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—Dr Hartwig's letter emphasizes some important points raised by our article. Indeed, we agree with Hartwig that malaria continues to be a major health threat throughout much of the tropical world. The title referred to the limited and diminishing awareness of this health threat in the United States and elsewhere in the industrialized world. The goal of the article was to alert readers to this problem.The looming crisis of parasite drug resistance presents an immediate threat to everyone who experiences acute episodes of malaria, including immune adults. It is especially threatening to all nonimmune persons, including children less than 5 years of age, pregnant women, both from endemic and nonendemic areas, refugees, migrant workers, and travelers. Antimalaria drug therapy remains the primary intervention for malaria infection worldwide, and drug resistance will compromise this intervention. Malaria is not the only infectious disease for which drug resistance is emerging
Olliaro P, Cattani J, Wirth D. Malaria: Submerged Awareness-Reply. JAMA. 1996;275(19):1482. doi:10.1001/jama.1996.03530430026033
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