Fighting malaria at the crossroads

Every year, malaria kills between 1 and 3 million people—mostly children under five years of age and pregnant women—and newly infects 300 million to 500 million. But malaria is by no means a problem for developed countries, where it was defeated a long time ago. This is the main obstacle to the fight against the disease: as measures to curb malaria are predominantly financed by rich countries who are not affected by the disease, there is little incentive for them to provide sufficient attention and money towards finding effective solutions for treatment and prevention. In the meantime, the situation in poor countries is alarming, particularly in Africa where 90% of the global deaths and infections occur. Not only does malaria seize young lives, but it also cripples the economies of afflicted nations. The World Health Organization (WHO) estimates that malaria costs some 1.3% of the annual gross domestic product of the states in which the disease flourishes; their economies have been cut by more than 30% since 1960 as a result of decreases in fertility, population growth, saving and investment, and worker productivity, coupled with increases in absenteeism, premature mortality and medical costs. In some parts of Africa, families spend as much as 25% of their income on malaria treatments. Even worse, the burden of malaria continues to increase due to widespread parasite resistance to existing drugs, the geographic expansion of insecticide‐resistant Anopheles mosquitoes (Fig 1) and a chronic infrastructural and organizational inability to tackle the problem. The Africa Malaria Report 2003 stated that in some parts of Africa the number of children killed by malaria doubled between the 1980s and 1990s (WHO & UNICEF, 2003). Thus, what was once thought to be a possible target for eradication is now considered to be an ‘emerging disease’.> What was once thought …