Malaria Continues as a Major Public Health Problem

Abstract

April is a busy month for days of emphasis in Global Health. On April 7, we mark the foundation of the World Health Organization (WHO) with World Health Day. On this date the WHO, to be headquartered in Geneva, came into being when the constitution was signed by a majority of members. The details of the first meeting and the aspirations for the work of the WHO are spelled out in the first issue of the WHO Chronicle.1 The 2015 World Health Day will emphasize the importance of food safety, a continuing public health problem.2 In early life, contaminated water and food causes diarrheal disease and a million child deaths each year, the second leading cause of death in children younger than 5 years. Most of these are preventable with clean water supplies, appropriate food hygiene, and adherence to WHO/UNICEF advice on breastfeeding.3 Later in the month, World Malaria Day is celebrated on April 25. It is interesting to note that the first WHO meeting on malaria was actually held several months before the WHO was formally established.1 One objective set by the emerging WHO was “the attainment by all peoples of the highest possible level of health.” The first meeting of the Expert Committee noted “Malaria remains a great obstacle to the achievement of this objective. Now each year in April, the world remembers the burden placed on humanity by the Plasmodium protozoan parasite that still causes 200 million cases each year.4 Those of us who have worked in malarial areas know only too well its many clinical presentations. Young men with acute psychosis may actually have cerebral malaria and require urgent parental therapy, pregnant women with chronic anemia, and children with lethargy and splenomegaly are but a few of many presentations. Malaria features widely in the history of public health. The features of malaria have been described in literature going back almost 5000 years, first in China and then in ancient Egypt and Greece.4 In ad 300 Chinese physicians described the antipyretic effect of the Qinghao plant (Artemisia annua) and in 1971, Chinese researchers isolated its active component, artemesinin, which has become one of our mainstream drugs. Alphonse Laveran, a French army surgeon stationed in Algeria, first described the parasites in the blood of a patient suffering from malaria. Camillo Golgi, described the different forms of the parasite in blood cells. Both Laveran and Golgi were awarded the Nobel Prize for their contribution to tropical medicine and public health.5 In the Asia-Pacific region, malaria has often controlled human settlement with populations moving to highland regions, as in Papua New Guinea, or drier or cooler locations, as in China. Today it is estimated that 3.3 billion live in areas where they are at risk of acquiring a malaria infection. Malaria kills almost 600 000 each year, mostly children and the majority from Africa. In the Asia-Pacific region, it is still a major problem with 25 million cases and 50 000 deaths per