Mankind's age-old fight against malaria.

• Position: Insect-Borne Illness

Malaria historically has been a major threat to the health of the world's people, especially those in China. In 1950, more than 30,000,000 suffered from the disease, with approximately 300,000 dying. The government subsequently launched national campaigns to combat infection. Programs of malaria control were integrated in the general rural development of land reclamation, irrigation, construction, and improvement of sanitary conditions for humans and livestock, explains Liping Bu, professor of history at Alma (Mich.) College.

While timely treatment of malaria is essential, these campaigns strongly emphasized preventive methods, as "prevention first" was the health policy from the 1950s through the 1980s. They aimed to eliminate mosquito breeding grounds, employing community efforts to dredge rivers, fill up ditches, pull out weeds, and breed fish and ducks to feed on larvae. Residential sprays and bednet use were common practices. To root out malaria completely, the government registered all who suffered the disease in the previous two years and gave them medicine to prevent relapses. Physicians reinforced the implementation of malaria control by distributing anti-malaria drugs and supervising patients taking them, Bu notes.

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Malaria basically was under control in China by 1990. In 1998, there were 31,000 cases, with a morbidity of one person per 40,000, a 99% drop compared to 1954. The proportion of malaria among the total cases of acute infectious diseases was reduced from 61.8% in 1954 to 1.3% in 1998, according to research published in the Chinese Medical Journal. China's success in malaria control lies in an integrated program that emphasizes community participation...