Tuesday’s New York Times prominently featured an article describing the debate in the public health community about what are appropriate goals for the fight against malaria. Goals for fighting malaria vary between improving access to control and prevention measures and full eradication of the disease. Full eradication of the disease would mean that no person has the disease, but also that it exists nowhere, except as the New York Times notes, in a laboratory. This was last accomplished with smallpox when the last naturally occurring case of smallpox was recorded in 1977 in Somalia. Smallpox was certified eradicated in 1980.

The most recent round of discussions were sparked late last year when Bill and Melinda Gates called for a push towards eradication at a conference they held in Seattle. Despite the excitement created for such an initiative, the announcement enlivened debate among the scientific community about whether eradication is a realistic goal to set for the community and the potential disappointment of setting the goal and not reaching it. Smallpox had a unique set of credentials that made it a candidate for eradication, including that it could only be carried by humans rather than be primarily carried by mosquitoes in the case of malaria.

The past several years have seen a rapid increase in funding for fighting malaria. Spending from the United States, the Global Fund and World Bank on malaria from 2001 to 2003 was only $348 million. From 2004 to 2006, this number rose to just over $1 billion. The current version of the PEPFAR bill just recently agreed to in the House called for $5 billion in spending on malaria over the next 5 years from the United States alone. This would fund the United States’ proportionate share of the global estimates to achieve universal access to control and prevention for those living in endemic countries. Senators Clinton, McCain, and Obama have all committed to significantly ramp up the United States’ spending on malaria if elected president.

Though the debate about eradication versus control is one that is largely restricted to academic settings and concerns about setting realistic expectations, it is one that is likely to increasingly play out in the public discourse as the United States moves to spend more on fighting this disease.

The ONE Campaign launched the new web site On The Record, which presents the plans of presidential candidates to end global poverty.  The videos are a result of hundreds of thousands of emails, phone calls, and letters sent to politicians demanding they put their plans to end poverty and achieve the MDGs on the record for everyone to see.

A great feature of the site is the ability to compare the action plans of politicians together side by side.  How does Rudy Giuliani's plan to end HIV/AIDS compare with Barak Ombama's? 

You can take part in the ONE Campaign by signing the On the Record Petition.  By getting every candidate to outline their plans to end global poverty, we will be able to hold whatever candidate becomes president in 2008 accountable to their promises.

This week in Seattle, an extraordinary group of people – scientists, policymakers, and advocates – came together for three days to discuss what can be done to stop malaria. Melinda and I issued a challenge to those attending the meeting. We asked them to begin charting a course to eradicate malaria – not just to control or reduce it, but to work toward a time when no one on earth is infected with malaria, and no mosquitoes carry the disease.

Today, malaria kills more than one million people every year, most of them children in Africa. That’s the equivalent of losing every student in the New York City public school system in one year.

We know that eradicating malaria is an audacious goal. But advances in science and medicine, new political commitments, and the dedication of people like you have given the world an historic opportunity to conquer malaria. It won’t be easy and it won’t happen quickly, but I’m optimistic that we can make this disease history.

At the forum in Seattle, Melinda and I called on the U.S. presidential candidates to commit to expand the President’s Malaria Initiative, a great program started by President Bush. I hope you will join us in asking all of the candidates to make this pledge and keep the fight against malaria on the national agenda.

I am confident that together, we can produce the energy, compassion, and commitment needed to win the fight against malaria.

“No one should die of malaria. We are here to save people from dying of malaria,” said former US President Bill Clinton in Dar es Salaam on Tuesday.  He was in the Tanzanian capital to speak at the launch of an Artemisinin based Combination Therapies (ACT) pilot program. 95 % of the drug cost will be subsidized to make the drug available to even the poorest people.

The program is a joint effort of the Clinton Foundation for HIV/AIDS Initiative joins, the government of Tanzania, Population Services International (PSI) and receives support from the Bill and Melinda Gates Foundation.

In the two pilot regions, an ACT dose  will be available for about 25 dollar cents in government hospitals, compared to 10 dollars at private chemists.

The news media is in a big kerfuffle over reports of a new genetically modified mosquito that is resistant to malarial parasites and all the stronger than wild mosquitoes for it. Sounds perfect, right? Stronger mosquitoes resistant to disease would easily eclipse those weaklings who fall prey. Release enough of them into the wild and soon enough there'd be no more malaria.