In the late 1940s, the Americans financed a blanket spraying of virtually all accessible areas, in Italy and then world-wide, with exceptionally successful results. Islands in particular -- Sardinia, Sri Lanka, Jamaica, Taiwan -- became famous success stories. But the scientists soon learned that immunity to DDT would eventually develop. The aim was therefore to achieve a zero presence of the disease before the mosquitoes returned. In that way the pool of malaria infection in human blood would be removed and the mosquitoes, though remaining troublesome, would no longer be lethal, at least with that particular pathogen.
With Taiwan this has proved to be the case. In Sri Lanka, unfortunately, malaria has made a major comeback, as it has in many other places.
And DDT itself is now a source of controversy. Despite the very dramatic success immediately after its discovery in 1943, its dangerous spread through eco-systems became apparent, and was given huge publicity by Rachel Carson's 1962 book Silent Spring. Ten years later, on Dec. 31 1972, the US Environmental Protection Agency announced a ban on the use of the chemical throughout the country.
Now the battle between environmentalists and those who see its continuing use as central in the struggle against malaria has reached a new phase with the pending ratification by the UN of the Convention on Persistent Organic Pollutants, known as the POP Convention. This was signed by 10 countries in Stockholm on May 23 this year.
The two sides of the DDT issue argue over why countries in, Africa, for example, should be subjected to a hazardous chemical when it is banned in the affluent US. But Professor Spielman believes the real question is not so simple. In his view, in poor countries where malaria is still rampant, and indeed increasing, a cheap and very effective chemical like DDT has a place, at least for the time being. But it remains a bitterly contested matter.
This is an excellent book, technical enough to be authoritative, but accessible enough to grip the targeted lay reader. It is a popular work, in other words, that is genuinely educative.
The battle against yellow fever in the American Deep South in the 19th century, malaria in the same place in the 20th, the appalling fatality rate from yellow fever that almost stopped construction of the Panama Canal, the reasons the British found West Africa a "white man's grave" and the near-miracle of yellow fever never having moved into Asia when it is endemic in much of Africa and the Americas all make for an absorbing narrative.
So next time you see a cabin attendant spray around you before take-off, don't turn up your nose. There may be a mosquito lurking under your seat that, single-handedly, could bring yellow fever to Asia, with millions dying as a result.
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