Monday, February 19, 2007

NICHOLAS D. KRISTOF: Let’s Start a War, One We Can Win

AFETA, Ethiopia

They were two old men, one arriving by motorcade with bodyguards and the other groping blindly as he shuffled on a footpath with a stick, but for a moment the orbits of Jimmy Carter and Mekonnen Leka intersected on this remote battlefield in southern Ethiopia.

Mr. Mekonnen, who thinks he may be 78, is a patient in Mr. Carter’s war on river blindness. He is so blind that he rarely leaves the house any more, but on this occasion he staggered to the village clinic to get a treatment for the worms inside him.

His skin is mottled because the worms cause ferocious itching, especially when they become more active at night. He and other victims scratch until they are bloodied and their skin is partly worn away. Ultimately the worms travel to the eye, where they often destroy the victim’s sight.

Ethiopia has the largest proportion of blind people in the world, 1.2 percent, because of the combined effects of river blindness and trachoma. As in many African countries, the wrenching emblem of poverty is a tiny child leading a blind beggar by a stick.

As Mr. Mekonnen waited on a bench by the clinic, there was a flurry of activity, and an Ethiopian announced in the Amharic language that “a great elder” had arrived. Then Mr. Mekonnen heard voices speaking a foreign language and a clicking of cameras, and finally the whirlwind around Mr. Carter moved on.

“Do you know who that was?” I asked Mr. Mekonnen.

“I couldn’t see,” he replied.

“Have you ever heard of Jimmy Carter?”

“No.”

Yet in remote places like this, former President Carter, at 82, is leading a private war on disease that should inspire and shame President Bush and other world leaders into joining. It’s not just that Mr. Carter’s wars have been more successful than Mr. Bush’s; Mr. Carter is also rehabilitating the image of the U.S. abroad and transforming the lives of the world’s most wretched peoples. (For a video of Mr. Carter’s trip, please go to www.nytimes.com/ontheground.)

On the previous night, Mr. Mekonnen had slept under a mosquito net for the first time in his life, as part of a Carter initiative to wipe out malaria and elephantiasis in this region. And Mr. Mekonnen now uses an outhouse as a result of a Carter Center initiative to build 350,000 outhouses in rural Ethiopia to defeat blindness from trachoma.

Mr. Carter has almost managed to wipe out one horrific ailment — Guinea worm — and is making great strides against others, including river blindness and elephantiasis. In this area, people are taking an annual dose of a medicine called Mectizan — donated by Merck, which deserves huge credit — that prevents itching and blindness.

Mectizan also gets rid of intestinal worms, leaving Ethiopian villagers stronger and more able to work or attend school. Among adults, the deworming revives sex drive, so some people have named their children Mectizan.

Mr. Carter’s private campaign against the diseases of poverty, put together with pennies and duct tape, is a model of what our government could do. Imagine if the U.S. resolved that it would wipe out malaria and elephantiasis (both are spread by mosquitoes, so a combined campaign makes sense). What if we celebrated science not by trying to go to Mars but by extinguishing malaria? What if we tried to burnish America’s image abroad not only with press releases and propaganda broadcasts, but also with a bold campaign against disease?

So I wish that President Bush could visit villages like this and see what Mr. Carter has accomplished as a private individual. Mr. Bush, to his great credit, has financed a major campaign against AIDS that will save nine million lives, and he is also increasing spending against malaria — but not nearly as energetically as he is increasing the number of troops in Iraq. So I asked Mr. Carter whether President Bush should be pushing not for a possible war with Iran, but for a war on malaria.

“That would certainly be my preference,” he said. “I thought the war in Iraq was one of the worst mistakes our country ever made, and we’re possibly about to make an even worse mistake by precipitating a war with Iran. But I would like to see us shift away from war being a high priority, to diplomacy and benevolent causes.”

So, President Bush, how about if we as a nation join Mr. Carter’s war on diseases that afflict the world’s poorest peoples — and are one reason they are so poor. That’s a war that would unite Americans, not divide them. Come on, Mr. Bush, sound the trumpets!

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