Shrinking the Malaria Map From the Outside In

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Science  14 May 2010:
Vol. 328, Issue 5980, pp. 849-851
DOI: 10.1126/science.328.5980.849

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No one questions the value of eliminating malaria, which means stopping disease transmission in a geographically defined area. But many malaria hands worry that going for the quick wins will divert money and attention from a far more urgent task: reducing the horrific toll of malaria in central Africa, where five countries account for 50% of all global deaths from the disease and elimination is not possible. In those countries, scaling up the use of existing tools—for instance, blanketing the population with insecticide-treated bed nets and ensuring fast, free access to malaria drugs—could have a huge payoff. Indeed, several countries, such as Zambia and Rwanda, have slashed cases by more than 50% (see p. 842).