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Reviewed by:
  • War and Disease: Biomedical Research on Malaria in the Twentieth Century
  • Mark F. Leep
War and Disease: Biomedical Research on Malaria in the Twentieth Century. By Leo B. Slater. New Brunswick, N.J.: Rutgers University Press, 2009. ISBN 978-0-8135-4438-0. Figures. Notes. Index. Pp. x, 249. $45.95.

Malaria, a mosquito-borne infectious disease caused by various parasites within the Plasmodium family, has proved a scourge to human populations for centuries. Even today in the early twenty-first century, millions of people in developing and tropical regions of the world suffer the ravages of the disease on [End Page 1352] a yearly basis. Military forces across the ages have been particularly susceptible to the disease as a force destroyer. World War II has proved to be a burgeoning field of research for a few historians exploring the debilitating effects of the disease on military forces and operations, beyond those of bombs and bullets. However, the role and accomplishments of the U.S. antimalarial research program in combating malaria during the war and the details of its evolution and operation as a division within the Committee on Medical Research (CMR), a subsidiary of Vannevar Bush’s Office of Scientific Research and Development (OSRD), has long demanded a well-qualified narrator. War and Disease proves that Leo B. Slater, a trained chemist as well as historian, fits the bill.

Slater wisely sets the program in context by first exploring in chapters 1 and 2 the prehistory of synthetic antimalarial drug development–the use by colonial powers of natural quinine extracted from the bark of the cinchona tree, native to South America, in colonization efforts, and the discovery of avian models as important research tools in understanding the chemical and biological linkages associated with the malarial parasites. He then addresses in chapter 3 the breakthrough synthetic antimalarial drug research of the German chemical and pharmaceutical firm, Bayer, in the 1920s and 1930s. Given its lack of colonial access to quinine supplies and its experience with malaria in Turkey, the Balkans, and East Africa during World War I, Germany searched for alternative compounds. Leveraging expertise in the synthetic dye industry and chemotherapy (defined as a broad range of chemical interventions in disease), German scientists developed the first generations of antimalarial synthetic drugs, plasmochin and atabrine. Slater further details Bayer’s interesting relationship with the U.S. firm, Winthrop Chemical Company, and the marketing of its new drugs in the southern United States. Bayer’s sales of atabrine reached its peak in 1936 due to reported psychosis side effects and the U.S. government’s focus on sanitary means to eradicate the disease in the South. Regardless, the American exposure to these synthetic drugs served as a launching pad for U.S. wartime drug development.

Chapters 4–7 tell the story of this development under the auspices of the CMR. Building on the work of Bayer and forced to act aggressively in light of the Japanese seizure of Dutch quinine plantations in the Dutch East Indies early in World War II, the U.S. program focused its attention on synthesizing new chemical compounds, understanding atabrine in more detail, and developing and testing the new generation drug, chloroquine, in the latter stages of the war. Atabrine was extensively used by U.S. forces globally and more particularly in the South Pacific and Southwest Pacific theaters of operation, but Slater only lightly touches on the drug’s success in curtailing the disease at the operational combat level. He also elects not to explore the circumstances and issues surrounding new antimalarial drug testing in American prison, hospital, and military populations. This is mildly surprising given the close attention paid by historians to human biomedical experimentation by both Axis and Allied powers in World War II. However, Slater stays true to his objective of examining the organizational development of the antimalarial program, the extensive web of relationships created among government, [End Page 1353] nonprofit, and academic researchers in drug discovery activities, and the resulting tension between research independence and creeping bureaucratic control.

Indeed, Slater effectively uses this wartime story to buttress his argument in both chapters 7 and 8 of the program’s influence...