Jennifer E. Fairman

Malaria: The Forever War

Malaria—the disease that for millennia has filled cemeteries, killed kings, wrecked empires and thwarted human attempts to quash it—begins modestly enough. About 100 parasites swim in the saliva of a female mosquito. 

That humble start spawns personal and global misery. The few parasites that invade a person can quickly expand to trillions, overwhelming the human body. The effect manifests in the dulled eyes of blinded children, the paroxysms of fever and chills racking the victim, the deaths of children and pregnant women, and the hobbled productivity of entire nations. Each year, malaria causes nearly 800,000 deaths and 225 million clinical cases.   

Were it not such a horror, the Plasmodium parasite would be one of the wonders of the world. The resilient shape-shifter constantly adapts to its surroundings, masters sexual and asexual reproduction, slips past the immunological defenses of the Anopheles mosquito and human beings, rides in the belly of its arthropod ally to new victims…. A testament to evolutionary engineering, the parasite has a solution to every barrier it meets.  

And so, Plasmodium has been virtually unstoppable. Humanity’s last global attempt at malaria’s eradication in the 1950s ended in shambles. Bright hopes were extinguished by the parasite’s resilience (and the mosquito’s growing resistance to insecticides).  

However, the malaria story does not end there.   

We Homo sapiens have our own brand of resilience, innovation and tricks for survival. As the following pages testify, breakthroughs in genetics, parasitology, entomology, drug development, satellite technology and other areas have summoned new hopes against our old enemy.