The Mosquito Brigades
During World War II, U.S. researchers tested malaria drugs on inmates who were
rewarded with parole.
Disease vector
E
An Anopheles gambiae mosquito feeding. SINCLAIR STAMMERS
By
WILLIAM BYNUM
Nov. 7, 2014 5:05 p.m. ET
A few years before the outbreak of World War I, war was pronounced by one public-health worker “good for babies,”
since it focused governments on the welfare of their future citizens and soldiers. Since then, war has been judged good
for economies, science, medicine (especially surgery) and other aspects of modern life. These propositions can be
argued either way, but Karen Masterson ’s timely book examines the case of malaria research during World War II.
THE MALARIA PROJECT
By Karen M. Masterson
New American Library, 406 pages, $26.95
During the first half of the 20th century, malaria commanded the attention of a cohort of outstanding researchers and
clinicians. Ever since Ronald Ross and Giovanni Battista Grassi separately demonstrated in the 1890s that this common
disease of warm climates and impoverished societies was spread by female Anopheles mosquitoes, it had seemed to
many that eradication ought to be possible. Countries in the interwar period with significant imperial possessions in
highly malarious countries actively sought to control it. These included Britain, France, the Netherlands and, to a lesser
extent, Germany. Most American involvement came via the Rockefeller Foundation, which supported research, ran
eradication programs and trained field workers.
The disease remained prevalent in the American South, however, where a number of Rockefeller officials cut their
teeth. One of the most active of them, Fred Soper (1893-1977), led a successful campaign in Brazil in the 1930s, where
the relevant vector,Anopheles gambiae, was of relatively recent introduction and was consequently susceptible to the
insect-control measures then available. The malarial community of doctors, entomologists and epidemiologists was
divided about the best way to control malaria elsewhere, however. Some favored the systematic use of quinine, which
kills thePlasmodium parasites that cause the disease, whereas others believed in controlling mosquito breeding sites and
using individual protection, with bed nets, house screens and insect repellents. Behind the debates was the chicken-andegg argument about the relation between endemic malaria and economic development. Would focusing first on
controlling malaria unshackle economies, or would economic advance render it relatively innocuous, as had happened
in Europe?
The outbreak of World War II pushed malaria up the American agenda. Troops found themselves in many highly
infected areas, including Africa, the southern Mediterranean and, above all, Asia. Ms. Masterson’s analysis of the
havoc caused by the disease and of the research effort by federally funded scientists and clinicians makes a compelling
read. Her book is brimming with colorful characters—some admirable, some less so.
The focus on Lowell T. Coggeshall (1901-87) resurrects a worthy malariologist from relative obscurity. Coggeshall
learned his field malaria in the South, funded by the Rockefeller Foundation, in the 1920s. His subsequent varied career
in medical research, public health, hospital administration and clinical practice was turned back to malaria by the
necessities of the war. He spent time in Africa trying to keep the airfields used by transport planes (flying via South
America to avoid German fire in the North Atlantic) free from the disease. He sat on several committees trying to
coordinate the research and preventive programs for the military and entered the naval medical services for a time. He
ended the war looking after a large hospital devoted to testing drugs and rehabilitating soldiers with chronic malaria
and other traumas of the conflict.
Coggeshall isn’t the most effective malariologist in Ms. Masterson’s narrative. That prize should go to Paul Russell
(1894-1983), a devoted Rockefeller stalwart. It was he who pushed the older idea of “mosquito brigades,” groups of
trained individuals—parasitologists, entomologists, technicians—who could enforce mosquito protection with bed nets
and appropriate clothing; treat breeding sites with oil; and educate troops and their leaders about the importance of
simple preventatives. Part of the problem was that quinine had been in short supply since the Japanese overran the
Dutch-controlled plantations of Cinchona trees in Java. The best available drug, atabrine, had awkward side effects. It
turned the skin yellow, often caused vomiting and diarrhea, and was widely rumored to produce impotence. Both
soldiers and their officers had to be convinced that the drug was worth taking, and it took the American military several
years to work out the best dosage. The Germans, who had developed the drug, already knew how to use it effectively.
Scientists in America developed dozens of alternative antimalarial drugs, looking for the magic bullet that would lack
side effects and be easy to take. They found a good one but only toward the end of the war. The drug, chloroquine,
became a mainstay of postwar efforts, until increasing resistance in the malaria parasites made it less effective.
Ms. Masterson is evenhanded in reporting the ethics of both human and animal experimentation during the war.
Conscientious objectors, psychiatric patients and prisoners were among the groups recruited as guinea pigs, sometimes
with lax guidelines for consent, informed or otherwise. The leading German malariologist, Claus Schilling (18711946), was hanged after the Nuremberg trials for his cruel use of humans in disease tests. The Nazis weren’t interested
in the consent of their subjects, but Ms. Masterson remarks that his behavior was hardly a million miles away from that
of some U.S. researchers. Ironically, one of the best-run American drug testing programs was carried out at Stateville
Prison, in Illinois. Among its inmates were the infamous teenage murderers Nathan Leopold and Richard Loeb.
Leopold became a mainstay of the program. He eventually got his reward of parole.
Ms. Masterson’s gripping tale unfolds seamlessly. She offers technical details without jargon and is refreshingly
without axes to grind. And she allows her readers to make up their own minds about whether war can be good for
science and medicine. I came away thinking that, even if it is, the price is frightfully high.
—Mr. Bynum is the author (with Helen Bynum) of “Remarkable Plants that Shape our World.”