Death By Mosquito


    THE CULPRIT: The female mosquito needs blood to produce eggs. It transmits malaria parasites when it bites again

    As current trends make clear, AIDS is surpassing the Black Death as the most devastating plague ever to afflict the human race. That helps explain the sense of desperation that permeated the 15th International Conference on HIV and AIDS in Bangkok last week. But in a cruel irony, all the well-deserved attention paid to AIDS over the past few years has overshadowed the rapid comeback of a second, nearly-as-deadly plague — malaria. The latest figures suggest that malaria sickened 300 million people last year and killed 3 million — most of them under age 5. (AIDS last year killed just over 3 million people.) What makes the malaria deaths particularly tragic is that malaria, unlike AIDS, can be cured.

    Countries in sub-Saharan Africa have suffered the brunt of this renewed assault, but nations in temperate zones, including the U.S., are not immune. A malaria outbreak in Florida last summer that hospitalized seven people was the first extended case of local transmission on U.S. soil in nearly 20 years. The cause was almost certainly a parasite that hopped a ride in a human or a mosquito on an international flight or ocean vessel, since none of the patients had recently ventured overseas.

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    Despite these setbacks, there is reason for hope. Doctors have made remarkable progress over the past few years in the treatment of drug-resistant malaria by combining several compounds — the most powerful of which is derived from an ancient Chinese herbal remedy that cures 90% of patients in three days. Meanwhile, community groups, nonprofit organizations and governments are redoubling efforts to control the mosquitoes that cause the disease through the sale and distribution of insecticide-treated bed nets and the indoor spraying of antimosquito pesticides. And after a few notably fiery fits and starts, there appears to be a real consensus among health officials about how to proceed. Certainly, the need for action has never been clearer.

    Doctors have long suspected that the malaria problem was getting worse, but the most searing proof has come to light in just the past year. Researchers believe the average number of cases of malaria per year in Africa has quadrupled since the 1980s. A study in the journal Lancet last June reported that the death rate due to malaria has at least doubled among children in eastern and southern Africa; some rural areas have seen a heartbreaking 11-fold jump in mortality. "The death rates from malaria are as high as those from HIV," says Dr. Christa Hook, coordinator of the malaria working group for Doctors Without Borders. "In many ways, it's a kind of silent Holocaust."

    Recognition of malaria's toll on the global economy is growing. Economist Jeffrey Sachs, director of Columbia University's Earth Institute, estimates that countries hit hardest by the most severe form of malaria have annual economic growth rates 1.3 percentage points lower than those in which malaria is not a serious problem. Sachs points out that the economies of Greece, Portugal and Spain expanded rapidly only after malaria was eradicated in those countries in the 1950s. In other words, fighting malaria is good for business — as many companies with overseas operations have long understood. By the end of this year, Exxon Mobil, which plans to expand activities in the sub-Saharan countries of Chad, Cameroon, Angola, Equatorial Guinea and Nigeria, hopes to triple its funding for antimalaria projects and research, from $2 million to $6 million. But the malaria problem is bigger than Exxon Mobil or even Bill and Melinda Gates. Government action is needed.

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