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The Conquest of Malaria

The Conquest of Malaria: Italy, 1900-1962

Copyright Date: 2006
Published by: Yale University Press
Pages: 304
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  • Book Info
    The Conquest of Malaria
    Book Description:

    At the outset of the twentieth century, malaria was Italy's major public health problem. It was the cause of low productivity, poverty, and economic backwardness, while it also stunted literacy, limited political participation, and undermined the army. In this book Frank Snowden recounts how Italy became the world center for the development of malariology as a medical discipline and launched the first national campaign to eradicate the disease.

    Snowden traces the early advances, the setbacks of world wars and Fascist dictatorship, and the final victory against malaria after World War II. He shows how the medical and teaching professions helped educate people in their own self-defense and in the process expanded trade unionism, women's consciousness, and civil liberties. He also discusses the antimalarial effort under Mussolini's regime and reveals the shocking details of the German army's intentional release of malaria among Italian civilians-the first and only known example of bioterror in twentieth-century Europe. Comprehensive and enlightening, this history offers important lessons for today's global malaria emergency.

    eISBN: 978-0-300-12843-7
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Acknowledgments
    (pp. vii-viii)
  4. Introduction
    (pp. 1-6)

    One of the most interesting aspects of historical research is its propensity to lead an author in unexpected directions. The project that produced this book is certainly no exception. It began as an attempt to explore popular political responses to the advance of economic development and modernization during the Italian industrial takeoff in the late nineteenth and early twentieth centuries. I expected to immerse myself in the study of peasant rebellion, political organization, and trade unionism, as well as in the problem of whether economic advances in this period improved the living standards of ordinary men and women. I had...

  5. 1 Malaria: The “Italian National Disease”
    (pp. 7-26)

    The full extent of the prevalence of malaria first captured national attention in the decade following 1878. It had been known for centuries, however, that intermittent fever was prevalent in the Italian peninsula. The very termmalaria(bad air) was Italian, and Italy possessed “the unenviable privilege of having given this word to the world.”¹ Before 1861, when “Italy” referred to a peninsula instead of a nation-state, it was as infamous for its lethal fevers as it was famous for its beauty. The radical revolutionary Jessie White Mario reported that midcentury Sardinia had such an evil reputation for malarial fever...

  6. 2 From Miasma to Mosquito: The Rome School of Malariology
    (pp. 27-52)

    Miasmatism persisted as the orthodoxy on malaria until the mid-1880s. Its great appeal to Italians was that it provided a plausible and easily understood explanation for the epidemiology of malaria in the nation. It established a framework for understanding the public health disaster afflicting the kingdom and for galvanizing opinion to combat it. In the late nineteenth century, however, miasmatic theory began to face a gathering intellectual crisis. A clear sign was its inability to accommodate the ever-growing body of information that careful studies such as those commissioned by the Italian parliament were producing. Instead of maintaining intellectual elegance and...

  7. 3 A Nation Mobilizes
    (pp. 53-86)

    The Italian crusade against malaria, which began in earnest in 1904, involved a close partnership among the state, local governments (comuni), and the medical profession. The central government purchased quinine wholesale on the international market, packaged it in tablets at its factory in Turin, and distributed it to municipalities in all the malarial zones in Italy. Bypassing the retail market of pharmacies, local governments provided the alkaloid—dubbed “state quinine”—free to those in need. The network of physicians employed by the campaign supervised the administration of the drug. The intention of the legislature was that every poor Italian at...

  8. 4 From Quinine to Women’s Rights: Hopes, Illusions, and Victories
    (pp. 87-114)

    The years between 1900 and the First World War marked a distinctive and important period in Italy’s protracted struggle against its greatest national enemy, malaria. In this phase, all hopes rested on quinine and the ability of health stations to distribute it to the people. It was also a period of euphoric belief that control or even eradication could be achieved within a few epidemic seasons. But how successful was the antimalarial campaign in this first period? How close was Italy to vanquishing malaria when the First World War severely disrupted the effort? What were the major obstacles and setbacks...

  9. 5 The First World War and Epidemic Disease
    (pp. 115-141)

    Italy’s decision in 1915 to join England, France, and Russia in their conflict with the Central powers of Germany and Austria-Hungary followed fifteen years of unprecedented progress toward control of malaria. From 1900 on, new scientific understandings of the disease were effectively applied to create a rural health infrastructure. Health stations and sanatoriums took medical care to the most remote areas of the nation. Peasant schools educated those at risk about the mechanisms of malaria and the best means of self-defense. Teachers, physicians, and trade unionists mobilized public opinion in favor of workers’ rights, improved sanitary conditions, and promoted universal...

  10. 6 Fascism, Racism, and Littoria
    (pp. 142-180)

    Although this fact is often forgotten, antimalarial campaigning formed a central part of Fascist domestic policy, involving both the substance of the regime and the image it sought to project to the world. Here it is important to recall that Mussolini’s movement spent nearly a decade completing its seizure of power after the Blackshirts’ famous March on Rome in October 1922. Thereafter the Fascists achieved full political control by a series of incremental measures. Their cumulative effect was to abolish elections, destroy democracy and parliamentary rule, outlaw competing political parties and trade unions, “fascisticize” the state apparatus by placing party...

  11. 7 Creating Disaster: Nazism and Bioterror in the Pontine Marshes
    (pp. 181-197)

    With the decision to launch its program of imperial expansion and foreign conquest, Fascism dealt a severe blow to the campaign against malaria. Even before the onset of the Second World War, the shift in political priorities led directly to the erosion of funds for the malaria campaign. Italy, the weakest of the European powers, could not afford both war and public health. Mussolini’s belligerent foreign policy signified the end of new state initiatives in the struggle against malaria and a steep decline in support for those already in place. Thus an unspoken corollary of the decision to invade Abyssinia...

  12. 8 Fighting Disaster: DDT and Old Weapons
    (pp. 198-212)

    A new stage in the world history of malaria began in the midst of the emergency that had engulfed the Pontine Marshes. In June 1945 Alberto Missiroli announced in a speech to the Provincial Antimalarial Committee (CPA), over which he presided, the availability of the new and magic weapon of DDT (dichloro-diphenyl-trichloroethane). It was so powerful that he predicted— “to the unanimous skepticism of his audience”—that within five years malaria would be vanquished both locally in Littoria and throughout Italy.¹ In this unexpected declaration, Missiroli had in fact proclaimed the beginning of a new era in malariology that was...

  13. Conclusion
    (pp. 213-224)

    The Italian triumph over malaria has enormous importance as an example of the successful eradication of an incapacitating disease that continues to hold much of the world in thrall. Today approximately five hundred million people fall ill of malaria annually, and over one million die, making malaria the most significant tropical disease and, synergistically with HIV/AIDS and tuberculosis, the world’s most serious infectious disease.¹ Unfortunately, the number of victims is increasing such that the World Health Organization (WHO) has declared reemerging malaria a “global emergency” and journals such as theLancethave written of a “malaria disaster.”² This dramatic problem...

  14. Notes
    (pp. 225-268)
  15. Glossary
    (pp. 269-270)
  16. Select Bibliography
    (pp. 271-286)
  17. Index
    (pp. 287-296)