The ascent of malaria
It is estimated that half of all human deaths since the Stone Age have been due to malaria. As this reviewer reads Sonia Shah’s The Fever: How Malaria Has Ruled Mankind for 500,000 Years, with an electric mosquito swatter in hand, it seems incredible that a disease man found a cure to 400 years ago, learnt to prevent in early 1900s and developed prophylactics for almost 50 years ago, continues to cut swathes through populations across the world today. Is the species Anopheles a super vector, and the protozoa that causes it, Plasmodium, a super bug? Ms Shah, an award-winning investigative journalist, answers those questions and more, delivering a timely, inquisitive chronicle of the illness and its influence on human history. Central to her narrative is the parallel evolution of men and mosquitoes; that human development has influenced, and indeed, been influenced by, the spread of malaria.
With the easy writing style of the seasoned journalist, Ms Shah examines the invisible link between malaria, poverty and the politics of development. Over centuries, malaria-prone regions and populations have been stigmatised as being somewhat inferior; she, in fact, links the disease to the growth of racism in America. People of African descent sold as slaves in America, were genetically resistant to Plasmodium falciparum, the microbe that causes some of the deadliest forms of malaria. When this disease began to affect European slave owners but not the slaves, fears of a slave rebellion caused white planters of divergent class and ethnic backgrounds to unify against the feared black majority. Later in the book, Ms Shah points out that even after the discovery that mosquitoes were vectors of malaria, mosquito eradication programmes were selectively carried out. In Britain’s West African colonies, for example, the antimalarial programme included sequestering the Europeans as far as possible from mosquito-ridden lowlands, as well as the malaria-afflicted natives.
Fever also makes the compelling case that the epidemiology of malaria has historically been rooted in environmental change. When oak forests were cut to accommodate the growing Roman republic, the denuded land became marshy, a perfect habitat for a migrant North African mosquito species to which locals were not adapted. The resulting waves of malaria contributed to Rome’s decline. Mosquitoes also proved to be free Scotland’s undoing. When the Scots embarked on an expensive colonising expedition to Panama, they sent fine ships filled with provisions and (what they thought) their most desirable produce to trade (wigs, muslin, tobacco pipes and pewter buttons to name some). However, thanks to recurring epidemics of malaria, all that soon remained of the Scots in Panama was a colony of gravestones. Scotland was bankrupted by this debacle and England offered to bail the nation out on the condition that it became a part of a new Great Britain. And the rest, as they say, is history.
The first real onslaught against malaria came about when malariologists begun studying the etiology of the disease. The author entertainingly describes scientist Ronald Ross’ failure to grow mosquitoes under laboratory conditions. However, after Ross’ important discovery that malaria was spread by mosquitoes, societies and governments across the world failed to curb mosquito populations. This, too, like the deadly fever’s inexorable march across the planet, was mired in politics and commerce.
Ms Shah’s lucidly conversational writing style brings many more such stories about science, history, and culture to life. She even manages to make the etiology of malaria sound like a gripping bestseller. For instance, she describes the complications in the journey of unicellular Plasmodium as it finds the exact species of vector mosquito, which then has to find a human to have its last blood meal before it lays its eggs, as being sort of like robbing a bank while stealing a car. Plasmodiumcomes across as the classic James Bond-type of villain — it creates armies of progeny, reproduces both sexually and asexually for greater impact and seems practically indestructible.
While the author adeptly manages to link human history with the spread of malaria across the globe, readers, however, will be left wanting to know more about more contemporary linkages between environmental change, the politics of development and the epidemiology of Malaria. Ms Shah writes that the creation of slums and poor development strategies for rapidly urbanising populations have been responsible for the growing population of mosquitoes. However, she fails to draw specific parallels between contemporary events and the spread/resurgence of malaria, as she has so beautifully done with historical events.
Ms Shah prophesises that the global construction boom predicted between 2018 and 2024 and climate change are likely to cause vector populations to skyrocket. And current malaria research is, in her opinion, far from ready for the challenge. Much of this research is being conducted oceans away from places where wild malaria actually exists; by scientists who work in rarified laboratories instead of in the field. Most of the big funders of malarial research are looking for that elusive miracle cure. However, given the plethora of mosquito species, malarial strains and genetic mutations across the world, there can be no one-size-fitsall solution for malaria. It’s an itchy thought, and quite like malaria, The Fever continues to linger with the reader long after it has been put down.
THE FEVER: HOW MALARIA HAS RULED HUMANKIND FOR 500,000 YEARS
Sonia Shah Penguin
309 pages; ~499