Malaria is the most fatal of infectious diseases. Its daily death toll tops the number of casualties on Sept. 11th, 2001 and dwarfs the combined mortalities from AIDS and Tuberculosis.

Americans are increasingly aware of the magnitude of this scourge. More and more elementary schools, church groups and bar mitzvahs are donating their collections to purchase malaria nets. The United Nations created its Global Fund to Fight AIDS, Tuberculosis, and Malaria in 2001. The Gates Foundation invested $168.7 million in the Malaria Vaccine Initiative.

But Americans are not yet fully cognizant of malaria’s relationship to climate change: A warming climate might facilitate the return of malaria to the world’s temperate regions.

History might help our nation once again appreciate the relationship between health and the environment. Malaria fell off the radar of many industrialized, wealthier nations as soon as they successfully eliminated the disease within their own borders. This neglect allowed malaria to not only resurge within endemic countries but also threaten nations long considered malaria-free.

For instance, malaria was successfully eradicated from the Southeastern United States in 1951. But since malaria remains endemic in most of the Southern Hemisphere, including places as close to the U.S. as southern Mexico, the Center for Disease Control and Prevention acknowledges that reintroduction of malaria into the United States remains a constant risk — one of the principal reasons that the CDC is located in Atlanta, Ga., not in Washington, D.C.

Now, warming global temperatures — which allow malaria-infected mosquitoes to survive in new areas and for longer periods — could endanger hundreds of millions in the coming decade.

American public opinion surveys reflect our inadequate comprehension of the effect of climate on health. The nation’s public health system has allowed for an unacceptable disconnect between climate change and human health. Information and recognition are the first steps to cure, and those first steps have already been taken by many countries. For instance, the Intergovernmental Panel on Climate Change, which co-won the 2007 Nobel Peace Price, warned the public in its acceptance speech of an altered distribution of infectious diseases due to rising temperatures.

In contrast to the international community’s efforts on this front, the United States has performed relatively few health-climate studies. The paucity of federally-funded research on the links between climate change and human health reflects the ignorance of the American public.

Americans must now strive to avoid becoming victims of our own success. Sound scientific study will give individuals and businesses the necessary behavior modification tools to stem the resurgence of a malaria pandemic. When it comes to developing a better understanding of the relationship between malaria and climate change, ignorance is no longer an option.

Leslie P. King, M.D., M.P.H., is the founding director of Flying Physicians International. She currently is completing a one-year mid-career masters degree at the Yale School of Forestry & Environmental Studies, focusing on communications of the impacts of climate change on human health.

(Yale Daily, 28/10/2008)