Ailing Populations Spell Ailing Economies
By Douglas Birch, The Baltimore Sun

	Jeffrey D Sachs has made a career out of doctoring ailing 
economies. He has recommended huge doses of capitalism to cure 
the ills of former socialist economies, from Bolivia to Mongolia. 
He has prescribed austerity to cool the fever of quintuple-digit 
inflation.
	But in recent years, Sachs says, he has looked for deeper 
causes for economic malaise. For many nations, he says, malignant 
poverty might be primarily the product of wretched public health.    
	Economists say, Reform the value-added tax. Get the budget 
deficit down. Open the borders, says Sachs, 45, head of the 
Harvard Center for International Development. That's great stuff 
if you happen to be Poland. But it's not the answer if you happen 
to be Tanzania, where you're suffering holo-endemic malaria, 
shistosomiasis [parasitic worms] and everything else you can 
imagine.     
	So Sachs and a colleague, Michael Kremer of Harvard, have 
joined health advocates in lobbying Congress to set aside 
$1 billion in tax credits to nudge the world's pharmaceutical 
companies to develop vaccines against tuberculosis, AIDS and 
malaria, some of the world's biggest killers.
	Sachs started studying the links between geography, disease 
and poverty about five years ago. He was struck by one pattern. 
	There are precious few people in the tropics that are rich, 
he says. And the people living in the temperate zones that are 
poor are usually poor for quite identifiable reasons, the 
dominant one of which is the Red Army.
	Sachs wonders what force plays the role of Marxist-Leninist 
doctrine in equatorial regions. 
	One suspect is malaria. Though malaria is only one of 
several tropical diseases, it sets the pattern. The microbe loves 
hot, wet climates. It is transmitted by an animal or insect in 
this case a type of mosquito that is expensive or impossible to 
control in tropical regions.     
	Because malaria was driven out of most industrial nations 
in the mid-1900s, there is relatively little research on it. Drug 
companies pay scant attention, because malaria's victims can't 
afford to pay for expensive new medications. As a result, malaria 
claims 1.1 million lives a year, most of them children in Africa. 
	The disease's affects on economies are also extensive. In a 
recent study, Sachs' fellow Harvard economist John Luke Gallup 
found that countries with high levels of malaria had incomes one-
third of those without malaria.
	There are huge negative economic effects of 
having...malaria, Sachs says. And huge positive effects of 
getting rid of it.
	Until the late 1940s, Italy suffered 300,000 cases and 
20,000 deaths a year from malaria, but a campaign to drain 
wetlands and spray mosquitoes wiped the disease out. That 
country's economy took off, growing five times faster than it had 
in previous decades and faster than those of the rest of Western 
Europe.
	Malaria's impact on countries such as Botswana, Tanzania 
and Nigeria is unrelenting. The disease doesn't just keep 
millions home from work and school every day. Chronic anemia or 
attacks of cerebral malaria can cause lifelong problems with 
learning and memory. Though they lack statistics, Sachs and 
Gallup suggest malaria discourages tourism, foreign investment 
and trade. It might prevent people with university educations, 
who live in mosquito-free cities, from working in the 
countryside.
	The burden of tropical disease, Sachs says, could help 
explain why some parts of the world have become increasingly 
wealthy while others have remained poor.
	Residents of the world's richest countries had average 
incomes three times higher than those in poor countries in 1830. 
Today, the average American or European earns 20 times more than 
the average resident of sub-Saharan Africa.
	Sachs doesn't blame the rich countries for that gap. 
Everybody started poor, and a part of the world got rich. It's 
not that everybody was rich and a part got poor through 
exploitation.
	Rapid advances in Western science haven't helped tropical 
regions because most technology wasn't designed to work in warm, 
wet regions. Factory farming techniques common in the US Midwest 
can't be used in the Congo river basin. Modern medical research 
is still primarily focused on diseases common in the US, Europe 
and Japan.
	Poor nations can do only so much for themselves, Sachs 
says. Wealthy nations have to help. Technology is advancing 
faster than at any other time, and fortunes are being spent on 
the problems facing the industrial world, he says, but almost 
nothing is going into problems that are strictly the problems of 
tropical societies.