Thursday, 05 June 2014

Bill Gates Says Capitalism Is Flawed in Fighting Malaria

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While speaking before the Royal Academy of Engineering’s Global Grand Challenges Summit in London last year, Microsoft co-founder Bill Gates lamented that malaria research “gets virtually no funding.” 

Gates blamed the “marketplace” for the lack of malaria research funding, stating:

The malaria vaccine in humanist terms is the biggest need. But it gets virtually no funding. But if you are working on male baldness or other things you get an order of magnitude more research funding because of the voice in the marketplace than something like malaria.

“Our priorities are tilted by marketplace imperatives,” Gates continued, asserting that the way to correct the imbalance is to address this “flaw in the pure capitalistic approach.”

The self-made billionaire’s comments (his net worth is estimated at $78.0 billion) raised eyebrows among some commentators who regarded his criticism of the capitalist system as being at odds with the system that enabled him to achieve his vast wealth. 

And he is not alone among his billionaire peers in this regard. A writer for The Guardian newspaper of Britain commenting on Gates’ statement at the London conference observed:

Bill Gates provided a striking example this week when he slated the market for distorting important priorities.... The software billionaire gave the example of the malaria vaccine getting virtually no market funding, whereas male baldness gets ample....

Gates is not alone among billionaires excoriating capitalism. Warren Buffett, one of America's richest investors, has lambasted the super-rich for failing to pay their fair share of tax. George Soros, another anti-capitalist financier, has long argued that the market system is falling apart.

Absent from all these reports is any meaningful definition of capitalism or capitalists. Everyone has capital, even communists. The major distinction to be made among capitalists is between those who favor a genuine free market (competitive capitalist) and those who seek to stifle competition (monopolistic capitalists). In this regard, socialist authoritarians have much in common with the monopolists of old such as John D. Rockefeller (who reportedly said, “Competition is a sin”).

Gates’ company was also accused of anti-competitiveness in the antitrust law case United States v. Microsoft Corporation, ultimately settled by the Department of Justice, where Microsoft Corporation was accused of becoming a monopoly and engaging in abusive practices contrary to the Sherman Antitrust Act of 1890.

A chief characteristic of the free enterprise supporter, therefore, is not whether he advocates for capitalism, but whether he promotes competition.

Regardless of Gates’ qualifications as a true free enterprise capitalist, the Bill & Melinda Gates Foundation co-founded by Gates does qualify him and his wife as philanthropists. A page on the Gates Foundation website provides details of its strategy to fund anti-malaria research. The website article notes, “In the past dozen years, malaria funding has increased nearly 10-fold and major gains have been made in controlling the disease in developing nations,” an apparent major commitment that might cause the reader to wonder why Gates said that that malaria research “gets virtually no funding.” 

The site notes, “Malaria was eliminated in most of Western Europe by the mid-1930s; the United States achieved elimination of the disease in 1951.”

Since methods effective at eliminating malaria in Western Europe and the United States existed decades ago, one wonder why these same methods have not been utilized in other area of the world where malaria has not yet been conquered.

The Gates Foundation plan includes “improving the delivery of existing interventions as well as developing new tools and new strategies that target not just malaria-transmitting mosquitoes but also the parasite itself, which can survive in humans for more than 10 years.”

Few would argue with that plan, since a multi-faceted approach to eliminating any disease is generally most effective.

The article notes that, to date, the Gates Foundation has committed nearly $2 billion in grants to combat malaria, which is certainly an example of how private, rather than government, funding can be used for the betterment of the human condition.

While acknowledging the foundation’s generous efforts, the outside observer might speculate about why its generous funding is apparently inadequate to make a dent in the fight against malaria. One might also wonder why Gates’ plea was focused almost entirely on the development of a malaria vaccine, since drug development can be a very long-term and costly undertaking. How did health officials eliminate malaria from Western Europe and the United States without such a vaccine and without billions of dollars in funding?

Before answering those questions, we note an April 25 article in The Guardian about a large mining company in the Obuasi area of Ghana — AngloGold Ashanti — that decided to combat malaria after noticing that a large percentage of its workforce was plagued by the illness. The company set up a program in collaboration with Ghana’s Ministry of Health to kill the mosquitoes that spread malaria by spraying the mines, surrounding buildings, homes, and entire districts. The result has been that there are simply fewer mosquitoes that can spread malaria.

“We had a goal of achieving a 50-percent reduction [in malaria prevalence] within two years,” said Sylvester Segbaya, program director for AngloGold Ashanti malaria control. “Within two years, we actually had a 74-percent reduction.”

While the article did not identify the specific insecticide used in Obuasi, The Guardian noted that the World Health Organization (WHO) recommends spraying with a residual insecticide (IRS) and linked to a WHO operational manual for IRS. The manual noted that the following “Insecticides approved for indoor residual spraying" fall into four major classes:

• carbamates (C): bendiocarb, propoxur

• organochlorines (OC): DDT

• organophosphates (OP): malathion, fenitrothion, pirimiophos-methyl

• pyrethroids (PY): alphacypermethrin, deltamethrin, lambda-cyhalothrin, etofenprox, bifenthrin, cyfluthrin

Note that the second item on the approved list, organochlorines, is DDT! The manual states: “These insecticides are chosen based on safety for humans and their residual efficacy when applied to a dwelling surface.”

The efficacy of DDT in malaria prevention has been well documented.

During his talked titled, “DDT and Malaria Control: Past, Present, and Future,” given to a conference sponsored by Accuracy in Media in Washington, D.C., in October 2002, Donald R. Roberts, Ph.D., professor of tropical public health at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, noted:

Rural malaria was a major public health problem prior to the mid-1940s, even in the United States. With the advent of DDT, the era of uncontrolled malaria ended, followed by decades of dramatic control or elimination of both urban and rural malaria. Unfortunately, those marvelous achievements were lost as countries complied with international pressures to abandon DDT and house spray programs.

There are many modern insecticides that might be used as substitutes for DDT, but they are not cheap and do not have a long residual action. The frequent re-spraying of chemicals with short residual activity (DDT alternatives) is not an affordable method of malaria control in rural areas. Thus, as developing countries were forced to abandon house spray programs, they gradually reverted to the conditions of uncontrolled rural malaria that existed before the mid-1940s.

Dr. Roberts’ conclusion? “In summation, without DDT, there is no real hope for reversing modern trends of increasing malaria (with the exception of control programs being restarted in urban areas).”

Considering Bill Gates’ lament that the main impediment to eradicating malaria is a lack of funding, one would think that the Gates Foundation would immediately start making funds available for residual insecticide programs that utilize DDT. After all, experts in the field have testified that DDT is not only effective, but also affordable. When the epidemics are controlled, there will be ample time to find supplemental ways to fight malaria, such as the malaria vaccine that Gates favors. Until then, Gates would be better off putting his foundation’s anti-malaria funds to use in practical, rather than highly theoretical, ways.

Photo of Bill Gates: AP Images