Enduring Warning: A Holistic Comparison of the Establishment and Spread of P. falciparum Evolutionary Lineage Malaria in Ancient Rome and the Threat of Zoonotic P. knowlesi Malaria in Modern Southeast Asia

Abstract. Our article presents a holistic analysis aimed at discerning patterns from ancient–modern comparative contexts of malaria. The article’s interdisciplinary and consilient methodology is drawn from a range of disciplines: the humanities and social sciences, medical knowledge (particularly epidemiology and pathology), molecular phylogenetics, demography, archaeology, paleopathology, numismatics, complex systems theory, etc. The article begins with a detailed exploration of a 463 BCE epidemic event that likely marked the, ultimately transformative, debut of P. falciparum evolutionary lineage malaria for ancient Roman civilization. It is important to note that the concept of evolutionary lineage is defined herein as a sequence of organisms, descended from a common ancestor and culminating, for the present at least, in the form existing currently. An interdisciplinary retrospective diagnosis methodology is utilized to establish, with what we believe to be a high degree of probability, a conclusion that effectively marks the beginning point for the ancient side of our comparative example. The deep interdisciplinary/historical methods used to elucidate the ancient side of the disease equation both lead to a clear conclusion and suggest potential modern analogies or even “prophecies.” These are used to highlight the threats emanating from the current spread of zoonotic P. knowlesi malaria in Southeast Asia. The article also utilizes six broader holistic and interdisciplinary factors in its contextual and comparative analysis: (A) political, military and security contexts; (B) the effects of cultural perceptions; (C) the role of climate and climate change; (D) additional anthropogenic environmental factors; (E) perceptions, practices and capabilities of prevailing medical systems and (F) holistic underlying states of the health of affected populations.