Malaria is a life-threatening disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who contract malaria are typically very sick with high fevers and flu-like illness, which can include shaking chills, headache, muscle aches, nausea. If not promptly treated, the infection may lead to kidney failure, seizures, coma, and death.

In 2017, there were an estimated 219 million malaria cases and some 435,000 malaria deaths around the world. It is also a disease of great military significance and endemic in much of Australia’s area of military operations with Africa accounting for the most global cases of malaria (92% in 2017), followed by the South-East Asia Region (5%) and the Eastern Mediterranean Region (2%). Although malaria can be a deadly disease, illness and death from malaria can usually be prevented by the use of preventive medication, insecticides and protective clothing/equipment. The most current global information about malaria is available on the World Health Organization website.

In all of the ADF’s major conflicts since the First World War, malaria has been a significant and, at times, the main cause of casualties. Malaria has severely impacted the Australian Army’s combat operations on three occasions: Palestine, 1918; New Guinea, 1943 and Vietnam, 1968.

people lining up outside getting their mouths checked

Malaria is one of the few infectious diseases that can quickly fill hospital beds with sick soldiers when a military unit is unable to prevent infection. During the Vietnam War, more than one per cent of infantry soldiers were hospitalised each day from malaria infection during an epidemic in 1968. In more recent times, operations in Timor-Leste 1999-2001 were impacted when nearly 400 ADF members became infected with malaria related to their deployment.

Preventative medications remain the basis of all malaria prevention plans which requires not only a knowledge of the regional malaria patterns, but a continuously renewed supply of effective medications for use by ADF members.  Although an effective drug combination was quickly developed after the 1968 epidemic, the malaria parasite can evolve and drugs that worked previously often fail during the next war. The risk of malaria varies greatly depending on whether an ADF member is in Vanuatu (low risk), Papua New Guinea (high risk), Timor-Leste (high risk) or peace-keeping operations in Africa (very high risk).  

During all four instances where combat operations were severely impaired due to malaria an Australian military malaria research group (operating under various names) was called on to determine the source of the problem and come up with a militarily-relevant solution. Currently known as the Australian Army Malaria Institute (AMI) located on Gallipoli Barracks since 1996, AMI’s mission is to prevent mission failure during tropical deployments of the ADF due to infectious diseases that are spread by insects, such as malaria and dengue.

The ADF’s recent experiences with malaria are detailed in the article:

Malaria notifications in the ADF 1998-2007 (PDF, 288.76 KB)

three photographs of groups of people outside

Despite significant progress being made through the rollout of effective prevention and treatment methods, malaria remains a significant problem around the world for both individuals and governments. According to the World Health Organization (WHO) around 3.2 billion people remain at risk of malaria and in 2017 alone there were an estimated 219 million new cases of malaria and 435,000 deaths.

While Africa continues to be hit the hardest by this disease, a significant threat still exists within the Asia-Pacific region and in the areas where the ADF conducts operations. The Australian Government recently reaffirmed its commitment to eliminate malaria in the Asia-Pacific by 2030 and the ADF’s own Malaria and Infectious Diseases Institute* (ADFMIDI) is currently working with a number of other research organisations, including the University of Queensland and the Queensland Institute of Medical Research to realise this goal. As the WHO’s Regional Collaborating Centre for the Western Pacific, ADFMIDI is responsible for both teaching military preventive medicine to ADF personnel as well as improving malaria and viral diagnostic capabilities throughout the region.

However the evolution of parasite drug resistance in the past decades has presented new challenges which can only be addressed by ongoing laboratory research and clinical field trials. This work is particularly important for the ADF as members are often deployed into remote areas and exposed to harsh environments where is it difficult to prevent mosquito bites using bed nets and insect repellents. Just as one has to field test any military equipment under realistic conditions to be certain it will perform well during war, new medical interventions such as drugs, vaccines and insect repellents must be rigorously proven to satisfy operational as well as safety and regulatory requirements.

The most current global information about malaria is available on the World Health Organization website.

*In 2017 the Army Malaria Institute was renamed the Australian Defence Force Malaria and Infectious Diseases Institute

Additional information can be found by clicking on the links below: