Eradicating Malaria: Discoveries, Challenges, and Questions

Malaria has been with us long before the dawn of civilization. It shaped the destiny of peoples, nations, and colonies, influencing the outcomes of ancient military campaigns. Malaria is suspected to have caused the death of Alaric, king of the Visigoths, after he sacked ancient Rome and that of the 18th-century English poet Lord Byron. The war against malaria has been long and hard. Looking back 20 years since my graduate studies in Nigeria, many smaller battles have been won in this war. Efforts such as the Roll Back Malaria initiative, the Multilateral Initiative on Malaria, the Global Fund and the WHO malaria programme inter alia led to improvements in malaria control, treatment recommendations and policies, coordinated purposeful research, new tools and strategies, and a heightened overall awareness about the disease. An arrest in the rise of malaria deaths has now been followed by a global net decline for the first time in 40 years! Yet more challenges remain before we can declare this ancient scourge eliminated globally as a public health threat. We must continue to pursue new medicines and approaches to kill the parasite, control mosquito vectors, limit disease transmission, and improve the immunity of people most susceptible to malaria. Until we identify and overcome barriers that prevent delivery of these tools, interventions, and policies, there are still many rivers to cross. The Future of Mosquito Control, beyond Insecticides