Malaria is an infectious disease like no other: it is a dynamic force of nature and Africa’s most deadly and debilitating malady. James C. McCann tells the story of malaria in human, narrative terms and explains the history and ecology of the disease through the science of landscape change. All malaria is local. Instead of examining the disease at global or continental scale, McCann investigates malaria’s adaptation and persistence in a single region, Ethiopia, over time and at several contrasting sites. Malaria has evolved along with humankind and has adapted to even modern-day technological efforts to eradicate it or to control its movement. Insecticides, such as DDT, drug prophylaxis, development of experimental vaccines, and even molecular-level genetic manipulation have proven to be only temporary fixes. The failure of each stand-alone solution suggests the necessity of a comprehensive ecological understanding of malaria, its transmission, and its persistence, one that accepts its complexity and its local dynamism as fundamental features. The story of this disease in Ethiopia includes heroes, heroines, witches, spirits—and a very clever insect—as well as the efforts of scientists in entomology, agroecology, parasitology, and epidemiology. Ethiopia is an ideal case for studying the historical human culture of illness, the dynamism of nature’s disease ecology, and its complexity within malaria.