NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Monday, June 9, 2014

MAE SOT, Thailand — MALARIA is a seasonal disease; with tropical rains come the fevers. In the news media, malaria is also seasonal. Every spring around World Malaria Day we hear about its devastating effects, including deaths in the hundreds of thousands. This year the reports were encouraging: Infections have been reduced and many lives saved. In May, researchers reported in Science that yet another potential malaria vaccine may be around the corner. Malaria seems to be on the retreat.

But is it really?

Malaria is caused by a tiny parasite, transported by a particular type of mosquito from person to person. Preventing mosquito bites by using insect repellents or nets and clothing treated with insecticides can reduce malaria in some areas. And if people are infected, drugs can be used to kill the parasites in their blood.

But the mosquitoes are constantly adapting and becoming resistant to the chemicals, while at the same time the parasites are adapting and becoming resistant to the drugs. So the fight against malaria is really a race against time in which we try to develop new treatments before they become ineffective, causing millions to die.

I have been working on the Thai-Myanmar border for 30 years. Once, in the early ’90s, we faced the prospect of untreatable malaria. The number of people infected with the parasite (Plasmodium falciparum in this case) had been in decline, but the drug we were using — mefloquine, brand name Lariam — was becoming less effective and more patients were dying.

I remember a young Buddhist monk who was carried to our bamboo clinic two weeks after taking Lariam. His blood was still full of parasites. Lying in his saffron robe, he was unconscious, burning up and agitated by frequentconvulsions. We tried in vain to save his life.