The outcry over this epidemic, until recently, has been muted. Malaria is a plague of the poor, easy to overlook. The most unfortunate fact about malaria, some researchers believe, is that prosperous nations got rid of it. In the meantime, several distinctly unprosperous regions have reached the brink of total malarial collapse, virtually ruled by swarms of buzzing, flying syringes.
Only in the past few years has malaria captured the full attention of aid agencies and donors. The World Health Organization has made malaria reduction a chief priority. Bill Gates, who has called malaria "the worst thing on the planet," has donated hundreds of millions of dollars to the effort through the Bill and Melinda Gates Foundation. The Bush Administration has pledged 1.2 billion dollars. Funds devoted to malaria have doubled since 2003. The idea is to disable the disease by combining virtually every known malaria-fighting technique, from the ancient (Chinese herbal medicines) to the old (bed nets) to the ultramodern (multidrug cocktails). At the same time, malaria researchers are pursuing a long-sought, elusive goal: a vaccine that would curb the disease for good.
Much of the aid is going to a few hard-hit countries scattered across sub-Saharan Africa. If these nations can beat back the disease, they'll serve as templates for the global antimalaria effort. And if they can't? Well, nobody in the malaria world likes to answer that question.
One of these spotlighted countries—perhaps the place most closely watched by malaria experts—is Zambia, a sprawling, landlocked nation carved out of the fertile bushland of southern Africa. It's difficult to comprehend how thoroughly Zambia has been devastated by malaria. In some provinces, at any given moment, more than a third of all children under age five are sick with the disease.
Worse than the sheer numbers is the type of malaria found in Zambia. Four species of malaria parasites routinely infect humans; the most virulent, by far, is Plasmodium falciparum. About half of all malaria cases worldwide are caused by falciparum, and 95 percent of the deaths. It's the only form of malaria that can attack the brain. And it can do so with extreme speed—few infectious agents can overwhelm the body as swiftly as falciparum. An African youth can be happily playing soccer in the morning and dead of falciparum malaria that night.