In the cases that lead to fatalities, the microscopic parasite invades and destroys red blood cells, leading to severe anemia. The parasite may also stick to the lining of small blood vessels in the brain causing cerebral malaria.
The parasite has developed a resistance to the commonly used and cheapest drug, chloroquine, according to Greenwood and the WHO-UNICEF report. Resistance to a common chloroquine replacement has also emerged in eastern and southern Africa. The report described artemisin-based therapy as the most promising new drug on the market, though its high cost remains a barrier.
Greenwood argues that the nearly U.S. $2 billion a year needed to "get everyone under a net and ensure access to artemisin is a small amount of money when compared to, say, the costs of the war in Iraq."
Global Response
The Tanzanian malaria researcher Wen Kilama offers a sobering analogy, famous in the malaria research community: If seven Boeing 747s full of children crashed into a mountain every day, would the world take measures to prevent it?
The number of children killed each day by malaria is slowly prodding the developed world to do something to mitigate the disaster. More ambitious anti-malarial initiatives have been announced in recent years.
Roll Back Malaria, a global partnership founded in 1998 by WHO, UNICEF, the United Nations Development Programme, and the World Bank, with the goal of halving the world malaria infection rate by 2010, includes a broad coalition of national governments, civil society, non-governmental organizations, research institutions, professional associations, development banks, and the media.
In Abuja, Nigeria, in April 2000, 44 African leaders met to endorse RBMs goal for 2010.
A new organization—The Global Fund to Fight Aids, Tuberculosis, and Malaria—represents another key resource in the fight against malaria. A partnership between governments, civil society, the private sector, and affected communities, the Global Fund seeks to attract and disburse additional resources to prevent and treat AIDS, tuberculosis (TB), and malaria.
The Bill and Melinda Gates Foundation and Rotary International are also active funders of malaria research and prevention.
Still, despite the growing activity, malaria researchers say the world is not doing enough.
Says WHO's David Alnwick, Project Manager of Roll Back Malaria: "While African governments and donors are beginning to take malaria more seriously, there is still far too much complacency. We can certainly do a better job of controlling malaria."
The Africa Malaria Report estimates $1 billion a year is needed to significantly reduce the problem—a conservative estimate, according to some researchers. Thus far, approximately $200 million a year is spent—a significant rise from past years, though still far below what's needed. Meanwhile, 26 African governments continue to tax the import of life-saving devices such as insecticide-treated bed nets, despite promises to WHO that they would discontinue the levies, the report says.
The report challenges the global community and African governments to increase funding for malaria-control programs, accord a higher profile to the disease in health agendas of endemic countries, and ensure the availability of a new generation of the most highly effective drugs.
In a statement accompanying the report, WHO Director-General Gro Harlem Bruntland and UNICEF Executive Director Carol Bellamy describe malaria as "a disease that has been ignored by the world for far too long."
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