A Few Dollars at a Time

How to Tap Consumers for Development

Courtesy Reuters

Starting in this quarter, hundreds of millions of people will have an unprecedented opportunity to help the world's most unfortunate inhabitants. When purchasing airline tickets through most major reservation Web sites or through a travel agent, consumers will be asked if they want to make a direct contribution to the fight against the world's three deadliest epidemics: HIV/AIDS, malaria, and tuberculosis. Part of a movement called innovative financing, the project is a new kind of aid that could fundamentally change the relationship between the rich and the poor throughout the world, a few dollars at a time.

Awareness about the epidemics that rage throughout the developing world occasionally crests in the international media when there is an outbreak, as there was of the Ebola virus in the 1990s and of dengue fever in the first years of this century. These periodic outbreaks usually subside within a year or two, or at least are contained before they become pandemics. The HIV/AIDS, malaria, and tuberculosis epidemics have shown more staying power, however, and even now, after years of attention and treatment, each of these diseases still causes more deaths in developing countries than any other single disease, according to the World Health Organization. In 2004, the last year for which statistics were available at the time of this writing, together these three diseases caused one in eight deaths in low-income countries.

Part of the reason these diseases are so harmful is that they reinforce one another. Hundreds of millions of people around the world have latent tuberculosis infections. In most cases, tuberculosis never becomes active, but the disease is much more likely to explode into a full-blown infection, and the infection tends to be much more severe, in people who also have HIV/AIDS. Even those without latent tuberculosis are more susceptible to getting the disease if they already have HIV/AIDS. This is partly because HIV/AIDS suppresses the immune system -- which also means that it is harder for people

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