How imperialism removed malaria from the developed world

Link to part 1 of this review:
How colonialism & imperialism spread malaria

Malaria and imperialism: A Review of “The Making of a Tropical Disease: A Short History of Malaria” by Randall M. Packard (Johns Hopkins Biographies of Disease).

As the 19th century drew to a close, scientists began to figure out the life cycle of the malarial parasite and its relation to anopheles mosquitoes. This knowledge became a weapon in interimperialist competition, as well as a tool to eradicate malaria.

While French scientists were active in investigating malaria, French policymakers didn’t use the developing prophylactics—mainly quinine—for their troops in malarial areas until after World War II. (See “Malaria & French Imperialism” in the Journal of African History, 1983.) Even though most of these troops were drawn from areas of the French empire outside the metropole, many of these troops had no or a very limited exposure to malaria, and so suffered tremendously when they were exposed to it. Some military units in Africa in the 1880s had mortality rates as high as 800 per 1,000.

French imperialism had the first concession to build the Panama Canal. After an attempt, the French withdrew in 1888 after 20,000-25,000 of their workers died. Financial backers grew leery of pouring money into a project that might never be completed because workers on the project were dying instead of working.

Packard tells how the United States was able to step in a few years later and successfully complete the canal. U.S. managers used what had been learned from eliminating malaria and yellow fever in Havana, during the time U.S. imperialism occupied Cuba after the 1898 Spanish-American War.

The limitations of Packard’s approach to the connection between malaria and colonialism can be seen in his chapter on “Tropical Development and Malaria,” in which he looks at Brazil, South Africa and India at the end of the 19th and beginning of the 20th century. Each history is fascinating and richly detailed but he fails to say directly that U.S. and European imperialism imposed the “patterns of economic development” in these three regions.

Packard just concludes: “Patterns of economic development linked to agricultural expansion prevented farmers in these regions from growing out of malaria at the same time that they contributed to an extension of malaria...” Their agricultural practices created conditions for the explosion of mosquitoes, exposing people living in these regions “to malarial infections” and contributing to “the movement of malarial parasites.”

In his chapter on the attempts at eradicating malaria after World War II, Packard has a chart showing countries achieving that goal: Italy, the Netherlands and the U.S. were among the imperialist countries; Grenada, Puerto Rico, and Cuba were among the island nations; and of the socialist countries in Eastern Europe, Bulgaria, Poland, Romania, Yugoslavia and Hungary succeeded. He points out that the Eastern European countries were “relatively poor but possessed reasonably well-developed health infrastructures.”

Packard doesn’t mention Vietnam, which succeeded in controlling malaria starting in 1991, when that country had nearly 2 million cases of malaria and 4,646 deaths. In 2003, among its 81 million people, Vietnam had only 37,416 cases and 50 deaths. (World Health Organization)

Vietnam used the “traditional” drug artemisinin, extracted from the indigenous Thanh Hao tree, that had been used by Chinese and Vietnamese physicians for 2,000 years. The Vietnamese also developed the industrial capability to make treated bed nets. But the most important factor in this campaign was creating village- and community-based health care networks, supported by 400 mobile outbreak teams. These local teams handled house spraying and bed-net distribution and got local communities involved in controlling malaria.

Before and especially after the White House had a summit on malaria in December 2006, foundations, governments and NGOs have poured tens of millions of dollars into malaria suppression and eradication, focused on Africa, where the most virulent form of malaria affects millions of people. Thousands of articles on malaria have been written. It is a hot topic.

Packard has a detailed analysis of the technical aspects of a number of these proposals and programs, pointing out, for example, that no vaccine has been yet developed against any parasitical disease. Since malaria has four distinct phases inside the human body, it will be especially difficult to develop a vaccine for it.

An interesting question that Packard does not raise in his analysis is why so much attention and money from major corporate-related foundations are going to controlling malaria.

One possible reason for this attention is the need to have healthy workers to extract the resources which Africa possesses in such abundance. The French imperialists learned in Panama that they couldn’t dig the canal they wanted without healthy workers.

Another possible reason is China’s current challenge to European and U.S. imperialism in Africa. The strength of this challenge became clear at the summit between the European Union (EU) and African countries held in Lisbon, Portugal, in December 2007.

African countries almost unanimously rejected the Economic Partnership Agreements with the EU because they had an alternative—China. But if the EU and the U.S. can show that they can solve a major public health problem in Africa, they might be able to entice, more likely coerce, more African countries into “partnerships.”

No progressives would disagree with Packard’s conclusion: “In the long run, the social and economic conditions that drive malaria transmission—including ... labor exploitation that places workers at risk of infection, warfare .., population displacements ... and poverty—need to be reduced or eliminated.” But anti-imperialists would add that this goal can only be realized in the poor and oppressed countries of the Third World by putting an end to U.S. and European imperialist domination of these countries.

“The Making of a Tropical Disease” has its limitations, mainly in not drawing all the obvious conclusions from the data so ably presented, but it is well worth reading.