Chapter 4: Combating Malaria

Anne Platt McGinn

Malaria, one of humanity’s oldest scourges, is making a strong global comeback, killing up to 7,000 people a day (more than AIDS)_primarily children in sub-Saharan Africa. Malaria has become resistant to most anti-malarial drugs, making treatment vastly more complicated and expensive. Poverty, war, and civil strife make it hard for governments to implement preventive and curative measures. And people are not making use of safe, effective, and affordable ways to control the mosquitoes that carry the disease.

Bringing this disease under control will require creative strategies and far more resources than are currently available. (Malaria is a disease of poor countries and thus tends to be under-researched: between 1979 and 1999, only four of the 1,393 new drugs developed worldwide were anti-malarials.) Despite the largely global phase-out of DDT, the insecticide remains an important tool for malaria control in epidemics in parts of sub-Saharan Africa.

On the front lines in Africa, governments are reducing the incidence of malaria by helping people acquire bednets treated with insecticides less toxic than DDT. Sleeping under a bednet radically reduces the number of infective mosquito bites a person suffers. The Mexican government has mounted a sophisticated program against malaria that combines community involvement, widespread prevention, locally tailored treatments, and the use of the least toxic option first. Through programs like the UN’s Global Fund to Fight AIDS, Tuberculosis & Malaria, the developed world has begun to provide the much-needed increase in financial resources.

• A Modern and Growing Threat
• The Biology and Evolution of the Disease
• The False Promise of Eradication
• Environmental and Social Changes Alter the Balance
• Mexico’s Approach
• The Challenge in Africa
• Improving Public Health, Engaging People