The other malaria

摘要

"WHEN is a disease not a disease?" sounds like a childhood riddle. One answer, though, might be, "when it is vivax malaria." No one could accuse the global medical establishment of ignoring malaria. There is, indeed, an entire international organisation, the Global Fund to Fight aids, Tuberculosis and Malaria, that is explicitly aimed at getting rid of it. Yet malaria comes in several versions, two of which are widespread. They are caused by related parasites, Plasmodium falciparum and Plasmodium vivax. They are both transmitted by Anopheles mosquitoes. And many actions, such as draining swamps where mosquitoes breed, and many drugs, such as artemisinin, work against both. But that does not mean the diseases are identical. In practice, most of the world's antimalarial effort is directed against falciparum. Those who study vivax sometimes feel that the object of their attention is invisible.