Malaria: current and future prospects for control

Malaria is the most important insect-transmitted human disease, but progress in its control has been slow, especially in Africa where approximately 90% of the infections occur. Several factors have contributed to the problem. Parasites and vectors have developed resistance to antimalarial drugs and insecticides; differences in the biology of major malaria vectors preclude the development of simple, universally applicable strategies for malaria control; and the cost of available malaria-control tools often exceeds the public health resources in the most malarious parts of the world. New tools are desperately needed. Current efforts include the testing of tools such as insecticide-impregnated bed nets that could become available in the near term, as well as long-term projects such as the development of malaria vaccines and mosquito-targeted genetic control strategies. The success or failure of any of these approaches will depend ultimately on understanding the natural patterns of malaria transmission in the field.