A Cure for Africa's Common Cold

Why Malaria Persists

Women receive mosquito nets in Babile district in eastern Ethiopia.
Women receive mosquito nets in Babile district in eastern Ethiopia during the largest bed net distribution campaign in the history of Africa, 2005. (Gates Foundation / Flickr)

Over the long course of human history, no infectious disease killed more people than malaria. Called the “mother of fevers” by the ancient Chinese, malaria has plagued us since we evolved from apes and it once affected the better part of the globe. By the turn of the twentieth century, thanks to a combination of industrialization, urbanization, and agricultural development in the temperate world, the disease had been corralled into the impoverished tropics. To this day, despite a $2-billion-a-year global campaign, the mosquito-borne disease still infects some 300 million people a year in those parts of the world and causes over half a million deaths, most of them among children and pregnant women. 

The story of malaria is inseparable from the history of poverty. The conditions of poverty heighten the risk of malaria infection; the disease slows GDP growth in affected societies by 1.3 percent every year, according to a study by the economist Jeffrey Sachs. Getting rid of this one disease could simultaneously slash mortality rates and inhibit a major drain on economic growth. That is why the effort to eradicate malaria has tantalized development experts for years. It sounds like low-hanging fruit, as the scientific community has known how to prevent malaria since 1897 and how to cure it since the 1600s. In fact, malaria is anything but, because of a complex interplay of political, biological, and cultural factors. 

The main challenge is coalescing political will to do the job. Despite its tremendous burden on affected societies, malaria, in the most heavily infected places, is considered a “relatively minor malady,” in the words of a 2003 World Health Organization (WHO) report. That might seem counterintuitive, but it is a matter of simple risk perception. In places such as Malawi, where the average rural villager receives hundreds of bites from malaria-infected mosquitoes a year, a child might suffer 12 episodes of malaria before the age of two. If she survives, she will keep getting malaria throughout her life, but, thanks to the immunity acquired through continuous exposure, she is much less likely to die of it. For her and millions of other adults in sub-Saharan Africa’s malaria-ridden heartland, the disease becomes something that comes and goes on its own. 

Register for free to continue reading.
Registered users get access to three free articles every month.

Or subscribe now and save 55 percent.

Subscription benefits include:
  • Full access to ForeignAffairs.com
  • Six issues of the magazine
  • Foreign Affairs iPad app privileges
  • Special editorial collections

Latest Commentary & News analysis