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Some months back, I wrote about how the Guinea worm — a vile and disgusting parasite that used to infect millions in Sub-Saharan Africa — is now on the brink of extinction. There is more good news on the war against two similar parasites. First, and amazingly when you consider just how recently we were powerless against it, polio appears to also be on the verge of eradication. Second, and though we’ve a very long way to go yet, we’re making significant headway against malaria. It’s entirely possible that both of these scourges could follow smallpox into the history books within our lifetimes; with polio, perhaps within the next decade or so.
It’s difficult to overstate how significant the progress has been, especially in Africa, or how heavy the human cost these diseases have wrought. As recently as the year 2000, malaria killed about 850,000 annually; it’s about half that number now. Polio infected about 350,000 in 1988; it was down to a few hundred cases earlier this decade and it’s in the low dozens now, restricted to three countries (Nigeria, Pakistan, and Afghanistan). When you consider the human costs endured by so many people for so long, it’s little wonder why some places have struggled to develop.
Getting over the finish lines with these diseases will be an extraordinarily difficult, expensive, and unspectacular affair. For polio — for which the vectors are relatively easy to control — this likely means keeping up what we’ve been doing, albeit under awful circumstances with regard to Pakistan and Afghanistan (bear in mind that polio vaccination programs there were, quite literally, subject to a CIA-sponsored conspiracy). For malaria, it’ll take an ever-changing combination of strategies, including vaccination (a weak one has already been approved and stronger ones appear to be in the pipeline), new products, better deployment of existing ones, mucking around with mosquito genomes, and lots of monitoring. So, so much monitoring.