Malaria is one of the 21st century’s great plagues. It is responsible for anywhere from 1 to 3 million deaths per year, most of them in sub-Saharan Africa. Efforts to eradicate the disease are mounting: in the year 2000, just 3% of children under 5, in sub-Saharan Africa, slept with mosquito nets; by 2008, that figure had risen to 56%. Aid groups now project that aggressive preventive measures can protect 100% of the population by the end of 2010 and reduce the number of deaths to near zero by 2015.

Doing so requires an aggressive and coordinated effort by governments across the region, in concert with world health experts, the UN’s WHO, aid organizations and local communities. Malaria, originally named “the bad air” because it was thought to be airborne, is actually a water and blood-borne disease, transmitted by a particular variety of mosquito. The scarcity of safe drinking water across much of the region leads to ill-advised practices like leaving whatever standing water one can find at hand for human consumption.

This allows mosquitoes to breed and proliferate. Advanced plumbing, with enclosed water systems, could help prevent the constant rampant spread of the disease, but other measures need to be taken first in order to secure the region’s water resources and ensure equitable distribution, to prevent water-linked trade and military conflicts and the further deterioration of troubled civil infrastructure, the collapse of which favors contagion.

Water-related conflict is an increasing threat to political stability across Africa, and ongoing “low-intensity” conflicts, including some that are taking thousands of lives, undermine basic pillars of organized society, like sustained agriculture, water quality, transport infrastructure, communications infrastructure, electricity and public health contact points. Populations deprived of one or more of these basic services are more likely to suffer from epidemic contagion.

Malaria is a disease that “comes back to visit”, according to Dr. Maghan Keita, of Villanova University, who addressed a gathering hosted by the Blood:Water Mission charity organization, on 19 November 2009, on Villanova’s campus. The Blood:Water Mission event was held to highlight both the gravity of the malaria pandemic, including the millions of deaths, but also to report on promising successes in spreading awareness and prevention to some of the most affected populations.

Dr. Keita, a leading Africana studies scholar who has studied epidemiology and migration in Africa, says sickle-cell anemia and other responses and after-effects of malaria infection can migrate in the blood of people never exposed directly to malaria itself, causing debilitating conditions and even death for some people. The malaria patient can also experience the direct return of the infection, even after it is treated, so prevention is the single most necessary mode of combating the disease in human beings.

LLIN (also known as long-lasting insecticidal nets) and other ITN (insecticide-treated nets) are now the front-line preventive measure of choice across sub-Saharan Africa. They can be up to 100% effective in mitigating the threat of mosquito-borne infection during sleep, not only due to the protective barrier they provide, but also as a result of being infused with insecticidal chemicals that can kills mosquitoes on contact, without endangering the health of human beings using them.

A UNICEF report on the subject notes the need to ensure the pesticides are safe for deployment in such proximity to human beings:

• In all cases, national governments must approve the use of insecticides prior to importing them into the country.
• ITNs, LLINs and insecticide treatment kits are for domestic use and can be handled by family members.
• It is advisable to order untreated nets set-packed with an insecticide treatment kit so that the net can be treated prior to use. It is also important that the user is made aware from the beginning that the net needs re-treatment.
• Each insecticide treatment kit is for the treatment of one ITN and consists of a measured dose of insecticide, a measuring bag, protective gloves and instructions on how to impregnate one net.
• The insecticide is public health grade and WHOPES (World Health Organization Pesticide Evaluation Scheme) approved.

The plant variety artemisia annua, a Chinese wormwood, has been found to have strong anti-malarial properties, and is being planted in Africa in hopes it will take to the sub-Saharan climate, and help produce a potent, locally grown pharmaceutical treatment to prevent or treat malaria. According to USAID:

The fight against malaria increasingly uses Chinese sweet wormwood, but demands for the plant have exhausted supplies, leading USAID to promote new plantings in East Africa.

The Agency is working with the World Health Organization (WHO) to transplant the ancient Chinese remedy to Africa, where the soil and climate are suitable. Artemisinin is the extract of wormwood that is useful against malaria.

Planting of 450 hectares of Artemisia annua began in Kenya in January 2005. In spring 2005, 450 hectares will be planted in Tanzania.

“By this time next year, we will be looking at the extraction of 20 metric tons of artemisinin,” said Dr. Dennis Carroll, malaria expert with the Bureau for Global Health (GH). Malaria kills more than one million people each year.

The artemisia annua shrub appears to have been found to also work against certain parasitic worms that can infect human beings leading to a number of disease symptoms. As reported on the Science and Development Network:

Different forms of bilharzia — also known as schistosomiasis — occur throughout the tropics. Together, they kill 15,000 people each year, according to the World Health Organization.

The disease is caused by five species of worm that enter humans through their skin as juveniles, then mature and reproduce in the blood vessels. The worm eggs are usually evacuated from the body in urine or stools but some remain in the body leading to disease symptoms, which include damage to the kidneys, spleen and bladder.

The plant produces extracts that might be able to help combat parasites that are developing a dangerous resistance to current modes of treatment. The hope is that use of the artemisia extract to fight malaria and/or parasitic worms, could also lead to new research as to how to target and eventually eradicate such disease agents.

It is estimated that as many as 15 million cases of malaria infection were treated by way of artemisinin-based combination therapies (ACT), a “cocktail” of drugs that work in sequence and in concert to destroy the parasites that cause the disease. The WHO reported that by the end of 2006, demand had risen to 150 million cases.

Logistical challenges related to treating 150 million to 200 million cases across dozens of countries are one of the chief remaining obstacles to effective global prevention and eradication of malaria. In many countries the response is fourfold: nets, chemical treatments, drugs and landfill, to eliminate standing water. Only nets are minimally problematic in terms of side-effects and environmental fallout.

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Russian president Dmitry Medvedev has called for sweeping political and economic reforms, designed to make Russia a modern, advanced democratic society. In his state of the nation address, Pres. Medvedev said Russia needs to evolve from being a “primitive” economy based on raw materials and natural resources to an advanced economy based on unique innovative human knowledge. He also said the new Russia needs to be one of “intelligent, free and responsible people”, not one where political bosses dictate policy.

He said Russia’s very survival required overcoming a “humiliating dependence on oil and gas”, leaving behind the authoritarian infrastructure of Soviet-era industry and power. Observers reported that much of the content of his address implied a severe criticism of his predecessor, the current prime minister, Vladimir Putin. Some in the west have speculated if the election of Barack Obama —whose editions of the Harvard Law Review he read while studying— and a newly pro-active US diplomacy have liberated Medvedev to reveal more liberal tendencies than expected of a Russian leader.

Others speculate Medvedev’s sudden declaration of a commitment to rapid and far-reaching pro-democracy reforms might in fact be an effort to liberate himself from the shadow of PM Putin, widely seen as Russia’s premier power-broker and de-facto ruler. By putting Russia on a new course to more humane and democratic standards and a more fair and grassroots modern economic system, Pres. Medvedev in effect announces his opposition to the continuation of the politics of raw power, oligarchy, corruption and the police state.

That last point is perhaps the most problematic: Putin, while president, vastly expanded the power of the executive and of security forces, loading his cabinet with current and former spies. His efforts were sold to th public in a complex and effective but always tenuous dual logic: on the one hand, the people’s government was cracking down on the mafioso abuses of billionaire oligarchs, taking on Chehen militants, imposing order, and at the same time Putin’s power grab and military grandstanding were a nostalgic evocation of the power of Soviet empire.

Implicit in that dual narrative was the recognition of Russia’s long tradition of authoritarian leadership. Some political analysts have gone as fat as to say Putin not only used this to his advantage in terms of nostalgia for past dominance, but actually sought to persuade Russians that his unapologetic consolidation of power was, within Russian political history, a salient legitimizing feature of his exertion of power.

But Pres. Medvedev is of a different generation. He is better positioned, by his coming of age and intellectual development to view rigid authoritarianism as a weakness instead of a strength. But the first truly resonant evidence we’ve seen of this way of thinking was this week’s national address. Medvedev not only called for a more democratic and “intelligent” Russia, strengthened by a free and modern people, but said the colossal state-run industries created by Vladimir Putin would have “no future” in Russia.

Now, just one day after giving the pro-reform speech, Pres. Medvedev has ordered Prime Minister Putin to come up with a plan for restructuring the massive state-run firms he helped create, and which Medvedev now suggests are a threat to Russia’s long-term economic prosperity. Medevedev wants the plan finalized and presented by 1 March 2010. A statement from the Kremlin, issued Friday, reads: “The absence of controls on their activities in a number of cases has led to the inadequate use of state resources”.

As the AFP reports:

During Putin’s 2000-2008 presidency, Russia created an array of massive state corporate “champions” with the aim of spurring growth in sectors such as car manufacturing, aviation, nanotechnology, nuclear energy and arms building.

Many economists however say the sprawling congolomerates are costly to the state and their opaque structure gives huge powers with little accountability to Putin allies like Sergei Chemezov, head of Russian Technologies.

There are indications Putin’s state industry strategy may be coming into focus now more as a different kind of oligarchy, one favoring Vladimir Putin, instead of the end to oligarchy that he has promised. Even as the number of millionaires and billionaires in Russia seems to be exploding, due to waves of new wealth from the raw materials economy (oil and gas, primarily), average Russians are seeing costs of living explode and decent wages harder to come by.

Pres. Medvedev is likely aware of the spreading dissatisfaction, and he also likely needs to craft his own policies going forward in a way that points the finger at those who were in charge throughout the boom and drove the comprehensive restructuring of Russia’s economy to rely perilously on the volatile shifts in world commodities markets. It is no small thing that Medvedev called this dependence “humiliating” and used this context to launch into the public consciousness the idea of a brave new democratic Russia.

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For the first time in decades, the United States Senate has voted to open floor debate on comprehensive healthcare insurance reform legislation. All 58 Democratic members of the Senate, plus the two independents that caucus with them, voted to approve debate. 39 of the 40 Republicans voted against opening debate, except Sen. George Voinovich (R-OH), who did not vote. Though not expected to vote with Democrats today, Maine Republicans Olympia Snowe and Susan Collins were thought to be more conciliatory with regard to passing legislation containing a compromise on the public option, so their no-votes are seen as a further challenge to the Democratic majority.

Many senators were adamant that their vote to approve debate is not a guarantee they will vote to end debate or to approve the legislation. Joe Lieberman continues to threaten a filibuster if he doesn’t like the language regarding a public option, and conservative Democrats Mary Landrieu, of Louisiana, Blanche Lincoln, of Arkansas, and Ben Nelson, of Nebraska, have all said they are not promising to vote for passage. Sen. Bernie Sanders (I-VT), a committed liberal who is demanding a strong public option, has also said he is not predetermining a yes-vote, if the result of debate is a bill he cannot approve.

Senate majority leader Harry Reid (D-NV) has his work cut out for him. He will need to find a way to shepherd the bill through what is likely to be intense and vitriolic floor debate, with threats running rampant and distortions a constant irritant, and produce something that is not just workable but able to win committed support from strict conservatives and staunch liberals in his party, in order to get the 60 votes he needs to break a filibuster and call an up-or-down vote.

There is already an escalating campaign of political pressure by Democratic organizing groups to urge every member of the Democratic caucus to back a floor vote. Where Sen. Lieberman may want to oppose with all his might the public option, he is already being urged by ads, email and calling campaigns, to support the Democratic majority’s right to hold an up-or-down vote on the bill, especially if a majority are committed to the language of the legislation. Sen. Lieberman would be the first senator in history to vote to filibuster his own majority.

Sen. Lieberman has also been accused of lying to support his claim that the legislation under consideration would undermine economic recovery and balloon the federal deficit. He has made claims about analyses by the Congressional Budget Office that are simply different from what the CBO found. While CBO found the bill would reduce the deficit by over $100 billion over ten years, Lieberman says it would increase it; while CBO found it would insure more people and reduce the average premium cost, Lieberman says it will drive costs up.

During the first week after he made his pledge to filibuster the public option, MoveOn.org secured $3.5 million in pledges from its members to stage an electoral challenge against Sen. Lieberman. Other groups are already pressing Democratic leadership to strip the Connecticut senator of his chairmanship of the Homeland Security committee.

Debate is now scheduled to open on Monday, 30 November, the week after Thanksgiving. The Senate is moving at its reputed glacial pace, with healthcare proponents accusing even Democratic leaders of foot-dragging and lack of commitment to passage. Pundits and pressure groups will now turn to the guessing game of what words do wavering Democrats need to hear in order to stir up the strength to vote 60-0 to block a Republican filibuster.

There may also be a continuation of efforts to court Sen. Olympia Snowe, of Maine, whom many Democrats see as an inspirational figure, a principled public servant, and a secret weapon they could use to out-flank both the Republican majority and Sen. Joe Lieberman. Ohio is a battleground state even in the US Senate, and specifically on health insurance reform. The freshman senator Sherrod Brown, a Democrat, is a staunch proponent of a strong public option, while the state’s senior senator, George Voinovich, vehemently opposes the bill and, strangely, for reasons unknown at this writing, was not present to vote.

According to the Examiner:

For Voinovich, who did not vote and who was not in the chamber, the proposed bill “cuts Medicare, raises taxes, increases premiums, hurts states and threatens the health choices that millions currently enjoy,” according to a statement posted on his office Web site that added, “This is not reform, and it is not what the American people are asking for. That is why I cannot support Sen. Reid’s health care bill and will not support the vote on the motion to proceed to the bill.”

But for Brown, who has expressed confidence over the weeks that the bill would indeed include a public option for a government run health exchange that will provide competition to private health insurers, the bill was historic for many reasons. “Passing health insurance reform means that Americans won’t lose health coverage if they change or lose their jobs,” he said in a statement on his office Web site. “It means an end to insurance industry practices that limit medical care or charge higher rates to women or individuals with pre-existing medical conditions. We’re one step closer to lowering costs for small businesses and middle class families,”

Ohio has a higher than average unemployment rate and made headlines last year for having more than 20% of its residents on food stamps, a sign of deep economic hardship from a state economically dependent on industrial production. Brown argues that a strong public option is the only way to bring down private insurers’ soaring fees, while Voinovich —who voted for over $2 trillion of tax giveaways and over $1 trillion in war spending, under George W. Bush— is focused on reducing the deficit and demanding that no new government policy entail any new spending.

Among the key provisions contained in the comprehensive proposed reforms:

• Low-cost exchanges: The legislation would set up a low-cost insurance “exchange”, where individuals and small businesses could choose among a range of options, including a public option states could “opt out” of. States could form larger regional exchanges to expand pool, increase competition, lower costs.
• Minimum benefits: The exchanges would mandate minimum benefits insurers must provide to consumers in four categories of insurance policy.
• Ban on dropping coverage: Immediately, in 2010, insurers would be barred from dropping coverage for existing customers.
• Ban on pre-existing condition discrimination: Starting in 2014, insurers would be barred from denying coverage based on “pre-existing conditions” (the lag-time is presumed to be necessary for the affected firms to reformulate their business model.

• Mandatory coverage: By 2013, most US citizens would be required to secure health insurance in one form or another.
• Assistance for buying coverage: Scaled subsidies would be available to anyone making up to 400% of the official poverty level.
• Reduced out-of-pocket costs: The bill will place limits on how much insurers can charge in deductibles and other out-of-pocket expenses; limits will vary based on income-level.
• Penalties for non-coverage: Fines for failure to purchase insurance to be phased in, starting at $95 per adult in 2014, moving to $350 in 2015 and $750 per adult in 2017. Failure to insure children will incur higher fines.
• Exemptions from mandate: Financial hardship and religious views could permit an exemption from the insurance mandate.
• Young adults: The age for remaining on parents’ health plans would be increased to 26 to help young people secure coverage at low cost.
• Medicaid expansion: Medicaid would be expanded to cover anyone earning up to 133% of the official poverty level.
• No employer mandate: Employers are not mandated to provide insurance, but any business with 50 or more employees could pay fines up to $750 per employee, if any of their workers buy federal insurance options.
• Small business: Tax credits will help small businesses provide coverage to more employees.

• Tax on “Cadillac plans”: Bill will tax expensive insurance policies, with premiums of $8,300 or more per year for individuals and $23,000 or more for families; threshold $3,000 higher for high-risk jobs or high-premium states.
• High-income: Individuals earning $200,000 or more and couples with a combined income of $250,000 or more, would pay 1.95% Medicare payroll tax, up from 1.45%.
• Industry fees: Health insurers will pay collective $6.7 billion annual fee, pharmaceutical companies $2.3 billion, medical device makers $2 billion, with fees allotted in each industry according to market share.
• Bo-tax: Elective cosmetic surgery will see a 5% excise tax applied.

Once floor debate begins, the form of the legislation may change dramatically, as senators will be able to offer and vote on amendments to the legislation. One major sticking point is abortion policy. Conservatives want a strict ban on any government assistance funding any plan that covers abortion; Democrats might be willing to stick to language of the Hyde amendment, which bars federal funds from specifically paying for abortion.

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Healthcare Reform

Two Senate Democrats have pledged not to aid Republicans in blocking a full Senate vote in healthcare reform legislation. That moves the Democratic majority closer to the 60 votes needed to avoid a filibuster and bring the bill to a floor vote that will require only 50 votes plus one. This means the public option is now far mor likely to enter into the final legislation, as majorities in both houses support it.

Recent polling shows an increase in support both for the public option and for the president. Insurers’ sponsored report announcing they would raise rates by 40% over the next few years if reforms are not to their liking is thought to have made the president’s argument for why the public option is a market-based solution, and a necessary one, resonate more clearly with the public.

Sen. Chuck Schumer (D-NY), a key Senate leader working to marshal support for the public option and for healthcare reform broadly, says the Democratic majority is close to winning support from 60 senators to pass comprehensive health insurance reform that includes a public option. A provision that would allow states to “opt out” of a public option is reportedly winning support from conservative Democrats wary of any expanded government involvement in healthcare.

Education Reform

Arne Duncan, the Secretary of Education, has said that “teaching has never been more difficult, it has never been more important” and significant improvements need to be made to the network of institutions that train career teachers. He criticized some education schools as “cash cows” that do “mediocre” work and foster an inadequate standard for professional educators.

Duncan has sought to improve the system’s ability to staff schools with quality teachers, demanding that standards not be limited to specific training requirements or preferred methodologies, but that the aim be to cultivate and hire the best quality teachers.

The Department of Education has an unprecedented amount of increased federal funding, in part from the Recovery Act, as the long-term return on investment is high for education spending, and improved education is vital to both rebuilding communities and fostering a dynamic 21st century workforce.

Nuclear Non-proliferation

The nuclear non-proliferation movement has gained significant ground with the coordinated efforts of Pres. Obama, the UN Sec. Gen. Ban Ki-moon and other world leaders, to forge a framework for total joint nuclear disarmament over the coming decades. The total disarmament paradigm for nuclear policy negotiations has taken root, as the US and Russia agreed this year to cut their stockpiles in half and all 15 Security Council members voted to move toward global disarmament.

Iran has followed through on its pledge to allow IAEA inspectors access to its uranium enrichment facility at Qom, and talks are ongoing to establish a remote processing system that would allow Iran to acquire processed civilian-use uranium from a partner country, where proliferation is not a risk, likely Russia and/or France.

If the Iran deal goes through, and a comprehensive new civilian-use framework can be established, the risk of nuclear proliferation can be significantly reduced across the world, and the military tensions between Iran and the west can also be calmed. The geopolitical logic regarding nuclear weapons is moving away from the presumption that all nations implicitly seek them to an understanding that such projects are related to political and security circumstances.

Military Spending

The last 30 years have seen military spending in the US increase at a rate that is fiscally unsustainable and undermines the solvency of government and its ability to adequately provide for and maintain vital infrastructure and civil services. The Iraq and Afghanistan wars now mean the US spends well over $650 billion annually on its military, more than twice as much as all the nations of the European Union combined —despite the EU’s having a 50% larger population—, and only $85 billion less than half the entire world’s joint military spending.

The $663.7 billion in current annual Defense expenditures is significantly more than double the $305.4 billion requested for the 2001 budget. An aggressive militaristic foreign policy, open contemplation of a deliberate nuclear arms race and wasteful spending on flawed and over-budget “weapons systems”, not to mention corruption and no-bid contracts, in recent years, have inflated the Pentagon budget massively, without producing the desired improvements to conditions on the ground for US soldiers or for the people living where we fight our wars.

Intelligent, politically delicate decisions have been made, to scrap failed over-budget weaponry, plan a more efficient, vast and flexible missile defense system, and move toward a zero-nuclear multilateral security posture that will allow increased security with smarter spending that does not keep growing out of control, all while focusing more resources on the welfare and service of soldiers. The F-22 fighter jet program will be de-funded, after outstanding orders are filled; the program had been extremely costly and had not produced any specific tactical or strategic benefit.

Energy & emissions reform

Congress has spent a significant amount of time this year debating language that will go into a major climate bill. In an historic vote, the House of Representatives passed its version, the American Clean Energy and Security Act, in June, by a narrow 219 to 212 margin. That bill would require that the nation derive at least 15% of its overall electricity consumption from renewable resources by 2020.

Wind and solar power have seen a boom in private and public investment in 2009. $8 billion has been set aside for automakers developing new battery technologies for electric vehicles (EV), and Texas is poised to reach 50,000 megawatts of wind-generating capacity when current projects are built and operational. New Jersey’s aggressive funding for solar panels makes it the second state nationwide in solar generating capacity.

While the Waxman-Markey bill in the House aims to achieve 17% reductions from 2005 levels by 2020, with an 80% reduction by 2050, the Senate’s Boxer-Kerry bill calls for a 20% reduction below 2005 levels by 2020. These targets are weak, given the estimated required reductions given by the Intergovernmental Panel on Climate Change (IPCC) to prevent a 2°C rise above preindustrial levels —40% emissions reduction below 1990 levels by 2020—, but the Senate bill would give the EPA expanded authority to regulate emissions.

Financial regulatory reform

There is a renewed push for major financial regulatory reforms, even as prosecutors begin looking into what could be a rash of persistent, systematic insider trading at some hedge funds. Financial fraud investigators in the FBI and the SEC say they need more funding and larger regular staffs to be able to adequately police the most complex and pervasive financial crimes.

The Federal Reserve Bank has been given expanded authority to lend to businesses directly in an effort to both restore confidence in the credit system and establish standards for lending that commercial lenders will have to follow. The Fed also seeks expanded oversight powers that would allow it to track how financial institutions handle and back-up certain types of investments.

The proposed financial regulatory reforms, at the urging of Pres. Barack Obama, will establish a Consumer Financial Protection Agency (CFPA), designed to ensure consumers are not subjected to misleading or even predatory lending practices. This watchdog agency is considered the key to effective financial regulatory reform and a primary means of guaranteeing that financial crimes against ordinary people will be caught or prevented.

Immigration reform

Immigration reform legislation will likely not come until next year, as the emotional issue of undocumented immigrants, which involves tax policy, basic human rights, and the human-trafficking cartels, cannot be permitted to interfere with the process of comprehensive healthcare reform. Republican opponents of both have consistently tried to link them as part of a reckless plan to transfer the nation’s wealth to “illegal aliens”.

But a national day of action and awareness on immigration reform has renewed the political pressure to move forward. Immigration reform actually impacts other major reform plans, because undocumented workers who are unable to earn money through the official economy are also unable to register for income and social security taxes, or acquire bank accounts, establish reliable addresses, set up savings or investment plans of any kind or buy health insurance.

Each of these disadvantages for the individual worker may cost the overall economy in opportunity costs — wealth not generated, businesses not started, health issues untreated, which can ultimately cost far more to treat. From an economic standpoint, it is not clear that anything less than regularizing the status of undocumented but employed immigrants would help close important revenue gaps for federal spending.

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