Local cases of malaria, the ?chicken flu? scare, the outbreak of SARS in Asia- all these have recently drawn attention, in quite a dramatic way, to the question of the control of infectious diseases in the modern world.

This was a problem that we thought had been solved. The discovery of antibiotics dealt with the killer-disease tuberculosis (TB). In the more developed countries, polio, a particularly cruel disease which left so many severely handicapped victims, has been eradicated through efficient and widespread vaccination. It still exists however-notably in some African countries where the World Health Organisation (WHO) is aiming to put an end to it through mass-vaccination in the next few years. Again thanks to vaccination, childhood diseases such as measles are no longer to be feared.

Indeed we have heard so much more in recent years of non-communicable diseases such as cancer and cardio-vascular illness and their spread to the developing world that we took it for granted that the fight against infectious diseases was more or less won.

The first shock was the HIV-AIDS epidemic which brought home the realisation that modern medicine was powerless to find a cure. Apparently linked to AIDS, TB has made a strong come-back. What had previously been considered as an eminently treatable disease suddenly became a killer again as new strains turned out to be resistant to all the antibiotics normally used to treat it.

Malaria remains a huge and practically untackled problem in sub-Saharan Africa, where over a million children die of it every year. Again this disease is resisting the traditional quinine-based medications and the more effective drugs which have recently been put on the market are much too expensive. All attempts to develop a vaccine have failed so far. Only 2% of children sleep under the insecticide-treated mosquito nets that could save their lives. How unfortunate that such simple solutions as the latter are out of the reach of so many people because of poverty or a lack of will on the part of governments.

Politics has often raised its ugly head in the context of disease-control. The Chinese government tried to keep the SARS outbreak secret, thus making containment of it much more difficult. Some African leaders refuse to accept that they have an AIDS epidemic in their country because they find it hard to deal with the sexual connotations associated with the disease. One step in the right direction however is that the big pharmaceutical companies have been forced to give up their intellectual property rights and accept that competitors produce much cheaper ?generic? drugs. Thus many more HIV/AIDS sufferers now have access to the medication they need.

Education on health issues, improved standards of public health, more research on the WHO?s three priority diseases of the developing world- HIV/AIDS, TB and malaria- more honesty, humanity and foresight on the part of governments ? these are just some of the ways in which this very alarming situation might begin to be brought under control.