Net Gains

By Jeffrey D. Sachs, the director of the Earth Institute at Columbia University, is the author of "The End of Poverty." (THE NEW YORK TIMES, 29/04/06):

AMERICANS have a perfect retort to Osama Bin Laden's call for expanding the terrorism war to Sudan. We should respond by showing our abiding concern for the plight of Africans by helping to save millions of children who are at risk of death from disease. In honoring the sanctity of the lives of the least among us we have the best chance to defeat the ideologies of hate.

A campaign by the American Red Cross, the Centers for Disease Control and Prevention, Unicef, the United Nations Foundation and the World Health Organization gives us just the right opportunity. For several years, these partners have been leading an initiative to ensure that measles vaccinations reach hundreds of millions of impoverished children. One dividend of the Measles Initiative's success has been that its methods to get vaccines out to remote rural villages can also serve to fight malaria.

Unlike measles, malaria has been increasing in recent years because the standard treatment has lost efficacy through spreading drug resistance. The Measles Initiative began experimenting with the distribution of long-lasting insecticide-treated bed nets to each household with children who came for a measles immunization. In trial programs in Ghana and Zambia, they learned that in a matter of days they could reach 70 percent or more of households in remote rural areas. In follow-up studies, they learned that the vast majority of the households retained the nets and that a significant majority used them properly. Even in utterly impoverished Niger and Togo, the campaigns were able to distribute bed nets on a national scale in just a few days.

Here, then, is a weapon of mass salvation. The bed nets themselves cost about $6. The cost of bed net distribution per household is less than 50 cents. Including the cost of transportation from manufacturers to the villages and of follow up by trained volunteers, the total price of getting each net to the hut is under $10. Since the net lasts five years and typically two children sleep under it, the protection is about $1 per child per year. Roughly every hundred nets in use will save the life of one child a year and prevent many dozens of debilitating occurrences of malaria.

The Measles Initiative is starting five measles immunization campaigns later this year, but it lacks the money to provide bed nets. The campaigns — in Ethiopia, Ghana, Nigeria, Senegal and Uganda — urgently need around 20 million nets, at a cost under $200 million. All of these countries have significant Muslim populations; all urgently need our help.

Full coverage in these campaigns would protect 40 million children against malaria and save perhaps 200,000 lives each year.

With a child expected to die every 15 seconds, this crisis cannot wait for, and rely only upon, government financing. For example, while President Bush should be commended for having begun a malaria initiative last year, the amount and timing of the money will not cover the shortfall of bed nets for the campaigns later this year. That's one reason that Millennium Promise, a civil society organization of which I am co-founder and co-chairman, has begun to take pledges for bed nets from across this country to give direct support to the Measles Initiative.

As President Bush said at the United Nations last September: "We must help raise up the failing states and stagnant societies that provide fertile ground for the terrorists." An outpouring of support from across America can show what our country stands for: life and hope over death and despair.