The collision between a Chinese F-8 fighter and an American Navy EP-3 electronic reconnaissance plane over the tropical island of Hainan threatens to cast a Cold War-style shadow over diplomatic relations between China and the Bush administration.

Yet most Americans may not appreciate that Hainan is also one of China’s poorest provinces and among the most destitute regions in Southeast Asia. The province is heavily plagued by a variety of tropical infectious diseases ranging from malaria to mosquito-borne viruses. Our medical parasitology research laboratory has worked in Hainan since 1998 when we first realized that there are more intestinal parasites in Hainan than just about anywhere else on the planet. Based on diagnostic examinations conducted on thousands of Hainan residents during a medical survey of the island in the early 1990s, the Chinese Ministry of Health reported that 94 percent of the population harbors at least one intestinal parasite. This includes more than 60 percent of the population infected with parasitic worms, including Ascaris roundworms, Trichuris whipworms and Necator hookworms. In many cases, it is common to find residents of Hainan who harbor all three examples of this “unholy trinity.” All too frequently children are the ones most heavily infected. As a consequence they suffer from malnutrition, physical growth stunting, and intellectual retardation. In many cases, the children of Hainan may experience life-threatening acute intestinal obstruction or perforation that result from the activities of large numbers of these worms.

In order to help alleviate the enormous burden of disease in Hainan, our National Institutes of Health, as well as the March of Dimes Birth Defects Foundation is sponsoring joint research projects to examine the impact of intestinal parasites on the populations of southern China, especially Hainan. Our work there is being conducted jointly with the Institute of Parasitic Diseases of the Chinese Academy of Preventive Medicine. In an unusually close cooperative effort we are learning why some people living in Hainan might be resistant to these parasites. We are using the information to design a novel vaccine in order to combat parasitic worms. In at least one instance our project took us to Lingshui county - not too far away from where the disabled EP-3 aircrafts sits on the tarmac. The work is hard and difficult; it has required lots of mutual give and take on both sides. One of the many benefits of the collaboration is its requirement for regular scientific exchanges to each country. Over the last few years we have built a strong scientific collaboration and close friendship.

Enormous good will has developed between the members of my laboratory and our Chinese friends and colleagues during the last few years. We are driven and touched by the enormous burden of disease that the people of Hainan face on a daily basis. We also recognize that infectious diseases are potential threats to everyone, even in the U.S. The events of the last few days should not distract us from the fact that we have much in common with the Chinese, and much to gain by continued peaceful and meaningful cooperation. We have learned that an anti-worm vaccine makes for a terrific instrument of diplomacy.

Peter Hotez MD PhD is Professor and Chair of the Department of Microbiology and Tropical Medicine, The George Washington University, and Senior Fellow of the Albert Sabin Vaccine Institute. He is also Visiting Professor of the Institute of Parasitic Diseases of The Chinese Academy of Preventive Medicine in Shanghai.