The details are hazy, but the mental snapshots are clear.  There were palm trees and red tile roofs, individual buildings interspersed with tropical plants and the occasional bird of paradise.  The images are faded in the orange glow of a Mediterranean sun.  Perhaps we took a bus to this location, far from our apartment complex in Lisbon.  It was an essential trip. Inside one of the cottages my first grade self received vaccines that would allow our family to travel to Africa and be unaffected by some diseases that, over the course of the last century, had killed millions. 

Several decades later – last week, actually – my youngest toddler of a daughter sat on my lap on a poofy chair. I distracted her by counting with her to ten and telling her she was so brave and opening a crinkly candy wrapper and. . . then it was over and she was crying.  In 1951 Max Theiler received the Nobel Prize for medicine for developing the yellow fever vaccine.  Seventy years later, this virus no longer kills hundreds of thousands.  It no longer destroys the liver, causing internal bleeding and a yellow, toxic hue to dye the body.  My daughter – all of us with the vaccine – have been spared that suffering.  

I rarely think about how my life would be different – how statistically I would lose half my children – if humans had not used their God-given time, talent, and treasure to develop tools to fight these terrible diseases.  As I pulled some vintage homeschool materials off my shelf recently, one title, published in 1987, caught my eye.  “The Disease Fighters: The Nobel Prize in Medicine,” by Nathan Aaseng, was a short book I read in 5th grade.  Before I laid it out for my students – my children – I started browsing and became completely engrossed in the introduction: 

“How often have you heard someone say, “It’s only a sore throat,” or, “It’s just a cut, nothing to worry about,” and thought little of it?  Medicine has come so far that it’s easy to forget the danger that used to lie behind these minor complaints.

   Throughout most of history, parents had to fight off panic when their children didn’t feel well.  A simple sore throat could be an early sign of diphtheria, a disease that once killed thousands of people, especially children, each year.  A small scratch or cut could not be forgotten once it was cleaned and bandaged, for it could lead to a deadly infection.  Cuts and sore throats weren’t the only dangers.  People also had to watch out for mosquito bites, crowded beaches, and hundreds of other hazards that could lead to incurable diseases. . .

    A brief look at nearly any era in history is all that is needed to illustrate the enormous advances that have been made in medicine.  When remembering past catastrophes that have taken many lives, people tend to focus on the more dramatic events such as a great battle and natural disasters.  But the truth is that erupting volcanoes and flying bullets have killed far fewer people than humanity’s greatest enemy: disease. . .

   Evidence of the triumph over disease can be seen in countries all over the world.  In 1900, infectious diseases were the top three causes of death in the United States, but by 1954, the death rate from all infectious disease in the United States was down more than 90 percent. . .  Before the 17th century, parents could expect that three of every four children born to them would die in infancy.  Even as late as 1900, 30 percent of the children in the United States died before they reached adolescence.  Most of them would have lived had their doctors had the knowledge [doctors have today].” (pages 7 and 9)    

That seems like ancient history.  However, for the first time in my living memory an infectious disease was a leading cause of death in the United States.  For many countries around the world, infectious diseases have always been leading causes of death.  They are, to a great extent, preventable with the right resources.  This is why there is no longer yellow fever and malaria and numerous other deadly diseases in the United States.  

I don’t know anyone who has suffered through yellow fever.  There’s a shot for that. But other diseases persist. As a child we took regular antimalarial drugs and endured a bout or two of the disease.  People were frequently out of commission, cancelling appointments, out for weeks. “They have malaria,” someone would say.  “Ah,” we’d nod in understanding and go about our day.  Sometimes people would end up hospitalized.  Sometimes people suffered related chronic health issues.  Sometimes people died.  Usually it was a child. Malaria infects and reinfects over 200 million people a year. Over 400,000 of those die.

When someone infected with malaria dies, you know what no one asks?  Well, was that really what killed them?  What about their pre-existing conditions?  Malnutrition? Anemia?  No, but for the parasite of malaria, that person might still be alive.  This is what it’s like in societies where infectious disease is pervasive. The disease doesn’t get a write-off. It doesn’t get an excuse. It doesn’t get a ‘yeah, but. . .’ Thousands upon thousands of parents lose children to malaria each year at disease rates Americans haven’t experienced since the Greatest Generation’s parents were children.  Last year in Africa more individuals lost their lives to malaria than coronavirus.

When the rains started and the mosquitoes procreated, it became malaria season.  We adapted, not spending time outdoors at night when the malaria [anopheles] mosquito was on the prowl.  We wore long sleeves and covered our legs, adapting our dress so our scrumptious skin wasn’t exposed.  We slept with nets. We carried bug spray.  We made lifestyle, comfort and clothing choices that decreased our chances of contracting the disease.  This was ‘malaria country.’  Occasionally someone would mention that a new vaccine was in development for malaria.  They never worked.  We stopped keeping track.  After decades and decades – and over 140 different vaccine trials – a malaria vaccine seemed an impossibility. 

Compared to malaria, the coronavirus genome is child’s play.  For decades scientists have been trying to develop a vaccine against the malaria bug, a parasite that contains thousands of genes.  By comparison, coronavirus contains about twelve genes.  ‘Malaria country’ would exist in perpetuity and physically and emotionally cripple families and entire societies.  It was too complex to resolve with a vaccine, the gift that has freed the world from other diseases such as yellow fever, measles, typhoid and more.  

Because there is a vaccine, the COVID-19 virus will likely no longer be a leading cause of death in the United States this year.  It will be a blip on the charts – the year an infectious disease showed up and was smacked in its genes back to where it belongs.  And, by God’s grace, the same will be said of malaria in a few years, because, for the first time in history, a vaccine has been developed that has proven effective at preventing malaria deaths.

Let me repeat: a vaccine has been developed that has proven effective at preventing malaria deaths!

Malaria maybe doesn’t affect the society you live in. Social media algorithms aren’t going to highlight it.  News feeds won’t flash it across your screen like the COVID vaccines.  But I know that a group of researchers in Burkina Faso and doctors, researchers, assistants, fundraisers, tropical disease scientists, parasitologists and millions others around the world have a glimmer of hope.  Communities impacted by malaria will rejoice when the vaccine is ready to be deployed in their neighborhood.  The disease that has marked generations and continents has finally met its match.  Praise God!

As my toddler sat on my lap, tears streaming down her face, I prodded her with the right words to say in response to receiving her yellow fever vaccine.  She looked at the nurse and spoke clearly.  “Thank you!”

More references:

History of the yellow fever vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2118520/

Academic Journal Article on New Malaria Vaccine: High Efficacy of a Low Dose Candidate Malaria Vaccine, R21 in 1 Adjuvant Matrix-M™, with Seasonal Administration to Children in Burkina Faso, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3830681