Malaria has killed more people over time than covid19 ever could. It has existed for millennia – over 10,000 years, from China to the Americas and everything in between – and has proven impossible to eradicate totally. The WHO estimates that in 2019 alone, 229 million clinical cases existed globally, 409,000 of those people died, of which 260,000 were children aged under five, in mainly sub-Saharan Africa – and that is a rough recurring annual figure. The US National Academy of Sciences estimates that malaria has caused the death of 150-300 million people just in the 20th century.

The fear of malaria has been, at some point, a preoccupation for everyone living in the tropics. It is a family tale that as a child my maternal uncle was successfully treated by my grandfather with a strong dose of quinine and fever grass tea. Quinine and DDT were once household words, but eradication programmes starting in the mid-1900s managed to control the disease so that any current cases in TT exist in people arriving from abroad, especially from neighbouring Amazonian countries – Venezuela, Colombia, Brazil and Peru, where it is still endemic. Sub-Saharan Africa seems to be the biggest current home of the deadly, mosquito-borne disease, with 94 per cent of all cases and deaths being recorded in Nigeria, Niger, Democratic Republic of Congo, Burkina Faso, Tanzania and Mozambique. North Africa is where a British friend of mine contracted it and suffered relapses of jaundice and horrible seizures before it finally left her severely weakened body a few years later, although I read that in Morocco and Tunisia it has been all but eradicated since 2000.

The malaria parasite invades the body and destroys the blood cells in order to reproduce. Its incubation period is usually three to seven days and the symptoms include fever, joint pain, shivers, diarrhoea, jaundice, blinding headaches, nausea and vomiting. Victims die of kidney failure, an enlarged liver, dehydration or blood loss. I was interested to learn during World Malaria Day, April 25, about the role of diet in managing an attack of malaria. Fruits are recommended to increase our immune systems and make the disease less severe. I wonder if the old folk knew that coconut water, juices of pomegranate, sugar cane and papaw, sugar-salt-lemon water and glucose water were treatments. It makes sense, as does the consumption of vegetable soups.

Research into the eradication of the most parasitic malaria-spreading mosquito, the P.falciparum, has been ongoing for at least a century, and finding a vaccine has been a priority. Only now has a vaccine been successful, after 30 years of dedicated research funded by Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid, with extra funding from the Bill and Melinda Gates Foundation. Last week, the RTS,S was approved by the WHO for rolling out across sub-Saharan Africa, and in other regions with moderate to high malaria transmission, for children aged over five months. It comes after a pilot program

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