For the last 15 years, we have studied the relationships among cichlid snail-eating fishes, intermediate snail-host density, and the prevalence of human infection of Schistosoma haematobium in Lake Malaŵi and concluded that the increase of human infection is correlated with the decrease in snail-eating fishes in the shallow waters of the lake. We postulated that a strain of S. haematobium from other parts of Africa, which was introduced into the Cape Maclear region of Lake Malaŵi by tourists, was compatible with Bulinus nyassanus—which is a close relative of B. truncatus, and interbred with the indigenous strain of S. haematobium, which ultimately produced via introgression a strain that can use both B. globosus and B. nyassanus as intermediate hosts. This actively evolving situation involving intermediate snail–host switching and decline of Trematocranus placodon, a natural cichlid snail predator, will impact on transmission of urogenital schistosomiasis within the local communities and on tourists who visit Lake Malaŵi.