April 4, 2007; Page A14
AYIM, Ghana -- Death by malaria is the opposite of quick and painless. When a malarial mosquito bites you, she -- only the females feed on humans -- injects a single-celled parasite into your bloodstream. It heads for your liver to camp out, and over a period of 10 days or so continues developing. The pathogen next invades your red blood cells, where it fully matures and reproduces until those cells burst, freeing the parasite to hunt for more red blood cells and continue the cycle.
It's around this time that you fall ill. A fever one day, violent shivering and profuse sweating the next. Your pulse becomes rapid but weak. Soon there's nausea, vomiting, diarrhea, jaundice, anemia. If you're a healthy adult, maybe you can tough it out. But if you're an expectant mother with a compromised immune system, or a young child with an underdeveloped one, the infection is more likely to have its way with you.
Each year, between 350 million and 500 million cases of malaria occur world-wide. About one million people die, the vast majority pregnant women and children under five residing in sub-Sahara Africa. The continent's high temperatures and humidity are what attract the mosquitoes, but underdevelopment and feckless governance are what allow the insect to thrive.
Last month Ghana, a coastal West African nation of 22 million people, celebrated its 50th anniversary of independence from colonial rule. But it turns out that mosquitoes have proven a much more persistent and deadly foe than any European oppressor. Public health officials here estimate that malaria is responsible for at least a third of hospital visits, and that the disease claims four people an hour, two of whom are children.
Most Americans process these figures in passing. Others are moved to act. One such saint is Lance Laifer, a hedge-fund manager in Connecticut. Back in 2005, he teamed with development economist George Ayittey of the Free Africa Foundation to set up "malaria free zones." The goal was to bypass inefficient international aid agencies and ministries of health and get medicines, insecticides, bed nets and other interventions directly to the afflicted.
Today, zones are up and running in Kenya, Nigeria, Benin and Ghana. Other private donors have also come forward. Not long ago Dick Wright, a retired Johnson & Johnson executive now living in Sanibel, Fla., caught Mr. Ayittey debating Columbia University economist Jeffrey Sachs on television. Mr. Sachs may be the foremost advocate of the highly dubious notion that massive increases in foreign aid via the United Nations is the key to ending poverty and pestilence in the Third World. "When it was George's turn to speak, he said he disagreed with almost everything Sachs said," explained Mr. Wright. "George said never give money to the governments of Africa. Ninety percent of it ends up in Swiss bank accounts. He said somewhere around a trillion dollars has been given to Africa since the 1950s, and most of it hasn't ever gotten to the people."
Mr. Wright and his wife, Maureen, contacted Mr. Ayittey, learned about the malaria-free zones, wrote to 100 of their closest friends and raised $25,000 in less than a month. Within a week of receiving the Wrights' check, Mr. Ayittey, a native Ghanaian who teaches at American University in Washington, D.C., was on a plane home. The Sanibel funds went toward malaria prevention in Ayim and two nearby villages with a combined population of about 1,200.
The villages are located 60 mostly unpaved miles northeast of the capital city of Accra. Inhabited by subsistence farmers scratching a living out of the earth, they lack electricity, running water, toilets. Yet the septuagenarian Wrights promised donors that they would travel to Ghana to see the results in person. And so the couple did, gamely accompanying Mr. Ayittey to inspect mud huts for bed nets and chatting up the tribal chiefs to assure that other interventions were being sustained. (Ayim reports that there have been no malarial deaths since the zone was set up four months ago.)
Mr. Ayittey says these return visits are what distinguish his efforts from other nongovernmental organizations, where the emphasis is on pushing money out the door, not tracking how it's spent or whether it's having an impact. "A typical NGO might come to Ayim and distribute some bed nets," he said, "but it's more of a cultural event. There's no follow-up."
Of course, Mr. Ayittey isn't going to end malaria in Africa. Neither will Lance Laifer or the Wrights. But their efforts still play an important role by demonstrating what's possible.
Ultimately, however, it's dysfunctional African governments that are going to have to get their act together, because economic development is the only way to bring about any lasting relief. Malarial mosquitoes aren't picking on Africa. At one time or another they've menaced Scandinavia, southern Europe, the Balkans, Asia and South America. In 1946 Congress established the Communicable Disease Center, the forerunner to the Centers for Disease Control, with the express purpose of eliminating malaria in the U.S.
Today, malaria remains a problem in those countries lacking modern economies and the infrastructure necessary to properly shield individuals from the elements. Africa is infamous for its abundance of such places. Until that changes, Africa's malaria woes probably won't.
Mr. Riley is a member of The Wall Street Journal's editorial board.