Malaria Redux: The History and Ethics of Malaria Eradication and Control Campaigns in Tropical Africa

During the 1950s, colonial malariologists, in conjunction with experts from the World Health Organization, set up malaria eradication pilot projects across tropical Africa. They deployed new synthetic insecticides such as DLD, HCH, and DDT, and new antimalarials, such as chloroquine and pyrimethamine, in an effort to establish protocols for eradication. These efforts 'protected' some fourteen million Africans. Yet by the early 1960s, the experts concluded that eradication was not feasible, and the pilot projects were disbanded. The 'protected' populations had lost their acquired immunities to malaria during the years of the projects, and in the aftermath of the projects, the Africans were subject to severe malaria, which sometimes afflicted entire communities in epidemic form, until they regained their immunities.

With the establishment of the Global Fund in 2002, the President's Malaria Initiative in 2005, and the Bill and Melinda Gates Foundation's call in 2007 for a new campaign of global malaria eradication, a new chapter in the history of African malaria eradication opened. The campaign has deployed some well-established malaria control tools, such as indoor residual spraying with insecticides, and has increased the availability of a new generation of antimalarials (ACTs, artemisinin combination therapies). The new campaign has forged ahead without an endgame in sight. The funders trust that the malaria control tools, perhaps in conjunction with technological advances in vaccines, transgenic mosquitoes, and antiparasitic fungi, will ultimately defeat malaria. The campaign, however, is already facing the specter of mosquito resistance to the synthetic insecticides and parasite resistance to the antimalarials. The danger is of a replay of the epidemic malaria that followed on the abandonment of the malaria eradication campaign in the mid-twentieth century.

This paper explores the parallels and differences between the two campaigns and the ethical dimensions of medical interventions that potentially create higher health risks for 'protected' populations. In what ways has the malaria problem itself changed over time? What can the study of antimalaria campaigns in the past tell us about the present?

Presented by James Webb, Colby College, at the Center for Historical Research, Dept. of History, The Ohio State University on May 18, 2012.

The Ohio State University Center for Historical Research in the Department of History provides a stimulating intellectual environment for studying important historical issues around the world. Each year the Center brings together scholars from various disciplines to examine issues of broad contemporary relevance in historical perspective.