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of diarrheal diseases fell only on countries with per capita incomes less
than $6,000 per year. I went back to examine the projections underly-
ing the DICE model, which include a set of regional estimates for sub-
Saharan Africa. Combining these with detailed regional data, the model
estimates the fraction of the African population with income below the
$6,000 threshold for the recent past and in the future. Whereas more
than 90 percent of the population fell below this threshold in 2000, the
model projections indicate that only about half will fall below this thresh-
old by the mid-twenty-fi rst century. By this century's end, less than 10
percent of the African population is projected to be below the $6,000
threshold. 11
Although these are just estimates, they have the advantage of being
consistent with the assumptions of the integrated-assessment model
used to predict the temperature increases. So the estimates of growing
malnutrition and related diseases in the climate-health scenarios are
incompatible with the estimates of growing incomes that produce the
very emissions that lead to the rapid warming.
The projected incidence of malaria provides another example of a
pessimistic bias in the WHO study. The IPCC Fourth Assessment Report
states that by 2100, there will be a 16-28 percent increase in exposure
to malaria in Africa. 12 These proportions are slightly higher than those
used in the estimates in Table 3. However, these estimates assume that
there are no socioeconomic adaptations in the coming years. This as-
sumption is contrary to the view among public health researchers that
poverty is a substantial contributor to the incidence of malaria. With
higher incomes, people tend to move from mosquito-infested rural ar-
eas to cities. Higher incomes also enable people to pay for insecticide-
treated bed nets, kidney treatment, and antimalarial drugs. 13 Moreover,
the projections would be completely wrong if medical research over the
next century were to produce an economical malaria vaccine or treat-
ment. We might be skeptical about Bill Gates's patent to reduce hurricane
intensity (see Chapter 6), but surely the Gates Foundation's program to
eradicate malaria should be taken seriously.
These examples suggest that many of the serious health impacts of
climate change are likely to be manageable and managed in a world of
 
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