Not long ago, an experimental malaria vaccine made newspaper headlines. Over six months, it more than halved serious episodes of malaria in 2,000 children in rural Mozambique. The only trouble is that it will take at least 10 years to come to market.

Fortunately, there are new, effective drugs already available that could start to loosen malaria's stranglehold on many impoverished countries. With a modest global investment, these drugs could be mobilised today.

Malaria is one of the world's greatest threats to life and human performance. Each year, it kills more than 1m people, mainly children in sub-Saharan Africa, and triggers some 500m debilitating attacks in people of all ages throughout the tropics. The toll in lost productivity is a big contributor to Africa's poor economic performance.

All concerned with malaria know that new drugs are needed. After the second world war, a drug called chloroquine became standard. Until about 20 years ago, it worked well in Africa. In addition, it was cheap, averaging 10 cents per treatment. However, chloroquine-resistant strains, which first emerged in south-east Asia, are now rife throughout Africa. The death toll from malaria is rising once again.

What makes this situation more distressing is the existence of an effective alternative. When the first signs of drug-resistant malaria appeared in Asia during the Vietnam war, Chinese scientists developed a family of drugs from sweet wormwood, a common shrub that had been used for centuries in traditional medicine. These "artemisinin compounds" are now standard components of malaria treatment in Asia, where they have proved to be the best ever anti-malarial drugs. To circumvent future drug resistance, however, the time has come to partner artemisinins with other anti-malarial drugs, creating artemisinin combination therapies (ACTs) - the same strategy that underlies the treatment of HIV and tuberculosis. In 2002, the World Health Organisation went on record urging governments to adopt such therapies rapidly in order to provide more effective malaria treatment and slow the spread of drug resistance.

Now the only remaining obstacles to these treatments in Africa are economic. At present, ACTs cost about $2 a treatment, not 10 cents. Subsidies are needed - probably in the region of $500m a year, a small amount on any global scale. The other challenge is how this money enters the drug supply chain.

To overcome the need for a new system of delivery, a recent report from the Institute of Medicine, the US-based health advisory organisation, recommended that ACTs be bought at competitive prices by an international organisation such as Unicef, then resold at a deep discount to governments and private wholesalers in countries where malaria is endemic. The main condition underlying access to subsidised ACTs would be that they flow freely through public and private channels - just as chloroquine does now. This approach would accomplish two objectives: it would allow the existing private market to support the switch to ACTs and it would keep the treatment's cost to consumers down to about the price of chloroquine.

Centralised purchasing has other advantages. It would assure a market for producers, and in particular would encourage the planting of sweet wormwood to overcome the existing reported shortage of artemisinin. It would also facilitate quality control. Moreover, the scale of any international subsidy of combination therapy would discourage the distribution of any solo drug whose use might encourage new resistance down the line.

Above all, in the case of anti-malarial drugs, centralised purchasing would provide the impetus for a swift change in the way the world treats malaria. Without a co-ordinated programme, the change is far more likely to be gradual and incomplete, the scenario most likely to jeopardise the effectiveness of artemisinins over the next few years.

There can be no excuse for delay. Resistance is overwhelming the usefulness of existing drugs, and deaths due to drug-resistant malaria are accelerating daily, especially among the poor of Africa. The IOM has proposed a feasible plan to introduce ACTs quickly. All that remains is for the international donor and finance communities to embrace the logic, allocate funds and take action once and for all against malaria.

The Presidential election campaign is in the home stretch. Neither the President nor Senator Kerry has secured a decisive advantage.

Iraq is now the central issue of debate, as one would expect, since the war is going badly, and the economy is reasonably robust. The debate is finally beginning to focus on substantive differences between the candidates after a summer in which they mainly exchanged personal attacks on their respective Vietnam records. Their strategies are now clear: Bush will challenge Kerry's steadiness and consistency; Kerry will challenge the necessity of the campaign in Iraq and the competence of the administration's efforts there. But while their diagnoses of the situation differ, their proposals for dealing with what is clearly a mess are not so clearly differentiated. Both propose to seek additional help from members of the international community; both emphasize the need to train and arm Iraqi security forces; and both are hopeful that elections will enhance the legitimacy of Iraqi leaders, fortify their efforts to dry up the insurgency, and allow American forces to be reduced and eventually withdrawn.

Historically, wars have been unkind to presidents on whose watch they occurred. The Korean War reduced Harry Truman's popularity so dramatically by 1952 that he gave up his quest for a second full term. The Vietnam War drove Lyndon Johnson from office, despite impressive domestic achievements. Victory in the Gulf War of 1991 sent George H.W. Bush's approval ratings soaring, but within a year he was defeated by an obscure Arkansas governor.

Yet President Bush still clings to a narrow lead in the polls. Why?

Senator Kerry has argued that the Iraqi campaign is a "war of choice." Perhaps so. But Osama bin Laden issued a fatwa declaring war on the United States nearly a decade ago. Whatever the outcome in Iraq, war with Islamic extremists will continue. And American voters remain nearly evenly divided as to whether John Kerry has the steadfast character and consistent judgment they want in a wartime leader.

Uneasiness about the financial and human costs of the war is growing. Casualty figures in Iraq are high compared to the numbers killed or wounded in post-cold war American interventions in Somalia, Haiti, Bosnia, and Kosovo. Yet, those earlier conflicts involved humanitarian interventions in which Americans perceived little strategic stake. However, military personnel killed in Iraq - now more than 1000 - still number less than a third of the civilians who perished in New York and Washington on 9/11. And ours is a volunteer military that is highly motivated.

When confronted by an attack, Americans have consistently taken the fight to the enemy, engaging them in combat as far from our shores as possible. The president has portrayed the campaign in Iraq as an integral feature of the war on terrorism. To at least a number of voters, the absence of any terrorist attacks in the United States since 9/11 provides evidence that his approach, while not without significant costs, is working.

Victory at the polls may be a dubious prize. Whoever is sworn in on January 20, 2005 will face daunting choices. American options in Iraq range from the "potentially disastrous" to the "extremely distasteful." We cannot simply walk away. And a host of other dilemmas - e.g. nuclear crises in Iran and North Korea, a Middle East peace process that has gotten off track, strains in the trans-Atlantic relations, a multilateral trade round that has lost momentum - demand urgent attention. Beyond this, the next president will be hampered by a gigantic fiscal deficit and a military that is stretched thin. In short, he will have few easy choices. It makes one wonder why politicians yearn for this job.

JAKARTA, Indonesia - Even here in Indonesia, where there is a strong tradition of tolerance, there is a war going on between radicals and moderates for Muslim hearts and minds. You can see that war in the police armed with automatic rifles, manning anti-vehicle barriers in front of my hotel and every other large Western-linked building in Jakarta. In August, Islamist terrorists blew up a suicide bomb in front of the Marriott Hotel here and are threatening to hit a long list of targets that includes schools attended by Western children. These are the same bombers who killed more than 200 people in Bali last November. The war is being fought on Indonesia's campuses, particularly secular universities where students are intrigued by radical Islam. Activists from Indonesia's liberal Islamic movement disdainfully call them "born-again Muslims'' and hold provocative campus forums with titles like ``There is no such thing as an Islamic state.'' At a religious boarding school in Yogjakarta, one of tens of thousands of pesantran spread across this vast country, they teach that the Koran is to be understood, not just rotely chanted in Arabic. "We are not frozen in those Koranic verses,'' director Tabiq Ali said. ``Interpretation depends on our own thinking.'' You can even see the war in a steamy best-seller about a Muslim woman whose faith was shattered by the hypocrisy of Islamic radicals who preached righteousness while sleeping with her. The subject of the book, a Yogjakarta university student, now fears retribution. This is a war we cannot afford to see lost. Indonesia is not only the largest Muslim nation in the world, but it could also become a base for radical Islam to spread throughout Southeast Asia. Alternately, Indonesia's struggling democracy could set an example for others in the Muslim world. "You have all the ingredients that could make this place the first Muslim majority democracy that works,'' says Sidney Jones, a leading expert on Islamic terrorism in Southeast Asia. ``And you have all the dark forces eager to push Indonesia in the opposite direction. The question is where does it come out.'' What can the United States do in this war? So far our efforts have focused almost entirely on aiding the pursuit of Jemaah Islamiyah, a Southeast Asian terrorist group linked to al-Qaida. Initially, the government denied it had a home-grown problem and was wary of seeming to follow American dictates. But after the shock of the Bali and Marriott bombings, the authorities have captured many of the terrorists and successfully prosecuted them. Ultimately, however, Indonesia needs to build a modern society. While the rest of Asia, from India to Vietnam, vibrates with the energy brought by the information technology revolution, Indonesia feels like a stagnant backwater. Its economy limps along, plagued by poverty and corruption. The key is a woefully underfunded educational system. Unlike Pakistan's madrassah system, the religious schools are integrated into the state system, and many offer a secular curriculum along with religious teaching. But in the pesantran that I visited, one in a city center and the other in the countryside, I found classrooms that offered little more than whitewashed walls and wooden desks. Computers are few in number and science labs primitive, if even existing. State schools are better equipped but still backward. Why not wire every school to the Internet, build science labs and, most importantly, train teachers? A recent report on U.S.-Indonesia relations by the U.S.-Indonesia Society and Stanford University's Asia-Pacific Research Center urged a significant effort to fund education. President Bush picked up on that idea, announcing a U.S. educational aid program during his October stopover here. But he alarmed Indonesians by tying the initiative to the war on terror. The U.S. ambassador had to make the rounds assuring Indonesians that the U.S. was not out to dictate curriculum in its religious schools. More troubling is the pathetic amount of money he offered -- most of it funds shifted from existing programs -- only $157 million over 6 years. Says former Ambassador Paul Cleveland, who heads the U.S.-Indonesia Society: "You would get more democracy out of $1 billion spent in Indonesia than $20 billion spent in Iraq.''