Malaria kills millions of people each year and hundreds of millions more suffer chronic illness. Economic development is inhibited and poverty is perpetuated. Tren and Bate argue that action against malaria is over-centralised and narrowly focused, ignoring local conditions and concerns. Health agencies in developing countries and some companies are trying to stem a resurgent tide of malaria. Their work is, however, hampered by pressure from environmentalist groups and donor agencies which still crusade against the use of DDT and which have a partial victory under the POPs (persistent organic pollutants) convention. A continuing anti-DDT campaign would have as its victims people in some of the world's poorest countries.