Advancing the War on Malaria

Malaria is a microcosm of all the problems that exist in global health care, and combating it is no small job. It is the most common and deadly parasitic disease, and one of the top three killer diseases along with tuberculosis and HIV/AIDS. Every year, hundreds of millions of malaria infections occur and 3 million people die of the disease.

Malaria's weakening effect on a nation's workforce can be devastating, too. In endemic regions, personal income levels languish at a third less than in a similar-sized nation without malaria, and the gross national product can be reduced by up to 1.3%. The disease primarily affects people living under the poorest conditions, where a course of antimalarial drugs or even a $4 bed net costs too much.

The situation will only get worse unless intensive measures are taken. Without effective control, infections and deaths are predicted to double over the next 20 years. But malaria is mostly a disease of poor people living in nations located far from the developed world. As a result, both treatment and research have been neglected.

“Investigation of diseases that mainly affect poor people, especially poor people in poor countries, tends to be neglected in research efforts, which are largely done in rich countries. … Even when science has found solutions to diseases, it often fails to deliver, especially to the poor,” Harold Varmus, MD, a past director of the National Institutes of Health (NIH) and one of the world's most influential scientists, wrote in a recent editorial in The Lancet (Lancet. 2002;360 Suppl:S1-4). Varmus called progress against diseases such as malaria inadequate, and he blamed this on the continuing unwillingness of wealthy countries to confront the difficulties experienced by poor countries.

Indeed, many life-saving antimalarial strategies that have been available for decades rarely—or never—reach most …