Humanity's Burden: A Global History of Malaria (review)

For an Africanist with a special interest in environmental history, malaria is an obvious focus. The disease has long been present on the continent, and it continues to be a major cause of morbidity and mortality there, despite over a century of scientific and humanitarian input into African disease control. James L. A. Webb, Jr., is well qualified to tackle these complex issues, and his short global history of malaria is packed with information and insight into the problems that have surrounded modern antimalaria activity.

Malaria has attracted a good deal of attention from historians and social scientists of late, and malariologists themselves have frequently drawn on their own experiences to produce important historical insights into the social and medical dynamics of this disease in the past. Webb uses some of these experiences creatively, but the real strength of his volume lies in his integration of contemporary research on both the plasmodium and the mosquito in order to produce a synthesis of what might have occurred when early human populations were routinely brought into contact with the parasite. He devotes almost half of his book to the period before 1600, during which much of what we can know about malaria must be inferred from what we now know about the patterns of infectivity, mortality of the several species of plasmodia, the ecological and behavioral characteristics of the many species of anopheles that can transmit the parasite, and—above all—about the genetic consequences on human populations long exposed to the disease. "Duffin negativity" and the sickle cell mutation get good coverage, although I was surprised by the omission of thalassemia, given its extensive spread and Webb's aim at global coverage.

These early chapters, reconstructing a possible scenario for malaria's early ecological history and spread, offer a new synthesis in which archaeological and anthropological insights are integrated into the more traditional historical accounts. Webb recognizes that much of his story must be speculative, but he is good at keeping the few bald facts we can know, and their wider remote historical interpretations, always in balance. The result is a fine addition to the "plagues and peoples" genre pioneered by W. H. McNeill and others.

Webb also has useful things to say about the more recent period, although the terrain is much better known to historians. Given Webb's wide brief and his modest word length, there are inevitable omissions or important topics only cursorily treated. Thus, the discovery of the role of the mosquito in malaria's transmission, for which Ronald Ross received the second Nobel Prize, in 1902, is summarized in a couple of paragraphs. He accords Ross's great rival, G. B. Grassi, a slightly more sympathetic hearing, but a reader coming to the topic for the first time would need to follow Webb's footnotes to make much sense of this fascinating episode in the history of science and medicine. Since this work underpins so much of our subsequent understanding of malaria, it deserves fuller consideration, even in a short book. At the same time, Webb's sensitivity to the importance of local environmental and social conditions in determining the prevalence and morbidity of malaria is a salutary reminder that Ross's optimism about how easy the disease would be to control, and maybe even eradicate, was sadly unfounded.

There are a few other places where my interpretation of the people and events differs from his, but Webb has read very widely and intelligently and always attempts to situate his narrative within a broad scientific framework. His book complements rather than duplicates Randall Packard's recent fine history of malaria, and the two can be profitably read in conjunction.