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Slow Progress
"In 1955 the World Health Organization first attempted to eliminate the disease with a combination of insecticides and a new medicine called chloroquine. Its plan wiped out malaria from the Caribbean to the South Pacific, but over the past 40 years, the parasite has evolved resistance to chloroquine in parts of Africa and Asia. Today the epidemic has returned with a vengeance: The annual death rate has doubled in the past decade.

"The Roll Back Malaria Partnership will reinforce proven methods—like the distribution of insecticide-treated bed nets—but will also devote $750 million a year to research and development. The newest and most powerful treatment derives from a 2,000-year-old Chinese herbal remedy called artemisinin, or sweet wormwood. Combined with other treatments, artemisinin "is 100 percent effective in successfully treating malaria," says Jan Van Erps, M.D., with the Roll Back Malaria Partnership. "Every other drug available right now is only between 25 and 90 percent effective—anything less than 100 percent is just not good enough." One artemisinin treatment is currently awaiting FDA approval.

"Doctors still recommend prophylactic drugs as an effective defense against malaria, but popping pills can be complicated. (See "Beat the Bite," below.) "It’s not a one-size-fits-all thing. There are different strains of malaria in different regions, so treatments have to be tailored," says Alberto Acosta, M.D., medical director of Traveler’s Medical Service. The deadliest strain, falciparum, is most prevalent in sub-Saharan Africa, while another strain, vivax, thrives in Asia and Central and South America. Vivax can remain in a person’s system months after infection, but it is entirely curable. Each requires different medication, though "there is a finite success rate with even the best drugs," says Vinetz.

Next: Race to the End

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