Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955-1975 (review)

When eradication efforts began in Mexico in the 1950s, medical officials had two very different models to guide them. One set of initiatives, typified for Marcos Cueto by Tennessee Valley Authority (TVA) projects in the United States, involved fighting malaria through urbanization, better housing, improved sanitation, altered agricultural practices, water drainage, education, and better medical care. A second model involved committing everything to a heroic campaign to eliminate the disease. This was done either by giving individuals chlorquinine, the most common chemical then in use to kill the microscopic plasmodia that cause malaria, or by employing larvicides to wipe out the mosquitoes that spread the disease. In the literature, this second model is sometimes referred to as a "magic bullet" solution. Cueto argues that the varied and complex approach adopted by the TVA is more effective in the long run than the search for a magic bullet and would have been much more appropriate for the eradication campaign in Mexico. Unfortunately, it was not the path taken.

During World War II, Americans used the miraculous insecticide DDT to eradicate mosquitoes and save thousands of soldiers' lives. Based upon this success, the U.S. Department of State along with international agencies like the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) pursued quasi-military campaigns using DDT around the world in an attempt to eradicate the vectors for malaria in the post-war era. DDT seemed like a universal panacea. The United States took the lead in the effort to eradicate malaria because it served U.S. Cold War interests do so. It showed that the United States could deliver the scientific goods better than the Soviets. It presented the most benign face of America to the developing world and made countries more amenable to the global capitalist system.

Thus, the malaria campaign was a key element of the Cold War, and it was steeped in Cold War terminology. Health workers pursued the "containment" of malaria with DDT, described as an atom bomb for insects, and officials like Fred Soper imagined that people freed from malaria would also be freed from the contagion of communism. Part of the malaria campaign involved a new procedure for testing asymptomatic people for the presence of the plasmodium in the blood. Cueto writes: "There was a parallel between the new system of identifying malaria cases and a Cold War fear. The new laboratory techniques," suggested that asymptomatic carriers could still "harbor invisible germs that could spread malaria in a healthy population. Likewise, in Red-Scare America of the 1950s, communism could exist in a few apparently normal people who could 'contaminate' other citizens and an entire society. It was of the utmost importance that infected individuals—carriers of malaria parasites or communists in disguise—[be] isolated and treated so that they would not become dangerous, and even fatal, to the rest of society" (p. 48).

Mexicans sometimes greeted malaria eradication efforts with suspicion, partly because little effort was made to involve local leaders in the effort. As a result, clashes at the local level hampered efforts to eradicate the disease. One lesson Cueto extracts from this history is that anti-malaria campaigns must be sensitive to local traditions and forms of knowledge in order to include people as subjects of their own liberation. By the late 1960s a series of problems, especially environmental concerns associated with DDT, derailed malaria eradication efforts. "By the end of the 1960s," writes Cueto, "malaria eradication seemed hopeless" (p. 151) and funding dried up. People realized that malaria would always be present and mosquitoes would always exist. This could not be controlled by any "magic bullet." Mexicans in the 1970s settled into a strategy of living with malaria, what Cueto calls a "culture of survival" (p. 158).

This, he believes, is the most intelligent response to the problem of malaria, not just in Mexico but around the...