w o r d s

When we moved closer Durham in June, I started seriously considering the idea of riding my bike to work. Several guys I work with already do that. It’s a great way to stay in shape and reduce your environmental footprint. So, now that the weather is cooler (less than 90F/32°C) I really ran out of excuses not to try it. Heck, one of my coworkers ran to work the other day, and he lives just down the road, maybe a mile or two closer. So, yesterday I put road tires on my bike and cleaned it a bit, so that I could take it into town.

This morning, I got up at 8:00 and did a test run. At least Sunday morning there would be less traffic. It took me 30 Minutes to get to the office, where I took a 30-Min break, and then I turned around and biked back. The ride back is uphill, and so it took me 45 Minutes to get back home. I think I can do this maybe twice a week. The most direct way to go is not a particularly nice ride, mostly along a busy, four-lane road. At least there are decent sidewalks for a good part of the ride, which makes it much safer. Probably I’ll try to take the North/South Greenway part of the American Tobacco Trail, although that’s not so direct, but it might be a more pleasant ride.

Today is Africa Malaria Day. Malaria is an ancient global killer, and in Africa, more than 3,000 children die each day from malaria (Red Cross). In order to raise awareness about Malaria, and what to do about it, the WHO’s Roll Back Malaria initiative issued a statement that expresses hope that global collaboration can finally make inroads against the plasmodium falciparum:

The progress in fighting malaria in the last few years offers great promise. After too many years of debate, there is now widespread agreement about what works for prevention, diagnosis and treatment. Resources to fight malaria have grown considerably. New spokespersons from the developing world and donor countries have begun to relay key messages. Corporations and multilaterals are working together to replenish the development pipeline and bridge the supply gap of essential prevention tools and treatments. Foundations and other donors have catalyzed investments in new technologies, such as new single dose Artemisinin-based combination Therapies (ACTs), and research into vaccines continues. Some afflicted countries are paving the way for reducing barriers created by import tariffs and malaria service user fees. The world has recognized the toll that malaria takes on the developing world and is poised to respond.

RBM - Malaria Community Statement

Here is a recent update about the cleanup from the Probo Koala toxic waste scandal:

‘We do these kinds of operations all around the world, but this is big,’ Alwin Booij, managing director Tredi Internationale, the French firm contracted to handle the cleanup told Deutsche Presse-Agentur dpa Thursday.

So far, Booij said, his teams have removed more than 6,000 tons of contaminated soil and toxic liquids from 18 sites around Abidjan, a city of around five million inhabitants. The 141 tanker and box containers aboard the MN Toucan constitute only the first of an expected four shipments.

[…]
Today, Ivorian authorities are carrying out no fewer than five inquiries into the affair. Two top Trafigura executives are among ten men currently being held in an Abidjan prison pending the results of a criminal inquiry. And police in the Netherlands are looking into an attempt by the Probo Koala to offload its cargo in Amsterdam in July.

The Ivorian government is also concerned with recuperating cleanup costs, which are likely to run well into the millions.

‘We’re talking about six thousand tons of very hazardous waste to repack, transport, and incinerate,’ Tredis Booij said Thursday. ‘There are big bucks involved.’

[…]
The MN Toucan left Abidjan late Friday night with its poisonous cargo bound for Le Havre, France. From there the tankers and containers will be transported to an incinerating facility outside Lyon for disposal. But it leaves behind it unanswered questions.
Ivory Coast toxic cleanup nears end, but questions remain, by Joe Bavier, Oct 28, 2006

Ten innocent people dead, thousands of people sick, and millions of Euros/Dollars wasted in cleanup cost. At least two of the executives of Trafigura are sitting in a prison in Côte D’Ivoire! If they are found to be responsible for this mess they deserve to rot in the deepest, darkest hole in that prison for the rest of their lives.

Computers are not a green product. Their production, use and disposal consume huge amounts of energy and involve toxic chemicals. At work, I buy and decommission dozens of computers every year, and I worry a lot about the impact of my decisions on our environment. So I find the Greenpeace “Guide to Green Electronics” very helpful, indeed.

One of the areas where I have some influence is purchasing, and for a variety of reasons, I mostly buy Dell computers. So I am really happy to see that Greenpeace rates Dell as one of the best - not really good, but better than most.

I was really surprised when I read that Apple, the brand of the oh-so-hip and huggable, is still pretty toxic, especially the laptops. And even the Greenpeacenics are Apple-fans, but they sure do wish those Apples were greener.

Thanks to intense activism by Greenpeace , the ship involved in the Abidjan toxic waste scandal, the Probo Koala, was impounded by Estonian police and a criminal investigation appears to be under way.

For three days, the Greenpeace ship Arctic Sunrise blocked the Probo Koala in the Estonian harbor of Paldiski. The activists painted the words EU TOXIC CRIME SCENE on the Probo Koala in order to draw attention to the fact that this ship is implicated in a toxic waste scandal that has killed eight people and injured thousands.

The Probo Koala, a Korean-built, Greek-managed, Panamanian-flagged and Dutch-chartered tanker, unloaded several hundred tons of toxic waste which were dumped in the sewers and open dumps of the city of Abidjan in Côte D’Ivoire, West Africa. The charter company, of course, “had no idea” that the waste was going to be illegally disposed of.

Yeah, they dock in Abidjan and in the middle of the night they unload their toxic sludge on trucks that disappear into the African night. No, they suspected nothing. Seemed all perfectly normal. Some fat envelopes change hands. No problemo. Seemed all perfectly legal. Yeah.

Anyway, maybe for once the crooks won’t get away with it. Maybe.

The Probo Koala, infamous now for the deadly toxic waste it unloaded in Côte D’Ivoire, is now in Latvia, en route to Estonia, Deutsche Presse reports. The tanker’s arrival is causing some concern in Estonia:

“The Probo Koala will be under very special treatment when it comes into (the Estonian port of) Paldiski,” Allan Gromov of the Estonian Environment Ministry told Deutsche Presse-Agentur dpa.
DPA report via The raw Story, Sept. 8, 2006

This DPA report also talks about a story (ne) in the Dutch daily de Volkskrant, that reports that the Probo Koala tried to unload its toxic waste in Amsterdam in July. When they began pumping the stuff to a facility operated by the Amsterdam Port Services (APS), the resulting smell led to the operation being halted. The ship was allowed to leave, supposedly for Estonia. On August 20, the Probo Koala unloaded several hundred tons of toxic waste in Côte D’Ivoire, where since 3 people died and 1,500 have fallen ill from the illegal and unsafe disposal of the waste in neighborhoods of the city of Abidjan.

Today is Africa Malaria Day and this year the focus is on the need to provide universal access to artemisinin-based combination therapies (ACTs). ACTs are the newest hope for making serious progress toward defeating the Queen of Diseases.

African children are dying of malaria at the rate of one every 30 seconds. Take a minute to try to comprehend that number – and two more die.

Malaria kills an estimated million people worldwide every year, 90 percent of them in Africa. That relentless toll saps energy, money and hope from communities all over sub-Saharan Africa. “Malaria is also a major cause of anemia in children and pregnant women, low birth weight, premature birth and infant mortality,” the Roll Back Malaria partnership says. “In endemic African countries, malaria accounts for 25–35 percent of all outpatient visits, 20–45 percent of hospital admissions and 15–35 percent of hospital deaths, imposing a great burden on already fragile health-care systems.”
New Hope for Tackling an Old Scourge on Africa Malaria Day, Tami Hultman, allAfrica.com, April 25, 2006

While I lived in Togo, I had malaria many times. I’ll never forget my first malaria attack: bundled up in a sleeping bag on the bed of a pickup truck in a 90-degree, humid rainy-season night, I was shivering uncontrollably for hours, thinking that this was it - I was just going to kick the bucket right then and there. For hours I tried to focus my mind by composing a suitable obituary in my head. By the end of my “malaria career” I had tried a wide variety of drugs to deal with it, and they either produced significant side effects or were useless. Some of the drugs produced side effects that were almost as bad as the Malaria itself (hallucinations and panic attacks, liver problems).

Artemisinin sounds like the holy grail to combat this ancient killer, and in combination with other comprehensive efforts, Malaria eradication is possible.

I have always liked Guinness, especially on tap. A nice, cool pint of Guinness slows things down a bit, as you watch it slowly settle to its characteristic dark stillness, with this creamy, meditative - but confident - head.

Recently, Beer Advocate published an interview with Fergal Murray, one of the company’s head brewmasters, and he gave the Alström Bros. the inside scoop about Guinness:

Murray explained that the recipe for Guinness has undergone only minor adjustments over the years. Every keg of Guinness Draught imported to the US comes from St. James’s Gate in Dublin (though Guinness Extra Stout is made in Canada). It contains water, malt, roasted barley, hops and yeast - and that’s it. Like many major labels, Guinness relies on “high-gravity brewing,” which involves large batches of wort (unfermented beer) high in fermentable sugars (note to beer geeks: the goal is a final gravity of 1072). Eventually these are watered down to attain a 4.2 percent ABV (alcohol by volume). The brewers also blend batches to aid in consistency, and the beer is pasteurized.
Mysteries of Guinness Revealed, Beer Advocate, by the Alström Bros, 04-11-2006

Guinness is a remarkable product - produced in enormous quantities by an international conglomerate. Every day, 10 million pints of Guinness are poured in 150 countries. Yet they manage a remarkable consistency and quality for such a mass-market product.

One of the interesting bits of information to me was the relative purity of the product, with no weird chemicals added to the beer, and the comparison of the caloric value: Guinness has only 125 kCal per 12 ounce serving - less than a Budweiser (ugh). Heck - a 12-ounce can of regular Coke has 144 kCal and may contain the carcinogen benzene. And then there are the Coca Cola deathsquads in Columbia. I have not heard of any Guinness death squads.

Forget soda - pour me another Guinness.

Food safety researchers have conducted more tests on soda pop involving heat and UV exposure, and they found clear evidence that even short exposure of soda to heat increases the levels of benzene, a human carcinogen. This is caused by the presence of two common preservatives in the soda: sodium benzoate and ascorbic acid.

“Heat is a major factor” in the formation of benzene in drinks, according to Mike Redman, a scientist with the American Beverage Association and who also represented the industry in meetings with the FDA over benzene in 1990.

Redman told BeverageDaily.com that soft drinks firms reformulated drinks in 1990, mainly by adjusting the levels of sodium benzoate and ascorbic acid, to reduce and control the potential for benzene traces to form.

Still, the continuing presence of soft drinks containing benzene above drinking water standards has led to calls for sodium benzoate to be taken out of drinks formulas.

“What are we to tell consumers? ‘Product contains cancer-causing substance, drink immediately, do not store in a warm environment or near sunlight?’ Preferably benzoate should not be used in combination with vitamin C (ascorbic acid) or added juice,” said the scientist involved in industry testing for benzene 15 years ago.
Heat tests key for benzene in soft drinks, By Chris Mercer, BeverageDaily.com, 4/11/2006

I found out about this a month ago, and I went cold turkey on my beloved Mountain Dew. These days, when I don’t drink beer or wine, I tend to stick to water, juice and Ice Tea. Instant Ice Tea is not any worse than soda, and it contains much less weird chemicals. And if you really need a caffeine kick, you can just make it more concentrated.
(Hat tip to Revere)

… at least not when it’s time fo my triple bypass, because you’d increase my chance of experiencing complications during recovery by seven percentage points, according to a recent study:

Percentage of Patients Having Complications After Surgery:
52% - Patients who were receiving prayers and did not know this.
52% - Patients receiving no prayers and not being told anything about prayers taking place anywhere for anyone.
59% - Patients knowing they were receiving prayers

Does this mean that knowing people are praying for you is bad for your health? Some say that the stress of thinking ‘I must be really ill if people are praying for my health’ may have contributed towards the health complications.
Praying Doesn’t Help The Sick Get Better, Christian Nordqvist, Medical News Today, April 1, 2006.

No, this is not an April fools joke - they really did this study, and the results are about to be published in the April 4 issue of the American Heart Journal. The John Templeton Foundation shelled out $2.4 million (!) for this study, where Harvard Medical School researchers divided 1,802 bypass patients at six hospitals into three groups. Two groups were uncertain whether they would be the subject of prayers. The third was told they would be prayed for. Too bad for them, because they had the highest rate of complications.

OK, so if you must pray for me, do me a favor and keep it to yourself.

So the FDA figured out in the 1990s that two common preservatives used in soda pop, when combined, can produce enough benzene in the soda to exceed legal levels for this stuff in drinking water. They just neglected to tell us, Foodnavigator.com reports:

Chemists from the US Food and Drug Administration (FDA) said they were surprised that recent tests showed benzene levels in some soft drinks above the country’s legal limit for drinking water.

They were not surprised, however, to hear the suspected source of the problem was two common ingredients regularly used in soft drink formulas – sodium benzoate and ascorbic acid (vitamin C).

That is because both the FDA and US soft drinks association have known about this for 15 years, as testified by an internal FDA memo, dated January 1991.

One FDA chemist, who was also at the meetings with industry back then, told BeverageDaily.com the industry had agreed to “get the word out and reformulate”. No public announcement was, therefore, ever made.
The benzene trail, Chris Mercer, Foodnavigator.com, 3/6/2006 (via Effect Measure)

Despite the knowledge of this reaction, apparently neither the FDA nor any food regulatory agencies in Europe have any limits on benzene levels in soda. This means they have no leverage to enforce any limits, and so the pop makers can hawk their wares which may contain benzene at levels above the limits for water. But how difficult could it be to say that soda pop has to conform to the same standards as drinking water, when it comes to known carcinogens?

What can we do? Well, read the labels! I checked the sodas in our fridge and found the following:

• Diet Mountain Dew lists both sodium benzoate and ascorbic acid
• Fresca Citrus lists sodium benzoate and ascorbic acid
• Coke Zero lists potassium benzoate, but no sodium benzoate or ascorbic acid
• Vault lists sodium benzoate, but does not list ascorbic acid (what the heck is erythorbic acid??)
• Pepsi One lists sodium benzoate and citric acid
• Diet Pepsi lists sodium benzoate and citric acid

The Beck’s I am sipping while typing this, supposedly was made only from water, barley, and hops.

Prost!

This report in the news raises hope for a comprehensive AIDS cure - in a decade, or so:

A chemical has been identified which could halt the progress of HIV, US scientists say.

Lab tests of the chemical - CSA-54 - at Vanderbilt University show it disables the virus’s ability to infect cells.

It was shown to attack HIV in a new way - targeting the membrane of the virus to stop it locking on to cells.

UK experts said the research was interesting - but warned a great deal more research was needed before its true value could be known.
Chemical ‘blocks HIV infection’, BBC News, 9 February 2006.

I really hope they can make this work.

Big promises, lots of talk today, and some quirky publicity, for World Aids Day. Anybody care to listen to the voices of those among us living with the dreaded disease? The stories of how the stigma, the ignorance, the silence kills millions? Anybody? Black Looks shares one of those stories, Rose’s story, with us:

R: The pressure he put on me to keep this secret was huge. And not being able to talk about it to my friends and family increased the huge shame he made me feel about what I had done. Because it also meant at the time that I could not have children. I became very frightened, depressed and isolated, loosing all confidence in myself and feeling very undeserving of everything. It was only thanks to the small women’s support group that I survived those early years but he eventually made me leave that when it (the group) became more public ally known in case I might be “spotted” there. It took me 10 years to get out of this abusive relationship because I always felt I had no option but to say as who would want a woman with HIV? Therefore I should just be thankful and put up with it.

It is very difficult to explain what it was like from one year to the next because so many people were dying and that is what we were told to expect. Every time I got the slightest sickness I thought this was it and of course every 3 months you had to go and get your bloods tested and wait the two weeks for the dreaded results.
Personal Story - Living with HIV - Black Looks, November 30, 2005

Thanks to “Rose” for coming forward and sharing her story and thanks to Black Looks for posting the interview (great blog, BTW, read it!) Only if more of those among us who live with HIV/AIDS get a chance to share their stories, get a voice, do we stand a chance to cure this world of AIDS.

Worried yet about the bird flu? At least the Feds are on the job, now, right? There are competent public-health experts hammering out plans for a response to a flu pandemic, right?

Meet Stewart Simonson. He’s the official charged by Bush with “the protection of the civilian population from acts of bioterrorism and other public health emergencies”–a well-connected, ideological, ambitious Republican with zero public health management or medical expertise, whose previous job was as a corporate lawyer for Amtrak. When Col. Lawrence Wilkerson, former chief of staff for Secretary of State Colin Powell, recently speculated, “If something comes along that is truly serious…like a major pandemic, you are going to see the ineptitude of this government in a way that will take you back to the Declaration of Independence,” many of those professionally concerned with such scenarios couldn’t help thinking of Simonson. They recalled his own unsettling words at a recent Homeland Security subcommittee hearing on government response to a chemical or biological attack: “We’re learning as we go.”
Germ Boys and Yes Men - The Nation - November 28, 2005 issue

A lawyer? A former Amtrak lawyer? And he is learning as he goes???

I dread the day the president announces that “Simonson, you’re doing a heckuva job!”

The Council on Foreign Relations held a conference on Nov. 16 in New York where a number of high-powered panelists discussed the threat of a flu pandemic and the status of avian flu preparedness in the U.S. and around the world. The intensity and complexity of the problem, as laid out in the discussions, is truly mind-boggling. The experts seem to mostly agree that we don’t know when the pandemic is going to begin, and we don’t know how bad it’s going to be. Most also agree that we are pretty sure it’s going to be bad, but just how bad is a matter of debate.

“Hope for the best and prepare for the worst” is the operating mode for folks involved in crisis preparation and contingency planning. Some of the scenarios kicked around in the discussions talk about a massive pandemic, a horror scenario where millions die, 1 in 2 are sick, critical infrastructure breaks down, hospitals are totally overwhelmed. Hundreds of millions have no power, no fuel, no medicines, little food or water. I have not seen any predictions as to the real probability of this worst-case scenario, but it is clearly out there as a possibility. The factors that will determine the scale of the pandemic are either unknown or variable. What we don’t know is how soon the H5N1 virus will be able to start jumping easily from human to human and the pathogenicity of that virus. And one of the changing variables we control is our level of preparedness.

The effects of the next flu pandemic are difficult to predict, because these major variables are unknown or changing. Preparedness is a major factor, and there is now momentum on a global scale to get ready. However, preparations are only in the beginning stages, and we need a lot more time to be able to cope with a major pandemic.

In a discussion with David Nabarro, UN system senior coordinator for avian and human influenza, and David Fedson of Aventis-Pasteur, Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at University of Minnesota lays out this picture in Session 2 of the CFR conference:

OSTERHOLM: (…) I mean, when you think about the fact that this if a pandemic were to occur today, there’s a very high likelihood we would begin to shut borders around the world. We live in a global, just-in-time economy today where this country, in particular, absolutely lives on the goods and services of much of the rest of the world. Many of our critical medical supplies, our pharmaceutical products, our food supply everything you can name that would come to a screeching and crashing halt if, in fact, pandemic began today.

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Europeans appear to take the bird-flu threat seriously: Germany now mandates that chicken be kept only inside. But although Bush said he read “The Great Influenza” his administration still slashes funding for public health preparedness by $129 million in next year’s budget.

“Critical funding is shrinking just as public health agencies are being required to expand their work in pandemic influenza preparation and response,” said Dr. Rex Archer, health director of Kansas City, Mo., and president of the National Association of County and City Health Officials (NACCHO).
The Bush administration, in its proposed 2006 HHS budget, slashed funding for public health preparedness by $129 million — from $926 million in 2005 to $797 million. The House version of the 2006 HHS bill appropriates $853 million while the Senate bill sticks with the$797 million requested by the administration.
Health directors say HHS flu cuts are for the birds Government Health IT, Oct. 18, 2005

All the while, more and more bird-flu reports across Asia.

The bird flu has reached Europe, and the US government is slowly waking up to the threat of a global flu pandemic.

The European Commission said Thursday that the lethal H5N1 strain of bird flu has been confirmed in Turkish poultry and probably is present in Romania.

If confirmed in Romania, it would be the first instance of the deadly strain known to have reached Europe, and would bolster the theory that it may be spread by migrating birds.
CNN.com - Bird flu strain found in Turkey - Oct 13, 2005

In another example of breathtaking competence, the US government holds tippy-top-secret meetings about the fact that a global flu pandemic would be really, really, really bad (something that many public health officials have been saying for years) and then they go ahead and leak this information to the NY Times:

The administration is putting the finishing touches on its long-awaited pandemic plan to be released after Leavitt returns from his trip. A draft version, dated Sept. 30 and leaked to The New York Times, reportedly predicts a major outbreak might kill up to 1.9 million people and make half the country sick.

Sen. Tom Harkin, D-Iowa, says he learned of the administration’s prediction on Sept. 28 in a top-secret meeting in a secure room in the Capitol. He and a few other senators met with Leavitt; Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; and Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC).

The administration, Harkin says, predicts U.S. deaths from pandemic flu could range from 100,000 to 2 million, and as many as 10 million might be hospitalized. Up to 100 million might become sick. Seasonal flu epidemics kill about 36,000 people each year in the USA.
‘Imagine what would happen if a Category 5 viral storm hit every state’, USA Today, 10/11/2005

via REVERE

Considering the Chinese government’s record of dealing with public health issues (SARS!), I had been wondering about all these reassurances from Chinese officials that “Everything is OK. Don’t worry. Just a couple of dead birds …”

But if there is no reason to be alarmed, why has China rushed to shut down all its national parks, sealed off Lake Qinghai, and ordered the vaccination of millions of poultry across vast areas of western China?
China bird flu could ’cause mayhem’ BBC News

This commentary at Recombinomics paints a scary picture of what may really be going on in western China: a phase 6 pandemic of H5N1!

Reports coming out of Qinghai suggest H5N1 infections in humans and birds are out of control, with birds distributing H5N1 to the north and west, while people are being cremated and told to keep quiet.

Reports from Chinese language papers detail over 200 suspected infections in over two dozen locations in Qinghai Province. In the most affected 18 regions, there are 121 deaths, generating a case fatality rate above 60%.
Final Phase 6 Bird Flu Pandemic in Qinghai China?

The folks at Effect Measure are also worried about the situation in Qinghai, but they don’t think that a news blackout has been imposed:

It is too soon to jump to conclusions about what is happening here. The suggestion there has been a news blackout is worrisome. China is especially sensitive about such charges because of the SARS episode so I think this is unlikely, but we just don’t know at the moment. We will keep our eye on this.

I think it is time that the Chinese government provides some clear, credible evidence of what is going on in Qinghai. The implications of a highly infections virus on the loose with a human death-rate of 60 percent (or higher) is not a Chinese problem. It’s a global problem.

Recombination or mutation, that seems to be the big question regarding the avian flu (H5N1) virus in Viet Nam. In yesterday’s edition of the journal Nature, Klaus Stöhr reports that the WHO has not received enough samples of the virus to judge the genetic changes it has found in the few availabe samples.

With so few samples to work on, it is impossible to judge how worried to be, says Klaus Stöhr, coordinator of the WHO’s flu programme. “It’s as if you hear a noise in your car engine, but you keep driving, not knowing whether it’s serious.”

Of the six human samples that the WHO has received from Vietnam, several contain a mutated version of H5N1. But that is not enough to indicate a broader change in the strain, says Perdue. It is also impossible for the agency to link this mutation of the virus to possible changes in how pathogenic and transmissible it is in humans.
The WHO isn’t being sent samples of deadly H5N1 virus., Nature, 11 May 2005

The WHO interprets the changes in the H5N1 virus as mutation, but Recombinomics argues that it may be a result of recombination, which is more troublesome because it means that the the H5N1 changes by acquiring genes from other viruses, which means it could easily acquire the properties of a human flu virus. That, in turn could allow it to start spreading like the human flu, but with the mortality rate of the avian flu. With the H5N1 mortality rate for humans well over 50 percent such a virus has the potential of killing millions of people all over the globe.

The WHO and the public health authorities in S-E Asia need to get their act together. This is an issue that goes far beyond worrying about the economic impact on a country or region. This is about making sure that in ten years there is an economy left in Viet Nam at all, and the rest of the world.

Plasmodium Falciparum is an ancient, accomplished killer on a global scale. It is one of the parasites that cause malaria, the disease that brought the Roman Empire to its knees, killed peasants and popes, and continues to ravage the population of many tropical regions of the world. Only massive use of DDT in the 1950s eradicated malaria from most of Europe and North America. Yet the disease still claims one million lives every year:

There are at least 300 million acute cases of malaria each year globally, resulting in more than a million deaths. Around 90% of these deaths occur in Africa, mostly in young children. Malaria is Africa’s leading cause of under-five mortality (20%) and constitutes 10% of the continent’s overall disease burden. It accounts for 40% of public health expenditure, 30-50% of inpatient admissions, and up to 50% of outpatient visits in areas with high malaria transmission.
WHO/RBM Infosheet

United Nations Decade to Roll Back Malaria initiative has declared April 25 Africa Malaria Day to raise awareness of this global killer.

One problem with malaria is its high correlation with poverty. It mostly impacts poor, and often unstable countries, and within those countries, mostly the poorer populations. So there is not much money to be made developing new, fancy drugs.

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