NIH News Release
Fogarty International Center
For Advanced Study in the Health Sciences

Thursday, August 2, 2001

Contact: Jennifer Cabe
(301) 496-2075

Scientists Find Drastic Underestimations of Malaria Morbidity, Mortality, and Economic Burden

National Institutes of Health, Bethesda, Md. — Challenging long-standing beliefs about the international burden of malaria, scientists have presented new information about the severity of malaria morbidity, mortality, and its economic toll in a supplement to The American Journal of Tropical Medicine and Hygiene. Titled "The Intolerable Burden of Malaria: A New Look at the Numbers," the supplement was published by the Multilateral Initiative on Malaria (MIM) with support from MIM partners, including NIH, The Centers for Disease Control and Prevention, GlaxoSmithKline, the Rockefeller Foundation, The United Kingdom Medical Research Council, The United Nations Foundation, the United States Agency for International Development (USAID), The Wellcome Trust, and the World Health Organization.

"With new data and a fresh look, this landmark supplement highlights the many burdens caused by malaria. To address the pervasive and intractable problems that malaria represents, it is essential that malaria's full burden on societies and families be measured both epidemiologically and economically," said Gerald T. Keusch, M.D., Director of the Fogarty International Center (FIC) and MIM, and NIH Associate Director for International Research. He added, "The enormous burden of malaria and the disparity in global malaria research efforts is the rationale for the MIM and the reason why U.S., European, and African scientists have joined together in the MIM to promote malaria research in Africa to develop new and improved control interventions."

For more than 50 years, the mantra of "one million annual deaths due to malaria" has been cited by scientists and journalists. Until recently, this estimate had generally gone unexamined in regard to its accuracy, clinical components, and economic implications. The supplement reports that, at a minimum, between 700,000 and 2.7 million people die annually from malaria, over 75% of them African children. New data presented in the supplement show that over 85% of these malaria-induced childhood deaths are due to anemia, low birth weight, and hypoglycemia. The supplement also reports that between 400 and 900 million acute febrile episodes occur annually in African children under the age of 5 living in malaria-endemic regions, and that this number will double by 2020 if effective control interventions are not implemented. This is notable because high fevers and febrile convulsions in infants and children can retard brain development, often resulting in impairments in high-order cognitive function such as planning, decision-making, self-awareness, and social sensitivity. Of all the manifestations of malaria, those impacting cognition and behavior are the subtlest, least defined, and have the most profound implications for children, families, and societies.

The supplement also presents new information about the cause-effect connections between malaria and poverty. For example, growth of income per capita from 1965 to 1990 for countries with severe malaria transmission was only 0.4% per year, whereas economic growth for countries with fewer malaria infections was 2.3% per year, more than 5 times higher.

Launched in 1997 by an international alliance of research and public health agencies and African scientists, MIM stimulates collaborative research to answer the needs of public health programs in malaria-endemic countries, to modernize communication systems used by the African research community, and to strengthen research capacity and human resources where malaria takes its greatest toll — sub-Saharan Africa. FIC currently serves as MIM Secretariat, and the 14-article supplement was edited by MIM Senior Scientific Advisor Joel Breman, M.D., D.T.P.H.

Detailed information about MIM, its partners, and activities is available on the MIM website at To request a copy of "The Intolerable Burden of Malaria: A New Look at the Numbers," e-mail MIM Secretariat Coordinator Andréa Egan, Ph.D. at

FIC is the international component of the NIH. FIC promotes and supports scientific research internationally to reduce disparities in global health and currently serves as the MIM Secretariat.

NIH is an agency of the U.S. Department of Health and Human Services. Fact sheets, press releases, and other FIC-related materials are available on the FIC website at