In Central Asia, the collapse of the Soviet Union has caused the breakdown of Moscow's central control programme for malaria. Without it, the number of infected mosquitoes has increased unchecked, and the disease has crossed borders between the breakaway states. For the first time since the 1950s, we have seen widespread epidemics in Afghanistan, Azerbaijan and Tajikistan. These countries do not have the resources to create co-ordinated international malaria programmes.
In Africa, huge refugee movements have exposed people to strains of the disease to which they have little natural resistance. For example, thousands of Rwandan refugees, who came from mountainous areas where there were few infective mosquitoes and little malaria, are now scattered across the jungle basin of eastern Congo, where they are highly vulnerable to the deadly falciparum malaria. Seventy-five per cent of all refugees we have found in this area are suffering from this strain.
In such situations, we can treat the sick, prioritise vulnerable groups such as young children and pregnant mothers, provide impregnated bednets and spray buildings against mosquitoes. But these are localised strategies. Without political stability, we cannot begin to prevent the spread of the disease across whole continents.