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A relative takes two malaria-stricken cousins for treatment Credit: D.Telemans/Panos

“Unless we fully embrace country and community ownership, we will be inviting chaos ten years down the road. We need to accelerate investments in desperately needed vaccines, as well as better treatments. Now is the time to combine long-term investments with crisis management.”

So said Peter Piot, executive director of UNAIDS, at the close of last month's International AIDS Conference in Bangkok. Piot was talking about HIV and AIDS, but his words apply equally well to malaria.

Both diseases kill millions — mostly in Africa, the focus of this supplement. But, compared with AIDS, malaria is neglected by researchers, drug companies, activists and the media. Piot's charismatic leadership is also sorely lacking in the fight against malaria, which is rife with sluggish and ineffective bureaucracy. The drive to fight AIDS has momentum and direction; malaria's seems to be heading for a dead end.

In the following pages, experts reveal that there is greater hope of beating malaria now than ever before. But they also express deep dissatisfaction with the pace and effectiveness of current projects. Patchy international efforts need to be scaled up and given fresh impetus and direction, they say. And billions, not millions, of dollars are needed — one bold move would be to divert some of developing countries' debt repayments to malaria instead.

African countries must also take the fight against malaria into their own hands. Too many big, external players, such as the United Nations' Roll Back Malaria initiative, place too much emphasis on implementing malaria control measures, in the process neglecting strategies to improve local research and infrastructure. Comparable global efforts here would fill a large gap.

Woody Allen famously said that “80% of success is showing up”. Scientists, statesmen and specialists: it's time to show up and demand results.

We are pleased to acknowledge financial support from a number of sponsors: MMV, EDCTP, Impact Malaria, GSK, MIM, MVI, NIAID and Novartis. As always, Nature carries sole responsibility for all editorial content. This supplement is also associated with the worldwide launch later this autumn of Fever Road, a documentary by London-based Films of Record Ltd.

Philip Campbell and Declan Butler

A collection of Nature's material on malaria can be found on our website at

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Malaria. Nature 430, 923 (2004).

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