Carnage on the roads v good news on malaria and guinea worm disease (and a brewing Opium War on Tobacco)

January 27, 2014

     By Duncan Green     

This week’s Economist resembles a reader on some of development’s top Cinderella issues (which are becoming a bit of a thing on this blog), covering road traffic, ‘tropical diseases’ and tobacco.

First up, the contrast between the falls in road deaths in rich countries (deaths there peaked in the 1970s), and rising carnage in the RTAs v tropical diseasesdeveloping world. New WHO stats provide a graphic account – at 1.3 million a year, deaths from RTAs (road traffic accidents) in poor and middle income countries have overtaken TB and malaria and will match those from HIV/AIDs by 2030. (see graph)

From the accompanying editorial,

‘The vast majority of victims die in poor and middle-income countries—1.2m in 2011, compared with 99,000 in rich ones. For every 100,000 cars in the rich world, fewer than 15 people die each year. In Ethiopia the figure is 250 times higher.

The cost of averting a death or injury using speed bumps at deadly junctions in sub-Saharan Africa is a piffling $7; fences between cars and pedestrians in Bangladesh, $135. Yet few places tackle road deaths with the same determination as infectious diseases, and charitable donations are a tiny fraction of the $4 billion promised annually to fight HIV/AIDS, malaria and tuberculosis.’

And from the main piece:

‘Where incomes are low, for example in Bangladesh and Kenya, pedestrians top the body count. As they rise, so does the use of motorbikes—often for the precarious transport of entire families. In Thailand motorcyclists are more than two-thirds of fatalities. A bit richer still, and four wheels dominate. In Argentina, Russia and Turkey the main victims are inside cars, buses and lorries.

In the Nesco school in Kibera, Kenya’s largest slum, the children recently received government-funded vaccinations for measles and polio. And aid donors have pledged $600m to fight HIV/AIDS, tuberculosis and malaria in the country in the next few years, and $4 billion globally. But with multi-lane highways to navigate on the way to school, and a lack of safe crossings, a quarter of the pupils have been in a road crash and a third have seen a close relative injured or killed. A little more spent on road safety would help more children in Kibera, and across the developing world, make it safely into adulthood.’

Global Fund for Speed Bumps, Seat Belts and Sidewalks anyone?

In contrast, some encouraging news on malaria and Guinea Worm Disease (dracunculiasis). On malaria, Chinese researchers led by Li Guoqiao, of Guangzhou University of Chinese Medicine,

‘turned a Chinese herbal treatment for the disease into artemisinin, one of the most effective antimalarial drugs yet invented. Now he is supervising experiments in the Comoros, using a combination drug therapy based on artemisinin, to see if malaria can be eradicated from that island country. If it works, he hopes to move on to somewhere on the African mainland, and attempt to repeat the process there.’

Guinea Worm diseaseGuinea Worm Disease is a debilitating, if rarely fatal, disease that 25 years ago affected about a million people. A campaign, led by the Carter Center, has got that down to just 148 known cases, mostly in South Sudan (see graph).

And a bit more good news from China, on tobacco, which kills about 5.5 million people in developing countries every year (4 times the toll from RTAs):

‘This month health officials in China, home to more smokers than any other country, called for a ban on smoking in public places. That would mainly affect state-owned China Tobacco, which has a near-monopoly. But multinationals’ shares wobbled anyway: the proposed crackdown could portend tighter regulation elsewhere.’

In a 21st Century remake of the Opium Wars, the battle between Big Tobacco and developing country governments will be fought out through trade negotiations, international courts and backdoor diplomacy, as well as public campaigning. Definitely one to watch.

January 27, 2014
Duncan Green