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Why Is Malaria on the Rise Again?

In recent decades, strategies for combating malaria have emphasized distributing easy-to-use commodities – including insecticides, insecticide-treated mosquito nets, and artemisinin-based antimalarial drugs – and expanding access to prompt diagnosis. This approach is reaching its limits.

DAR ES SALAAM – Mosquitoes are often described as the most dangerous animals on earth, because the diseases they transmit – including malaria, dengue, and Zika – cause more than a million deaths annually. But strategies for mitigating these threats remain far from adequate.

Consider malaria, which, according to the World Health Organization, infected over 200 million people in 2017, killing 435,000. Until the 1940s or so, anti-malaria strategies rested on three pillars: better environmental management, improved housing, and stronger health systems. Accounting for the mechanisms of malaria transmission (first described over 100 years ago), public-health authorities focused on minimizing the proliferation of the Anopheles mosquito, people’s exposure to it, and their access to appropriate medical care.

The countries that adopted this approach achieved great progress – and in most cases, have remained malaria-free. In the United States, for example, malaria deaths declined by 75% between 1920 and 1939.

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