Malaria: History’s Role

As the curators of the exhibition Mission Malaria: A Historical Overview our intention was to reveal the —often unsuspected—connections between the history of malaria and the social, cultural, economic and ideological history of humanity.

Working over the past few months to bring the story of malaria to the public has been a unique and priceless opportunity for me: fifteen years ago I left behind my “other life” to dedicate myself to the fight against malaria. That other life was a career as a science historian. You will, therefore, understand if I wax a little philosophical and share some observations about the exhibition entitled Mission Malaria: A Historical Overview, which opened recently at the National Museum of Natural Sciences in Madrid. It is not my intention to talk about the content of the collection–which is, after all, there to be seen–but rather about the basic premises on which Alain-Paul Mallard and I based our approach to the curatorship of the exhibition and the importance, in our view, of looking at this devastating disease through the lens of History.

The starting point for the exhibition was the collection compiled by Quique Bassat of books and objects associated with the history of malaria, a truly exceptional one. I could not believe I was holding a jar of cinchona bark powder or an original book by Grassi with scientific illustrations that could pass for abstract artworks.

Our goal as curators was to create the right habitat for these objects, to cocoon them in the threads of meaning that only the historical context can provide.

The exhibition starts out in the era of the Galenic paradigm, a time when “fevers” were attributed to corruption of the blood due to inhalation of putrefying miasmas (malaria was thought to be caused by bad air—mala aria in Italian), and moves on to the conceptual revolution of the 19^th century, when the symptoms of malaria were first attributed to infection of the body with an external agent. It then follows the story through the 20th century and also covers the dramatic crisis caused by malaria in the world today.

The story of malaria is one of dizzying sagas, great scientific insights and colossal health enterprises, interwoven with business and commercial interests, wars and state secrets.

However, what makes the history of malaria really fascinating, and what this exhibition seeks to reveal to the visitor, is the complex web of links connecting the history of this disease with the social, cultural, economic, and even ideological history of humanity. This web includes links between issues that do not, at first glance, appear very connected, such as the Cold War and public health or the fear of getting sick and the English custom of drinking a gin tonic in the evening in tropical climes.

The story of malaria is one of dizzying sagas, great scientific insights and colossal health enterprises, interwoven with business and commercial interests, wars and state secrets.

If Jesuit apothecaries were able to bring to Europe a miraculous bark that cured fevers in the 17th century, it was only because they had travelled to Peru with the Spanish conquistadors. The same context determined the way they interpreted their discovery: it was seen as a sign of divine providence that the territory conquered for the Catholic faith provided the Old World with a remedy effective against epidemics.

When Laveran observed the blood of sick patients in Algeria through a microscope and first outlined the hypothesis that malaria was caused by a parasitic infection, and when Ross dissected thousands of mosquitoes in India because he believed that malaria might be transmitted by these insects, neither of them just happened to be in those countries by chance. Both were living there as part of the armies of their respective countries in the context of 19^th century colonial expansion.

History reveals the complexity of the fight against malaria today and compel us to act with the utmost sense of responsibility on every front

In Europe, the paradigm shift opened the door to massive public health campaigns, which were no longer focussed on dispelling miasmas but instead targeted the mosquito vector with interventions such as screens on windows and draining swamps where larvae might breed. Once malaria had been eliminated, areas once virtually uninhabitable became economically viable.

Many years later, on the other side of the world, the discovery of artemisinin was the result of a desperate request made by Ho Chi Min to his ally Mao during the Vietnam War; the Vietnamese leader begged China to develop new antimalarial drugs to protect his troops from the ravages of malaria.

Today, the highest prevalence of malaria is found in remote areas of rural Africa. This distribution is, of course, influenced by biological factors: the most lethal species of the parasite, the most efficient vectors. But no one can deny that it is also a consequence of neglect and poverty. Returning to history, we should not forget that the Global Malaria Eradication Programme launched in the 1950s was simply never implemented in Africa. As a result of DDT spraying campaigns to eliminate mosquito populations, malaria was disappeared at that time from the world’s most affluent countries, but it has continued to ravage an entire continent.

If anything guided Alain-Paul and myself when we thought about how to present this exhibition, it was a desire to exemplify one of the most basic principles of historiography: the idea that the course of history is contingent rather than inevitable. What has brought us to the present situation is a long and complex process in which certain people at certain historical crossroads made certain choices based on their particular view of the world: their scale of values, their interests… in brief, their ideology. This was true in the past and is still the case today.

It is our hope that, after being apprised of this view and learning about the history of this disease, visitors to this exhibition will end up in agreement with the oft-repeated assertion that malaria is perhaps the best—the worst—example of the inequalities and injustices that exist in the field of global health.

For those of us who are, in one way or another, involved in the fight against malaria, we hope that the history of this disease will help us to better understand the immense complexity of the challenge we are facing and compel us all to act with the utmost sense of responsibility on every front.