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The relevance of research to the global antimalaria programme.

Malaria is part of a biological system that encompasses various Plasmodium species, their vertebrate and arthropod hosts, and the hosts' physical environment. In human malaria the range of Plasmodium species is restricted to P. falciparum, P. vivax, P. ovale, and P. malariae, and that of the arthropod hosts to Anopheles spp. While P. falciparum has received most attention on account of its often peracute and fatal clinical course, it would be wrong to neglect malaria caused by the other Plasmodium spp.; P. vivax is responsible for much suffering and temporary disability, especially in Asia; the pathogenetic role of P. malariae, frequently found in Africa south of the Sahara, has not yet been elucidated and we may well be facing the " tip of an iceberg ", with the real bulk of the problem still hidden. As with any other biological system, malaria and its transmission lend themselves to interference in practically every part or phase of the system, given the appropriate means. In the past, such means were found empirically; but at the start of this century when a large part of the malaria parasite's life cycle had been elucidated, a more systematic approach began to be employed. So far the range of financially and technically feasible means and methods of interference is quite limited, compared with the potential range of intervention. The means and methods at present employed for the control of malaria would appear to be rather unrefined compared with possible future approaches which may provide more effective and environmentally more acceptable weapons against the disease, as, for instance through subtle modifications of cellular receptivity to parasite invasion. The main pillars of antimalarial operations are still vector control using residual insecticides and antilarval measures, chemotherapy, and chemoprophylaxis. The choice of the appropriate tools depends on the objective of the antimalarial operations, the epidemiological situation, the environmen-