Tomorrow the White House hosts a summit on malaria to explain how the president's team is spending the $1.2 billion tax dollars pledged. The President's Malaria Initiative, launched in summer 2005, is unusual because, at least so far, it actually is delivering on its promises to assess malaria cases and then use the most effective methods to combat the disease. The PMI distinguishes itself from a long list of American and international aid failures.

Resident Fellow Roger Bate
Resident Fellow Roger Bate
Indeed, making taxation policies attractive to the center-right is often easier, at least in Europe, if the funds raised are shown to help the poor and sick. UNITAID is an instructive example of such political opportunism. Set up by France, Brazil, Chile, Norway, and the United Kingdom, UNITAID raises money from a tax on European air travel with which it subsidizes an international drug-buying facility to improve access to drugs in poorer parts of the world. Last week, on behalf of the Clinton Foundation, Bill Clinton negotiated lower anti-AIDS drug prices. He was able to do so because UNITAID promised to subsidize the program by purchasing $35 million worth of drugs.

Gordon Brown, Britain's chancellor of the exchequer, recently launched a $4 billion 10-year immunization program for 500 million poor children around the globe, which will be partly funded by air travel tariffs. Mr. Brown, who is focused on becoming prime minister, called his gesture "probably the best Christmas present for every child in the world," contributing toward the promises made at last year's G8 summit. "We have it in our power, in this world, to prevent these diseases of polio, tuberculosis, of diphtheria, of tetanus. It is possible to do this."

This all seems worthwhile, until one looks more closely at the history of similar efforts. Michela Wrong, a New Statesman columnist and author of books on Africa such as In the Footsteps of Mr. Kurtz and I Didn't Do It For You, warns about implementing such programs on that continent: "While worthy in intent, it comes across as lordly and top-down, treating African governance as of virtually no relevance in determining the continent's future. Once again, a piteous, passive continent will be saved by the generous, wealthy West."

AIDS treatment and polio vaccination programs are two examples where misguided charity can make things worse.

Polio vaccination is a miracle. There is no need for an injection, just suck on a vaccine-encrusted sugar cube and you're protected for the next decade. Yet, outside almost any African airport or Indian tourist attraction, you will see muscular upper bodies moving with acrobatic abilities on their hands--a novelty until you realize they have no legs. These are the crippling results of polio. How did this come about?

When a World Health Organization campaign was launched in 1988 to eliminate polio from the 123 countries still afflicted, it almost succeeded. By 2003 only seven countries still had cases and the end was in sight.

But clerics in the Islamic state of Kano, in northern Nigeria, counseled parents against the vaccination, proclaiming it an American plot to sterilize Muslim youth and give them HIV. When Muslim parents obeyed, the southern-based and largely Christian Nigerian government refused to demand vaccination in the north, since it did not want to create religious tension. And now Nigeria has over 70% of the world's cases and is rapidly exporting polio. Ms. Wrong explains, "After the boycott it skipped from Nigeria to Ivory Coast, from West Africa to Sudan, then across the Red Sea into Saudi Arabia and Yemen--polio-free for a decade--even jumping continents to surface in Indonesia. Since the 2003 boycott, about 25 countries previously declared polio-free have been reinfected."

Aware of this history, Mr. Brown is trying to persuade religious leaders to endorse future vaccination programs. But Mr. Brown still misses the bigger picture by fretting over how much the West will give rather than how well the funds will be used.

Unfortunately, Mr. Clinton makes the same mistake. Advised by left-of-center advocates, he focuses on the price of drugs, which is an understandable but particularly Western concern, rather than on all the other factors that impede delivery of AIDS drugs: lack of medical infrastructure, shortage of trained staff, and the immobility of poor populations. By concentrating only on price, he supports Indian drug-copying companies, whose products often are inferior, and thereby undermines Western, mainly American, firms that now develop nearly all anti-AIDS drugs.

Worse still, I witnessed patients in Zimbabwe failing to respond to the inferior Indian drugs. Undoubtedly, such resistance is occurring in other African nations as well. Yet Mr. Clinton continues, regardless of such failures.

Until programs to combat AIDS are driven by the African governments themselves, albeit with help from the West, they will continue to fail, irrespective of what we in the West want. Ms. Wrong aptly sums it up:

"Afflicted by a strange form of megalomaniac magnanimity, the West continues to assume it can deliver peace, prosperity--and now good health--to Africa pretty much irrespective of African participation.… The polio story shows just how bizarrely misguided that assumption is."

Roger Bate is a resident fellow at AEI.

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