War and Disease: Biomedical Research on Malaria in the Twentieth Century

Chapter 4: Preparing for War

84 When the war in Europe began in September 1939, researchers and health officials in the United States were already trying to address the shortcomings and potential shortfalls of quinine, cinchona, and the existing synthetic antimalarials. This period prior to U.S. entry into the war showed some of the weaknesses and strengths of the National Research Council’s approach to scientific research. The NRC had begun to take an interest in malaria chemotherapy some months before the invasion of Poland. Meeting in Washington, DC, in April, NRC’s Division of Chemistry and Chemical Technology (Chemistry Division) asserted the need for, and committed itself to, stimulating research “in the field of quinine substitutes and synthetic antimalarials.”1 Originally formed by the National Academy of Sciences in 1916, the NRC was composed of leading scientists. Its mission was to employ science and technology in the promotion of both national welfare and national security—two pressing concerns in the run-up to U.S. entry into World War I.2 With a second great war looming, the NRC established a temporary committee to look into the status of malaria and antimalarial drugs. Like Albert Einstein’s 1939 letter to President Roosevelt urging him to conduct research on the atomic bomb, this NRC committee meeting was part of the United States’ first slow mobilization for war.3 National Research Council The story of how a small, underfunded subcommittee of the NRC grew into a major research program has implications for much postwar biomedical Chapter 4 Preparing for War research.4 The institutional transformation was confused rather than systematic , characterized after the war by William Mansfield Clark (1884–1964), a professor of physiological chemistry at the Johns Hopkins School of Medicine and wartime chairman of NRC’s Chemistry Division, as “kaleidoscopic”: The changes in organization were sufficiently kaleidoscopic to give the impression of an unstable pattern. Indeed, a person concerned only with the superficial aspects of organization might be tempted to use the record in support of the contention that a similar emergency in the future had best be handled by a predetermined body in accordance with a pre-formed plan. But this would be to misread the record. It is a record of research in which organizational matters were continually adjusted to meet the demands of scientific advances.5 Much as Roosevelt’s modest Advisory Committee on Uranium first moved federal nuclear research onto the wartime path, so did NRC’s chemotherapy initiative launch the antimalarial program. Prewar federal resources and expertise in science, technology, and medicine were relatively minimal. During the first years of the NRC’s involvement with malaria chemotherapy , 1939 to 1941, the Chemistry Division operated largely as an independent , professional organization in concert with other such bodies, such as the American Association for the Advancement of Science (AAAS), the American Medical Association, and the American Chemical Society. In 1941, the Chemistry Division and the NRC’s Division of Medical Sciences (DMS) were co-opted by federal government programs for emergency management, specifically the Office of Scientific Research and Development (OSRD), which was a component of the Office of Emergency Management (OEM). Much of the work prior to large-scale federal intervention relied on the networks of the Rockefeller Foundation, which cooperated with commercial firms such as the United Fruit Company, the Squibb Institute for Medical Research, and Parke Davis and Company, to identify drug candidates and test them for efficacy against malaria. Lowell T. Coggeshall (1901–1987)—a physician/researcher of the Rockefeller Institute, the University of Michigan, and later the University of Chicago—was a pivotal figure. He was one of a handful of malariologists who successfully bridged the prewar and wartime regimes and made critical contributions to the development of a U.S. antimalarial program. NRC was motivated by the conflict already raging in Asia and imminent in Europe. They knew three things: that quinine was inadequate as a remedy; that synthetics might provide a way around U.S. dependence on Preparing for War 85 86 War and Disease threatened quinine supplies; and that malaria was out there—waiting—in a world at war. Promoting their research agenda required them to remind American medical and scientific audiences that malaria was a persistent danger. They publicly asserted, “Contrary to popular belief, malaria is still one of humanity ’s major scourges. India, with a...