Wall Street Journal essay examines historical efforts to control malaria

Jul 13 2010

In a Wall Street Journal essay, Sonia Shah, the author of an upcoming book on malaria, outlines the historical efforts to control malaria - from the Roman Empire through today.

"It was the emperor Caracalla's physician, Serenus Sammonicus, who in the second century came up with Rome's first antimalaria quick-fix, one that later became literally synonymous with magical solutions everywhere. An amulet should be worn, Sammonicus advised, inscribed with a powerful incantation: 'Abracadabra,'" according to Shah. "Yet the spirit of Sammonicus's cure for malaria still beckons. ... And even as the fight against malaria gains momentum, research reveals that malaria's tentacles continue to dig ever deeper," she writes, noting that the disease has caused half of all human deaths since the Stone Age.

"Part of malaria's wicked genius is that since ancient times, it has fooled us into thinking it is a trivial problem, easily solved," she writes before providing evidence for her contention that efforts to control malaria have treated it like a "weak foe" and allowed it to "flourish, nearly unchecked, to this day."

According to Shah, "[p]art of the trouble has to do with biology. The malarial mosquito and the malaria parasite within it are nothing if not innovative," and she cites examples of the parasite's ability to evolve and adapt, including recent developments, indicating resistance to "artemisinin, the first-line drug currently recommended by the WHO."

She reviews current efforts to control the disease, starting in 1998, "when the WHO launched its Roll Back Malaria campaign. ... Malaria has started to decline in a handful of African countries, which is no small feat. But at the same time, malaria continues to stalk even the most well equipped among us ... The very idea of eradicating the disease has come into question, with the finding this winter that the most virulent human malaria parasite, Plasmodium falciparum, presumed since the 1930s to be an exclusively human pathogen, also finds succor inside the bodies of gorillas."

Despite a history of failure, Shah hints at optimism. "As malarious countries prosper and develop, the day will surely come when those still vulnerable to the bites of malarial mosquitoes will live in screened domiciles, more than a stone's throw away from stagnant, mosquito-infested waters - or will suffer the brief sting of a highly effective malaria vaccine - and malaria will be no more. Until then, let the Abracadabra cures continue" (7/10).