May 10, 2010
This fascinating, mordant pop-sci account tells us why malaria is one of the world’s greatest scourges, killing a million people every year and debilitating another 300 million, and why we have remained complacent about it. Journalist Shah (The Body Hunters: Testing New Drugs in the World’s Poorest Patients) shows how the Plasmodium parasite, entering through a mosquito’s bite and feasting on human red blood cells, has altered human history by destroying armies, undermining empires, and driving changes in our very genome. We’ve learned to fight back with antimalarial drugs and insecticides, but malaria’s adaptability and its buzzing vector, Shah notes, give it the upper hand. Shah provides an intricate and lucid rundown of the biology and ecology of malaria, but her most original insights concern the ways in which human society accommodates and abets the parasite. (The impoverished denizens of Africa’s malaria belt, she observes, would sometimes rather use the pesticide-laced bed nets sent by Western aid groups to catch fish.) Shah’s is an absorbing account of human ingenuity and progress, and of their heartbreaking limitations. 16 pages of b&w illus.
June 1, 2010
Investigative journalist Shah maintains her signature pattern (Crude, 2004; The Body Hunters, 2006) here, exposing both the seemly and not-so-seemly aspects of the subject under review. As Shah demonstrates, when it comes to taming, never mind eradicating, malaria, the disease is cannily able to keep the ball in humankinds court. Notwithstanding, people in tropical climes who live with its ubiquitous presence have over time come to uneasy terms with the fever. That is not to say they would not benefit from a cure. Indeed, their need is most critical. Its just that when Western nontropical humans are exposed to malaria, they suffer its worst effects, then tackle the problem in largely ineffectual ways. And it is not for want of money (think Bill and Melinda Gates). But Shah takes no prisoners, blasting everyone, including the World Health Organization. Even Harvards state-of-the art Malaria Initiative takes it on the chin for eschewing unglamorous but effectual grunt work in favor of lavishly funded . . . economy building technology. Malaria may rule humankind, but Shah rules the in-depth investigative report.(Reprinted with permission of Booklist, copyright 2010, American Library Association.)
June 1, 2010
Investigative journalist Shah (The Body Hunters: How the Drug Industry Tests Its Products on the World's Poorest Patients, 2006, etc.) argues that the mosquito-borne parasite is in control and will remain so.
The author opens with a chapter describing recent outbreaks of malaria in relatively untouched areas, then digs deep into the past to chronicle the role Plasmodium falciparum—the most virulent malarial species—and its kin have played in human history. Warm temperatures and standing water create breeding grounds for the female Anopheles mosquito, the species able to house the parasite's sexual forms, which are transmitted in saliva when she bites a human or animal host. Environmental and ecological factors are critical in malaria outbreaks. Shah explains how such factors, natural and manmade, have accounted for the rise and fall of empires, battles won or lost, the success or failure of human settlements. The disease only became more devastating following the Industrial Revolution, which brought deforestation and the damming of rivers to create millponds and reservoirs. As the tropics were conquered by Western powers, malaria's devastation was inflicted unequally in colonies where white occupiers lived on high ground with proper drainage, areas off-limits to the natives below. While quinine was long recognized as malaria therapy, the cause of the disease was not established until the turn of the 20th century—that story by itself makes a fascinating chapter in medical history. Over time, other drugs appeared, as well as insecticides like DDT, once touted as the sure eradicator of malaria...until it wasn't. Shah's point is that global-health policymakers, including the Gates Foundation, continue to look for magic bullets to prevent or cure the disease. But there aren't any. Bed nets and combined therapies are useful, but until the focus is shifted to building native capacity and good governance—in education, schools, roads and clinics—malaria will continue to devastate millions.
A sad, sobering account with important lessons for medical historians, anthropologists, biologists and, most of all, policymakers.
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