Good New: Karlo Will Live

By NICHOLAS D. KRISTOF
Published: March 6, 2008
From The New York Times

NUBA MOUNTAINS, Sudan

The farm families living in these rocky hills in central Sudan confront every disease imaginable, from leprosy to malaria, and perhaps one-quarter of children die by the age of five.

Yet this is a “good news” column. Karlo will live.

The number of children who die worldwide each year before the age of five has dropped below 10 million for the first time in recorded history — compared with 20 million annually in 1960 — Unicef noted in a report last month, “Child Survival.” Now the goal is to cut the death toll to four million by 2015.

Think about that accomplishment: The lives of 10 million children saved each year, 100 million lives per decade.

To put it another way, the late James P. Grant, a little-known American aid worker who headed Unicef from 1980 to 1995 and launched the child survival revolution with vaccinations and diarrhea treatments, probably saved more lives than were destroyed by Hitler, Mao and Stalin combined.

One of the lives saved this year seems to be that of Karlo, an 8-month-old baby boy who lives in a thatch-roof hut here. His older brother, Kuti, had died a few days before I arrived: Kuti was taken to the hospital and tested positive for malaria, but the doctor believed that he probably died from meningitis.

Then Karlo fell sick, and his mother was frantic at the thought that he would die as well. The father, Bolus Abdullah, was more fatalistic.

“Many children die here,” Mr. Bolus explained to me as volunteers with an American aid group, Samaritan’s Purse, drove the family to the nearest hospital over a fantastically rutted road. “But if that’s the will of God, then there’s nothing we can do.”

Yet there are things we can do — and that brings us to the American presidential campaign.

African children like Karlo may actually have more at stake in the outcome of the presidential election than children in the United States. Just imagine if the next president were to wage a serious war on malaria. At a tiny fraction of the cost of the war in Iraq (or a war on Iran!) such a campaign would save millions of lives and be a huge boost to African economies whose productivity is sapped by diseases.

The hospital to which we took Karlo is run by an aid group, German Emergency Doctors, and is run by a husband-wife team of physicians, Karl Eiter and Gabi Kortmann. The hospital, whose “wards” are thatch-roof huts with no electricity, is perched on a rural mountainside to protect it from aerial bombings by the Sudanese government. (Sudan’s main involvement in health care in contested areas like this has been to strafe hospitals.)

Dr. Eiter ordered a blood test for Karlo, and it came back positive for malaria. He gave Karlo a medication that is almost always effective against malaria here, artemisinin combination therapy, costing just 50 cents for an entire course of treatment.

Saving children’s lives in rural Africa or Asia, where millions die of ailments as simple as diarrhea, pneumonia or measles, is achingly simple and inexpensive. The starting point is vaccinations and basic sanitation.

“We never have all the vaccines that are required,” Dr. Eiter said.

For years, the rationale for opposing foreign assistance has been that it doesn’t work. It’s true that humanitarian aid is devilishly difficult to get right, money is squandered and the impact of aid is often oversold.

But President Bush’s record underscores that other policies are difficult to get right as well: Iraq is a mess, and social security reform and immigration reform both failed. Mr. Bush’s greatest single accomplishment is that his AIDS program in Africa is saving millions of lives.

That makes it all the more stunning that Mr. Bush’s proposed budget for 2009 cuts U.S. funding for child and maternal health programs around the world by nearly 18 percent.

Fortunately, all the candidates are saying the right things about malaria, AIDS and support for education in Africa (although John McCain is fuzzier about commitments). You can compare the candidates’ positions on global humanitarian issues at www.onevote08.org.

Voters should remember this: A president may or may not be able to improve schools or protect manufacturing jobs in Ohio, but a president probably could help wipe out malaria. Compared with other challenges a president faces, saving a million children’s lives a year is the low-hanging fruit.

Karlo, bouncing in his mother’s lap, underscores the hope. With the medicine, he recovered quickly and was sent home from the hospital after a few days. The news here is simple and giddy ... he’s alive!