The Long Struggle Against Malaria In Tropical Africa

The first history of malaria control efforts in tropical Africa, contributing to the emerging sub-discipline of the historical epidemiology of contemporary disease challenges.

For more than 50 years, low-cost antimalarial drugs silently saved millions of lives and cured billions of debilitating infections. Today, however, these drugs no longer work against the deadliest form of malaria that exists throughout the world. Malaria deaths in sub-Saharan Africaâ€"currently just over one million per yearâ€"are rising because of increased resistance to the old, inexpensive drugs. Although effective new drugs called "artemisinins" are available, they are unaffordable for the majority of the affected population, even at a cost of one dollar per course. Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance examines the history of malaria treatments, provides an overview of the current drug crisis, and offers recommendations on maximizing access to and effectiveness of antimalarial drugs. The book finds that most people in endemic countries will not have access to currently effective combination treatments, which should include an artemisinin, without financing from the global community. Without funding for effective treatment, malaria mortality could double over the next 10 to 20 years and transmission will intensify.

Publisher description

At the present time, malaria is responsible for a million deaths a year, with 500 million reported cases of the disease and 2.5 billion people at risk of contracting it. The distribution and severity of the disease vary with the causative agents, vectors and environment. Of the 4 possible parasites, only P. falciparum causes fatal forms; the three others have debilitating effects related to frequent disease recurrence and reviviscence. More than 50 species of anophele are involved in the obligatory transmission of the parasite from man to man. Climate, environment and biogeography condition the distribution of anophele species and modulate the intensity of transmission. This is what is known as the biodiversity of malaria. At the present time, more than 90% of P. falciparum malaria deaths occur in tropical Africa where only 10% of the world's population lives. A child dies of malaria every 30 seconds. This continent is home to the most effective vectors and the climate favours transmission. Severe cases also arise in the forested areas of South East Asia, New Guinea and the Amazon region. Throughout the rest of the tropical and subtropical world, the disease caused by P. vivax and/or P. malariae is less serious.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

A global history of malaria that traces the natural and social forces that have shaped its spread and made it deadly, while limiting efforts to eliminate it. Malaria sickens hundreds of millions of people—and kills nearly a half a million—each year. Despite massive efforts to eradicate the disease, it remains a major public health problem in poorer tropical regions. But malaria has not always been concentrated in tropical areas. How did malaria disappear from other regions, and why does it persist in the tropics? From Russia to Bengal to Palm Beach, Randall M. Packard's far-ranging narrative shows how the history of malaria has been driven by the interplay of social, biological, economic, and environmental forces. The shifting alignment of these forces has largely determined the social and geographical distribution of the disease, including its initial global expansion, its subsequent retreat to the tropics, and its current persistence. Packard argues that efforts to control and eliminate malaria have often ignored this reality, relying on the use of biotechnologies to fight the disease. Failure to address the forces driving malaria transmission have undermined past control efforts. Describing major changes in both the epidemiology of malaria and efforts to control the disease, the revised edition of this acclaimed history, which was chosen as the 2008 End Malaria Awards Book of the Year in its original printing, • examines recent efforts to eradicate malaria following massive increases in funding and political commitment; • discusses the development of new malaria-fighting biotechnologies, including long-lasting insecticide-treated nets, rapid diagnostic tests, combination artemisinin therapies, and genetically modified mosquitoes; • explores the efficacy of newly developed vaccines; and • explains why eliminating malaria will also require addressing the social forces that drive the disease and building health infrastructures that can identify and treat the last cases of malaria. Authoritative, fascinating, and eye-opening, this short history of malaria concludes with policy recommendations for improving control strategies and saving lives.

NEW YORK TIMES BESTSELLER • A worthy heir to Isak Dinesen and Beryl Markham, Alexandra Fuller shares visceral memories of her childhood in Africa, and of her headstrong, unforgettable mother. “This is not a book you read just once, but a tale of terrible beauty to get lost in over and over.”—Newsweek “By turns mischievous and openhearted, earthy and soaring . . . hair-raising, horrific, and thrilling.”—The New Yorker Though it is a diary of an unruly life in an often inhospitable place, Don’t Let’s Go to the Dogs Tonight is suffused with Fuller’s endearing ability to find laughter, even when there is little to celebrate. Fuller’s debut is unsentimental and unflinching but always captivating. In wry and sometimes hilarious prose, she stares down disaster and looks back with rage and love at the life of an extraordinary family in an extraordinary time. From 1972 to 1990, Alexandra Fuller—known to friends and family as Bobo—grew up on several farms in southern and central Africa. Her father joined up on the side of the white government in the Rhodesian civil war, and was often away fighting against the powerful black guerilla factions. Her mother, in turn, flung herself at their African life and its rugged farm work with the same passion and maniacal energy she brought to everything else. Though she loved her children, she was no hand-holder and had little tolerance for neediness. She nurtured her daughters in other ways: She taught them, by example, to be resilient and self-sufficient, to have strong wills and strong opinions, and to embrace life wholeheartedly, despite and because of difficult circumstances. And she instilled in Bobo, particularly, a love of reading and of storytelling that proved to be her salvation. Alexandra Fuller writes poignantly about a girl becoming a woman and a writer against a backdrop of unrest, not just in her country but in her home. But Don’t Let’s Go to the Dogs Tonight is more than a survivor’s story. It is the story of one woman’s unbreakable bond with a continent and the people who inhabit it, a portrait lovingly realized and deeply felt. Praise for Don’t Let’s Go to the Dogs Tonight “Riveting . . . [full of] humor and compassion.”—O: The Oprah Magazine “The incredible story of an incredible childhood.”—The Providence Journal

A people-centered approach to global health When People Come First critically assesses the expanding field of global health. It brings together an international and interdisciplinary group of scholars to address the medical, social, political, and economic dimensions of the global health enterprise through vivid case studies and bold conceptual work. The book demonstrates the crucial role of ethnography as an empirical lantern in global health, arguing for a more comprehensive, people-centered approach. Topics include the limits of technological quick fixes in disease control, the moral economy of global health science, the unexpected effects of massive treatment rollouts in resource-poor contexts, and how right-to-health activism coalesces with the increased influence of the pharmaceutical industry on health care. The contributors explore the altered landscapes left behind after programs scale up, break down, or move on. We learn that disease is really never just one thing, technology delivery does not equate with care, and biology and technology interact in ways we cannot always predict. The most effective solutions may well be found in people themselves, who consistently exceed the projections of experts and the medical-scientific, political, and humanitarian frameworks in which they are cast. When People Come First sets a new research agenda in global health and social theory and challenges us to rethink the relationships between care, rights, health, and economic futures.