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No one knows exactly why resistance to malaria drugs always emerges first in this remote western province of Cambodia, nestled in the Cardamom Mountains. “The reasons are as much social as biological,” says malariologist Tom Peto, who is here in this dusty, unremarkable-looking town battling the latest threat to global malaria control: multiple drug–resistant (MDR) malaria.

Young man behing a mosquito nest, in Southeast Asia
Migrant workers such as this man in Pailin, Cambodia, near the border with Thailand, are at especially high risk of contracting malaria. Jeffrey Lau

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