Battling Malaria: Bring Your Questions for Sonia Shah, Author of The Fever


Malaria has been infecting and killing humans for many millennia, yet it continues to elude man’s efforts to control it. Sonia Shah‘s fascinating new book, The Fever: How Malaria Has Ruled Humankind for 500,000 Years, describes our long relationship with the disease:

These days, mosquitoes infect between 250 million and 500 million people with malaria every year, and close to 1 million perish. Equally shocking is the sheer length of malaria’s tenure upon us. Humans have suffered the disease for more than 500,000 years. And not only does it still plague us, but it has also become even more lethal. That’s quite a feat for a disease we’ve known how to prevent and cure for more than a hundred years. During that same time, we’ve vanquished any number of similarly once-commanding pathogens, from smallpox to the plague, and have come to expect nearly complete control over newer pathogens, such as SARS or avian flu….Yet despite the fact that we’ve known about malaria since ancient times, and have the drugs, killing chemicals, and know-how to avoid it, something about this disease still short-circuits our weaponry.

Shah explores the history of the disease and explains why malaria hasn’t “mellowed” with age (like other diseases have) and why humans haven’t adapted to the disease. She explains why our many efforts to conquer the disease — the drugs and DDT “spray-gun wars” of the 1950’s – have failed so miserably, and she offers the following, rather depressing conclusion:

No one can accuse us of lack of diligence in our devotion to the magic-bullet cure, the miracle drug, the wonder pill. And yet, though antimalarial drugs are ‘one of humanity’s most precious and cost-effective public health resources,’ as the nonprofit Medicines for Malaria Venture puts it, it’s useful to remember this: even if we somehow got our act together to unleash the full power of our antimalarial drugs upon the malaria parasite, we still wouldn’t win.

Humans, who often fail to comply with simple measures like sleeping under treated bed nets, don’t get a free pass either, in a comparison that will resonate with readers of SuperFreakonomics:

So while it’s true that sleeping under a treated net is simple and effective, it is so only in the same way that, say, physicians washing their hands before attending to their patients is simple and effective.

Shah has agreed to answer your questions about her new book, so fire away in the comments section and, as always, we’ll post her answers in due time.

Addendum: Shah answers your questions here.


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  1. iamreddave says:

    How much do westeners spend on malaria drugs for tourist trips to malarial regions? What would be the effect of this much spent on local schemes?

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  2. Mark Wolfinger says:

    I understand looking for cure/prevention etc. All worthy humanitarian goals.

    My question is this: When you save hundreds of thousands, if not millions, of lives, who is going to feed the gigantic population boom?

    Equal time and effort must be spent on projects that feed the population – based on the assumption that your goals will be realized.

    Otherwise, poverty and starvation await

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  3. Brett says:

    How much did DDT’s ban set back anti-malarial work?

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  4. David Leppik says:

    Mark (comment #2): the rate of population growth in many parts of the world is high enough relative to malaria deaths that curing malaria wouldn’t make a big difference to the population size. In fact, curing malaria could even reduce the population. For one thing, parents may be having more children in order to compensate for childhood death. For another, if fewer children die of malaria, fewer resources will need to be expended on treating them (or in caring for ultimately doomed children), helping the remainder to escape poverty. And if fewer adults die of malaria, they will be around to raise the next generation more effectively. Reducing poverty reduces the demand for more children, as well as increases the opportunities to get access to effective birth control.

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  5. Paulo says:

    @iamreddave – On a recent trip to northern Laos, our group of ten spent over a $1,000 on anti-malarial prophylaxes. Some on the trip were doctors, other well-traveled yet lack of solid information lead all to err on the side of caution. Ultimately, very few of us were even bitten during the entire trip. We later learned from locals malaria only occurred in areas we had passed through only briefly and of course had slept with mosquito nets.

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  6. Jon L. says:

    “mosquitoes infect between 250 million and 500 million people with malaria every year”

    Is there an extra zero in there somewhere? That number is way too high, since even on the low end everyone in the entire world wold have malaria in 30 years. From the CDC:
    “WHO estimates that in 2008 malaria caused 190 – 311 million clinical episodes”
    which is within the lower bound of the range, but they use the word clinical episode whereas you use the word infect. There isn’t a good link for defining what a clinical episode is, but it appears to be a period of time in a clinic – which means that if you have a disease that isn’t cured, every time you visit a doctor is a clinical episode. From it looks like there are perhaps 500 million people with the disease, which is a very high number but does not indicate such a high infection rate, unless everyone is cured of the disease every year.

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  7. Drill-Baby-Drill Drill Team says:

    The Greatest Predator of Mankind is the Mosquito. It is the the top vector for infectious disease. Mosquitos are Mankind’s Greatest Pest.

    Can an enviormentalist morally defend the eradication of the mosquito? What would a world without mosquitos look like? Should we “Save the Mosquito”?

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  8. frankenduf says:

    sorry i haven’t read your book, but thank-you for writing about this intriguing disease- i have 2 questions- 1- “humans haven’t adapted to the disease”- isn’t this not entirely true? i have a friend from ghana who says he is immune (so can you acquire immunity if you live there and survive the infancy period?); and i thought that G6PD deficiency (particularly northern african males) are immune, and that prevalence is increased in malaria areas- 2- If you were omnipotent, would you kill all mosquitos? (spoiler alert- i think this is a trick question?!)

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