The devastating effects of malaria on communities, tourism, agricultural and industrial development in the provinces of KwaZulu-Natal and Mpumalanga were the major motivating forces behind attempts at control in the first half of the twentieth century. The disease pattern in 1938, before large scale intervention, was characterised by dramatic inter-annual variation with severe epidemics as far south as Durban and reaching Pretoria on the Highveld .( see map)
The current distribution of malaria in South Africa shows a dramatically reduced incidence of the disease ( see map). The current high risk areas today are all border areas, indicating the importance of viewing malaria as a regional, rather than a country-specific, problem.
Southern Africa has experienced a major resurgence in malaria transmission since 1996, a result of several factors including population migration, drug and insecticide resistance and climatic changes.
Malaria control is a dynamic process requiring research backup, private and public sector as well as national and international collaboration. Successful control must be based on scientific principles and ongoing success requires continual research input, government commitment to control of the disease and appropriately skilled and trained personnel. The detrimental effects of malaria on economic development, particularly eco-tourism, agricultural and industrial development, point to an urgent need for cost-effective control based on sound scientific principles.
