for National Geographic News
After several decades of moldering inattention, malaria is moving into the spotlight as cases reach epidemic proportions amid growing resistance to the drugs and insecticides used to combat the disease.
In the first hard look at epidemiological data in 50 years, researchers say the number of deaths from malaria has been seriously underestimated.
For the past 50 years, it's been widely cited that malaria causes one million deaths a yearone person dies from the disease every 30 seconds. But the Multilateral Initiative on Malaria (MIM) recently found that the number of annual malaria-related deaths could be as high as 2.7 million. Most of the victims are children under the age of five.
"Malaria is a global disease," said Regina Rabinovich, director of the Malaria Vaccine Initiative (MVI). "It affects 40 percent of the global population, and it's killing children. It's a disease worth preventing, and if we can't do it with a vaccine, we need to do it with the tools we have at hand, which is a combination of bed nets, insecticide spraying, and mosquito control strategies."
Malaria received a great deal of attention several decades ago, and during the 1930s to the 1950s it was essentially eliminated in most temperate regions of the world. But in sub-tropical regions, where the Anopheles mosquito is never killed off by the cold, the infection rate has steadily risen.
Factors contributing to the soaring infection rate include increased irrigation for agriculture, dam building, deforestation, rapidly growing populations in regions of high malaria transmission, and weakened public health care systems.
The determination to tackle the disease has steadily gained momentum in recent years as international agencies, non-governmental agencies, pharmaceutical companies, and research scientists have formed collaborative anti-malaria efforts.
A "Roll Back Malaria" campaign sponsored by the World Health Organization (WHO) is urging governments to devote more funding to malaria prevention and treatment, with the aim of cutting the burden of the disease in half by 2010. MIM was formed in 1997 to coordinate research and work with African scientists; many of the main funding agencies work through MIM. The Malaria Vaccine Initiative, supported by the Bill and Melinda Gates Foundation, was established in 1999 to spearhead the search for a vaccine.
"There is a pragmatic malaria control strategy to reduce the burden of disease using tools available," said Gerald T. Keusch, associate director for International Research at the National Institutes of Health and director of the MIM program.
"Those tools include case detection, effective drug treatment, and attempts to reduce exposure where possible," said Keusch. "But some of the hurdles that must be overcome are huge."
High Social, Economic Costs
The problem of malaria has raised greater concern in recent years because of increased awareness of the social and economic impacts of the disease. Malaria is not an "equal opportunity disease." It strikes hardest in the poorest countries of the world; 90 percent of all cases today occur in sub-Saharan Africa.
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