ABSTRACT
The determinants of malaria vary on many scales throughout the world in their effects as well as their occurrence. In many regions, one could argue that there is little justification for considering malaria at a continental scale; often the differences within a continent are too great and diverse. But for Africa, a good case can be made: the vector species are limited in number but widely spread across the continent, and malaria itself has a relatively coherent epidemiology throughout much of sub-Saharan Africa. In particular, because Africa is the home of the most efficient anopheline transmitters of malaria and because transmission reaches much higher levels than elsewhere in the world (with only local exceptions), the characteristics of African malaria are more extreme than observed elsewhere. In addition, the responses to changes in determinants may be different, or more subtle, than may be suspected elsewhere.
