For most of us travellers, the government and medical men and women have a good deal to answer for.
Your average holidaymaker is content to become a human pincushion in the name of safety before shipping off to exotic foreign parts because he believes the shots enable him to travel virtually anywhere with immunity. Besides the utter deceit of it (since most of these jabs don't work very well), the problem with this health policy is that the search for the magic bullet has replaced more common sense management of disease.
In the case of malaria, the medical profession continually searches for new and stronger drugs, which only causes the malaria bug to mutate, outwitting and ultimately eluding the latest and strongest preparations. If this drug policy continues unrestrained, we will soon have no effective treatment for malaria.
Nevertheless, we already have a simple and effective preventative. It doesn't cause transfer resistance in the malaria bug population, and it doesn't even require drugs.
This amazing medical breakthrough is the mosquito net.
Nets are a highly effective means of cutting risk of malaria. In one study, the number of deaths from malaria among African 5 year olds was cut by up to a third and hospital admissions plummeted by 40 per cent through the use of bed and door nets impregnated with the biodegradable insecticide pyrethroid. WHO estimates after large scale trials that the lives of half a million children could be saved each year simply using the nets.
The other bonus is unlike a vaccine, the net doesn't put off exposure indefinitely. Children are exposed to malaria but the net reduces the frequency of severe infections. Immunity is thus allowed to develop naturally for these children (BMJ, 1996; 312: 995).
For Western travellers, holiday jabs also cause a displacement of personal responsibility. We are led to harbour the illusion that we can head off to the most unsanitary and epidemic infested locale without the slightest risk to our health. All we need to do is take our jabs.
These potentially dangerous and often ineffective drugs often take the place of simpler and more effective measures of warding off disease.
Simply obeying certain hygiene rules, particularly concerning water and uncooked food, and replacing lost fluids may protect you against all forms of cholera; studies have shown that a healthy person can have more than a billion cholera bugs in their body without developing the disease (Times, June 3, 1993).
Avoiding uncooked vegetables which are irrigated with raw wastewater in arid parts of the world such as Peru (Lancet, 1992; 340: 20) or raw fish, such as ceviche, which played a minor part in a cholera epidemic (Lancet, 1992; 340: 20) can also prove lifesaving.
But perhaps the best suggestion is to consider carefully about where you go on holiday and where you and your family stay. Ignoring the government's suggestions, which would have you believe everywhere outside your own country is infested with lethal illness, find out where in the world the real epidemics are and avoid them like people very sensibly used to avoid the plague. Assuming you can't count on vaccines for absolute protection, is it really worth vacationing in the midst of an epidemic of Yellow Fever?