Outlook in 2004

Greg Bear glimpses the future of human reproduction.

Across the developed world, birth rates are plummeting. Is this just a social phenomenon, or is our biological fertility also declining? We don't yet know, and that is worrying, says Declan Butler.

Advances in reproductive medicine hint that female fertility might be extended into late middle age and beyond. But will the methods be safe? And is society ready for this demographic shift? Kendall Powell investigates.

During the past few decades, worries about environmental threats to human health have centred on the possible induction of cancers. Now risks to the male germ line, both real and potential, are also causing disquiet.

A child's genes are not all equal: in some cases, the copy from either the mother or the father is turned off. This affects the child's ability to acquire resources in the womb, after birth, and perhaps throughout life.

Contraceptive research is seriously in need of revitalization.

“It is high time we addressed the widening inequities that characterize our planet today. We need to focus our energies towards achieving basic healthcare for all.” Pascoal Mocumbi, former prime minister of Mozambique

The malaria vector is back in scientists' sights, says Janet Hemingway, with insecticides and transgenic insects offering fresh hope.

Creating a malaria vaccine will be tough. But Africa needs one now more than ever, says Stephen Hoffman.

Campaigns against malaria are multiplying, but so are malaria deaths. Brian Greenwood asks what can be done to turn the tide.

Documentary makers can get as close to the war zones of disease as doctors and researchers — perhaps even closer. Julie Clayton and Declan Butler talk to Kevin Hull about his experiences.

To win the fight against malaria we will need to scale up existing programmes and develop new weapons, say Richard Klausner and Pedro Alonso.

The world must increase collaboration to meet the pressing need for a malaria vaccine, argue Carter Diggs, Sarah Ewart and Melinda Moree.

We have the science to make new antimalarials, say Robert Ridley and Yeya Toure, but we need better mechanisms and resources to develop drugs and deliver them.

In Africa, where malaria hits hardest, scientists are crying out for countries to take matters into their own hands, says Declan Butler.

International agencies have failed to meet their own malaria performance targets and should be held to account, says Amir Attaran.

The malaria and mosquito genomes will allow us to find new drug and vaccine targets, says Daniel Carucci.

We need to know how bad the malaria situation is before we can make it better, says Robert Snow.