When in 1955 the malariologist Paul Russell predicted without hesitation the imminent end of malaria,¹ little could he have imagined that half a century later malaria would still be one of the most important public health challenges in the world. At the beginning of the 21st century, 3000 million people (almost half the world’s population) living in malaria endemic areas in 100 countries are at risk, with the biggest burden of both disease and death concentrated in African countries. Between 300 and 500 million clinical cases and up to 2.7 million deaths are believed to occur annually.^2,3

Although there are four species of Plasmodium that infect humans, only two (P vivax and P falciparum) cause significant disease, with nearly all deaths being caused by P falciparum.

IS A MALARIA VACCINE NECESSARY?

Over the last century, malaria has disappeared from significant areas of the world, and in some places this has been due to the use of control measures. Nevertheless, in areas where this infection still occurs, we are witnessing an increase in the total number of malaria cases due to population growth, which implies that today more people die from this disease than 40 years ago.⁴

The causes of this resurgence are many. The parasite’s extended and increasing resistance to the most common antimalarial drugs, the mosquito’s resistance to the widely used insecticides, the hitherto insufficient interest of the pharmaceutical industry in developing new drugs, the shortcomings in the implementation of available control measures, the collapse of national malaria control programmes and the increase in tourism and the migration of non-immune populations to malaria endemic areas, have all contributed to the general rise in malaria cases.⁵

Despite the increasing availability of effective malaria control tools, which should have …