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The good fight

Bush can be proud of his leadership in the effort to eradicate malaria, but the battle is far from over.

December 14, 2006

PRESIDENT BUSH today will take time out from his "listening tour" of his mistakes in Iraq to focus on one foreign policy initiative of which he can be justifiably proud. His "White House Summit on Malaria" will include many of the major players in the global fight against the disease. The meeting comes a year and a half after Bush announced a $1.2-billion crusade to combat malaria in the most afflicted countries in Africa.

Being proud, however, isn't the same as being successful. On this score, the fight against malaria has more in common with the war in Iraq than Bush would care to admit. The difference is that we know how to beat malaria, and there is little disagreement over how best to do it.

Malaria is among the three deadliest diseases in the developing world, and unlike the other two (AIDS and tuberculosis), it is fairly easy to prevent and cure. Yet it's hard to say whether malaria is getting worse or better because it is very poorly monitored. The best estimates are that it kills an estimated 1 million to 3 million people a year, mostly African children under 5. Overall, malaria is probably killing as many people today as it was five years ago.

There are success stories, however, that prove the disease can be beaten, even in desperately poor countries. In southern Mozambique, Swaziland and Eritrea, cases are down between 80% and 90%. These are among the places that have seen a comprehensive eradication effort, including heavy distribution of insecticide-treated bed nets, which kill malarial mosquitoes before they can transmit the disease, and the widespread use of effective anti-malaria drugs. In other countries, the problem is primarily domestic chaos. Malaria tends to thrive in nations with unstable or ineffective governments.

Unfortunately, the expansion of effective anti-malaria efforts may be endangered. The budget that Congress will consider in January for the current fiscal year, which ends in September 2007, caps overall spending at the same level as the previous year. That means the president's programs to fight malaria may not have the same effect next year. In addition, the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria could be frozen at last year's level of $545 million. (The fund is counting on $700 million to help it meet its goals for eradication.)

Congress will have the flexibility to move funds around from one area to another, even if it can't increase overall spending. It should make sure these vital programs get the money they need. If lawmakers wonder where to find the cash, they need look no further than the $17 billion in "earmarks" that congressional leaders have cut from this year's spending plan.

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