation endures, chronic unrest and state failure could persist through the 2020s — or even longer if fertility fails to drop.”

Failing states cannot eliminate malaria.  Cholera and now likely malaria are killing people in Zimbabwe. Refugees in the continuing crisis in eastern Democratic Republic of Congo are exposed malaria and other diseases, and in the Niger Delta of Nigeria poverty, unemployment and instability amidst great oil wealth threaten health and social infrastructure.

Greater attention to poverty alleviation and youth employment will be crucial for stabilizing and strengthening governments so that they can address poverty-associated endemic diseases like malaria.

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