In a Foreign Affairs “Snapshots” feature, investigative journalist and author Sonia Shah examines why malaria persists in Africa, noting, “despite a $2 billion-a-year global campaign, the mosquito-borne disease still infects some 300 million people a year in [the impoverished tropics] and causes over half a million deaths, most of them among children and pregnant women.” She discusses the relationship between poverty and malaria, and highlights a lack of political will as a major challenge to fighting the disease. “Despite its tremendous burden on affected societies, malaria, in the most heavily infected places, is considered a ‘relatively minor malady,’ in the words of a 2003 [WHO] report,” she writes, noting that because some level of immunity is acquired through continuous exposure, a child who has suffered repeated episodes of the illness is less likely to die from it.

“Much of the world’s malaria, therefore, occurs in individuals with a degree of acquired immunity and is never diagnosed or treated — or, for that matter, formally counted,” Shah continues, likening infection to that of a common cold in the West. “What that means politically is that people who suffer the highest burden of malaria, such as those in countries in sub-Saharan Africa, tend to be the least motivated to do much of anything about it,” she states, adding, “As a result, in the absence of economic development, there is little political will within malaria-infected countries to take on the disease.” Shah continues, “Because of the lack of domestic political will, most concerted attempts to address malaria have been financed by external donors from unaffected countries, as part of foreign aid and charitable programs.” She concludes, “The donor-driven campaign against malaria gained momentum by arguing that attacking the disease would spur development. Now, it seems advocates are saying that the opposite may be true: development is required to attack malaria” (10/24).