Malaria is by far the world's most important tropical parasitic disease and kills more people than any other communicable disease except tuberculosis. It exacts an enormous toll in lives, in medical costs, and in days of labor lost. It is a widespread and pernicious disease, cutting a swath stretching from Southwest Asia to Central America -- wherever there is warmth and water. Yet for decades malaria has remained on the back burner of international public health efforts. It is estimated that malaria has cost Africa $100 billion dollars over the last 30 years. Meanwhile, the good news is that malaria is a curable disease if promptly diagnosed and adequately treated. Furthermore, malaria control and prevention methods are relatively cheap, simple and effective.

Over the past decade, HIV/AIDS has occupied an increasingly prominent place in the international health spotlight. Surprisingly, many Africans themselves, from the continent where 90% of all malaria deaths reside, will mistakenly consider AIDS as the #1 killer of children under five years of age. Such is the level of cultural acceptance of malaria over the centuries. Now we are uncovering the interaction between these two diseases; for example, the interaction between malaria and HIV during pregnancy is becoming more evident. Malaria infection is more frequent and more severe in HIV positive pregnant women and malaria may contribute to increased HIV viral loads in those carrying the virus. This could explain the increased transmission of HIV and the more rapid disease progression found in Africa- a substantial public health implication for programs and policy.

Despite scientists' best efforts, an effective malaria vaccine has yet to be developed. And the most widely used, low-cost anti-malarial drugs are now useless in many places due to widespread resistance; the mosquito, the vector of the malarial parasite, is itself showing increasing resistance to many insecticides. To make matters worse, there is evidence that the effects of global warming are aiding malaria to make a comeback in places from which it was thought to have been eliminated.

Malaria is a disease of the poor and the world's poorest people living in rural communities are particularly affected. According to a recent WHO report, "Highly malarious countries are among the poorest in the world and typically have low rates of economic growth."