Your Aug. 15 editorial, “An effective, but costly, cure,” properly calls attention to the growing resistance that has made useless current malaria remedies, such as chloroquine. Newer drugs, the so-called ACTs, do not meet resistance and are effective. Further, ACTs will prevent or at least greatly slow the emergence of resistance to the new drugs. But at $2 a treatment, compared with 10 cents for chloroquine, ACTs are very costly for African (and some Asian) countries with annual per capita incomes of $1,000 or less.
As chair of the Institute of Medicine committee whose report [that called for a global fund to pay for ACTs] your editorial cited, I was disappointed in the silence with which the report was received. With about 1 million deaths a year, one would have supposed more of a response. I am now happy to report that the World Bank is making a serious feasibility study of the specific proposals of the Institute of Medicine committee, which were expounded so ably by you. The expertise of the World Bank can be helpful in developing the much-needed specifics to bring our proposals to fruition.
KENNETH J. ARROW
Professor of Economics