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Fred Soper and the Global Malaria Eradication Programme

Journal of Public Health Policy, 2002 by Gladwell, Malcolm

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In December of 1943, the typhus team was dispatched to Naples, where in the wake of the departing German Army the beginnings of a typhus epidemic had been detected. The rituals of Cairo were repeated, only this time the typhus fighters, instead of relying on MYL (which easily lost its potency), were using DDT. Men with dusters careened through the narrow cobble-stoned streets of the town, amid the wreckage of the war, delousing the apartment buildings of typhus victims. Neapolitans were dusted as they came out of the railway stations in the morning, and dusted in the streets, and dusted in the crowded grottoes that served as bomb shelters beneath the city streets. In the first month, more than 1.3 million people were dusted, saving countless lives.

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Soper's diary records a growing fascination with this new weapon. July 25, 1943: "Lunch with L. L. Williams and Justin Andrews. L. L. reports that he has ordered 10,000 lbs of Neocid [DDT] and that Barber reports it to be far superior to [Paris green] for mosquitoes." February 25, 1944: "Knipling visits laboratory. Malaria results (for DDT) ARE FANTASTIC." When Rome fell, in mid-1944, Soper declared that he wanted to test DDT in Sardinia, the most malarious part of Italy. In 1947, he got his wish. He pulled out his old organization charts from Brazil. The island-a rocky, mountainous region the size of New Hampshire, with few roads-was mapped and divided up hierarchically, the smallest unit being the area that could be covered by a sprayer in a week. Thirty-three thousand people were hired. More than two hundred and eighty-six tons of DDT were acquired. Three hundred and thirty-seven thousand buildings were sprayed. The target Anopheles was labranchiae, which flourishes not just in open water but also in the thick weeds that surround the streams and ponds and marshes of Sardinia. Vegetation was cut back, and a hundred thousand acres of swampland were drained. Labranchiae larvae were painstakingly collected and counted and shipped to a central laboratory, where precise records were kept of the status of the target vector. In 1946, before the campaign started, there were seventy-five thousand malaria cases on the island. In 1951, after the campaign finished, there were nine.

"The locals regarded this as the best thing that had ever happened to them," Thomas Aitken says. He had signed on with the Rockefeller Foundation after the war, and was one of the leaders of the Sardinian effort. "The fact that malaria was gone was welcome," he went on. "But also the DDT got rid of the houseflies. Sardinian houses were made of stone. The wires for the lights ran along the walls near the ceiling. And if you looked up at the wires they were black with housefly droppings from over the years. And suddenly the flies disappeared." Five years ago, Aitken says, he was invited back to Sardinia for a celebration to mark the forty-fifth anniversary of malaria's eradication from the island. "There was a big meeting at our hotel. The public was invited, as well as a whole bunch of island and city officials, the mayor of Cagliari, and representatives of the Italian government. We all sat on a dais, at the side of the room, and I gave a speech there, in Italian, and when I finished everybody got up and clapped their hands and was shouting. It was very embarrassing. I started crying. I couldn't help it. Just reminiscing now . . ."

Health Care Industry

Fred Soper and the Global Malaria Eradication Programme

Journal of Public Health Policy, 2002 by Gladwell, Malcolm

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