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Buy The Making of a Tropical Disease: A Short History of Malaria (Johns Hopkins Biographies of Disease) by Randall M. Packard available and for sale on Brightsurf
| View Larger Image | The Making of a Tropical Disease: A Short History of Malaria (Johns Hopkins Biographies of Disease)
by Randall M. Packard
| | List Price: | $24.95 | | Price: | $16.47 | | You Save: | $8.48 (34%) |  | | Available: | Usually ships in 24 hours | | | | | Sales Rank: | 60412 | | Studio: | The Johns Hopkins University Press | | | Binding: | Hardcover | | Number Of Pages: | 320 | | Publication Date: | December 18, 2007 | | Publisher: | The Johns Hopkins University Press |
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EDITORIAL REVIEWS |
Product Description
Malaria sickens hundreds of millions of people -- and kills one to three million -- each year. Despite massive efforts to eradicate the disease, it remains a major public health problem in poorer tropical regions. But malaria has not always been concentrated in tropical areas. How did other regions control malaria and why does the disease still flourish in some parts of the globe? From Russia to Bengal to Palm Beach, Randall Packard's far-ranging narrative traces the natural and social forces that help malaria spread and make it deadly. He finds that war, land development, crumbling health systems, and globalization -- coupled with climate change and changes in the distribution and flow of water -- create conditions in which malaria's carrier mosquitoes thrive. The combination of these forces, Packard contends, makes the tropical regions today a perfect home for the disease. Authoritative, fascinating, and eye-opening, this short history of malaria concludes with policy recommendations for improving control strategies and saving lives. |
CUSTOMER REVIEWS (Average Customer Rating: 4.5 based on 35 reviews)
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"It's the ecology, stupid." 
This book isn't nearly as arcane as one might think. The subject and general theme are far outside my standard reading zone, yet I never once lost interest nor felt lost in the subject matter.
Author Randall Packard's central message is abundantly clear: malaria is a social disease and only significant economic development and social change can eradicate it. He seeks to demonstrate his point with historical case studies. For instance, malaria once thrived in such places as southeastern England and across the United States as far west as Illinois. Yet, malaria is practically unthinkable in those places today despite the fact that no concerted anti-malaria campaigns were ever undertaken.
So how did malaria disappear from such places in the absence of even elementary knowledge of the disease and its transmission? Simple, Randall argues: the social ecology of those places changed in ways that are not conducive to the propagation of malaria. Namely, it was plantation cash-crop farming that relied on large numbers of indigent, migrant labor residing close to irrigation water sources that allowed malaria to thrive. It was the introduction of inland rice and cotton farming in South Carolina, for instance, as well as the introduction of African slaves who in all likelihood brought the parasite to the US, that brought the disease to this country, and it was the industrialization of the south and the end of sharecropping in the early twentieth century that eliminated it. Again and again, through numerous examples, Packard shows how human action, usually related to farming practices and then industrialization, led to the introduction and/or elimination of the disease.
The fundamental lesson that Packard draws from his work is that only human ecology and economic development can address malaria in any meaningful way. Any effort to destroy the disease either through killing off the vector (female anopheline mosquitoes) or attacking the parasite itself (Plasmodium falciparum, in particular), Packard argues, can at best keep the disease under control, but with no hope to eradicate it. Although he never comes out and says so explicitly, Packard makes it clear that the Gates Foundation's push for a malaria vaccine is "here we go again" and will ultimately end with disappointing results like previous attempts at malaria eradication by attacking the vector or parasite only.
Needless to say, I learned a lot in this book. One thing that surprised me was just how difficult the transmission of malaria actually is. In order for a person infected with the most serious form of malaria (Plasmodium filciparum) to pass the disease on via the mosquito to another host a string of statistically unlikely events need to occur. First, the malaria parasite needs to be at a phase in its life when it is producing a sufficient number of gametocytes, which are required for sexual reproduction in the gut of a female anopheline mosquito. According to one study cited by Packard, only about 1% of an infected population has a sufficient number of gametocytes in their bloodstream to serve as "infectors." Second, even if a mosquito bites an "infector" host there is only about a 35% chance that it will actually ingest a gametocyte. Finally, before the parasite can be passed from the mosquito to a new host, the gametocyte needs to reproduce and send sporozoites to the mosquito's salivary glands, a process that takes 14 days to complete - and the lifespan of a female anopheline mosquito is just 10 to 21 days. Another study cited by Packard suggests that for every 10 gametocytes ingested by a mosquito, only one successfully reproduces and is introduced to a new host to start the lifecycle anew. Thus, the numbers required to keep malaria alive in a population - both infected people and mosquito vectors - is enormous. I did some back-of-the-envelope analysis and determined that it would take over 3,000 people infected with malaria in a mosquito-rich environment to pass the disease on to just a single new host.
In 1957 epidemiologist George Macdonald sought the eradication of malaria by treating the problem as a mathematical challenge that sought to achieve the cross-over point the disease simply could not sustain itself and ultimately vanished from existence. Given the numbers above, I can see why this approach had appeal. The end result of this hypothesis to disease eradication, Packard notes, is that malaria became viewed a vector-borne disease (i.e. efficiently kill the mosquitoes and you will wipe out the disease) rather than what the author argues passionately it is, a social condition. Moreover, the wonder chemical that promised to end malaria once-and-for-all by destroying mosquitoes was DDT.
That anti-malaria effort of the 1960s was actually quite effective in rolling back malaria in many countries, although the disease quickly returned once the aggressive pesticide treatments abated, while no economic development had occurred.
In sum, this is a fascinating book and is highly recommended to anyone with an interest in economic development or simply intrigued by difficult puzzles to solve. Unfortunately, the book is somewhat depressing as Packard maintains that only serious economic development in sub-Saharan Africa and other depressed areas where malaria is endemic will end the disease. And, of course, that is a nut not easily cracked.
July 04, 2008 | |
Interesting History of the Forces that have Shaped Malaria's Epidemiology.
"The Making of a Tropical Disease: A Short History of Malaria" is true to its title. Malaria used to be prevalent over much of the globe, but its decline in other parts of the world have made it a disease primarily of the tropics. Randall Packard draws on his personal experience with the disease and 20 years of research to explain how and why malaria came to be the tropical disease it is today. He discusses the interplay of climactic, biological, social, and economic factors that have shaped the history of malaria, with particular emphasis on the socio-economic factors that have sometimes been neglected in the past century in favor of medicinal and technological approaches. Packard insists that efforts to combat malaria must consider all historic reasons for the disease's expansion and decline if they are to be successful.
The author is the first to admit that the early history of malaria is contested, but he starts it in Africa anyway, for lack of better information. Malaria is caused by a protozoan that is transmitted through the bite of the female Anopheles mosquito. The first four chapters of the book explain the history of malaria, how biological and broad societal forces caused the disease to spread in Africa and then to Europe, Asia, and the Americas, through case studies of the incidence of malaria in different locations at different times. The last four chapters focus on efforts to eradicate the disease in the 20th and 21st centuries and the reasons for their failures or limited successes, including the World Health Organization's failed Malaria Eradication Programme and the current global Roll Back Malaria initiative.
"The Making of a Tropical Disease" impresses upon the reader the role of social change, especially agricultural development, in shaping epidemiology. Although he is a sharp critic when he believes a strategy is flawed, Packard is passionate about decreasing malaria in sub-Saharan Africa. Nonetheless, I am left unconvinced that the resources dedicated to combating malaria are worthwhile. Packard states that the "vast majority" of malaria deaths in tropical Africa are among young children. He doesn't say what percentage. And he doesn't say what the birth rate is in those areas. He also mentions a number of genetic blood conditions that confer immunity to malaria but doesn't say how many Africans benefit from this protection. He does say that malaria control does not affect economic development and that it has increased poverty in some cases. So I can't say how big a problem malaria really is or if programs that target malaria specifically are the best way to fight it.
June 16, 2008 | |
Excellent 
I finally finished this book after many months. I say that as a compliment because it kept my interest through the course of normal life. _A Short History of Malaria_ was dense reading for me. My background is not in the medical field, epidemiology or biology but I do have a background in history and science. The book is definitely not for beginners or for those with a lukewarm interest it is definitely for the more engaged reader who is comfortable with a more academic prose style.
The book was informative and made me think about the relationship of disease and unintended consequences such as, infrastructure development and how a disease evolves with its victim population. It also made me more aware of the deep impact this disease has on the developing world. I t was interesting to re-read passages from Diamond's _Guns, Germs and Steel_ with chapters in this book to see even larger impacts.
Definitely informative, sometimes dry and always required focus and attention to the text.
May 16, 2008 | |
Interesting, but not what you'd expect
This book may not be what you expect. The notion of biography implies something of a narrative style, and I was expecting an innovative approach to a disease. Packard instead takes a somewhat academic approach, albeit an extremely interesting one. Rather than the conventional view - the mosquito bites man story - he demonstrates how economic and social choices contribute to the spreading of this disease, as well as how seriously it impedes societies, especially in Africa. One thing is certain, I certainly knew a lot more after I read this book than I did before, and it offered much food for thought.
May 15, 2008 | |
An interesting and informative read
I have read quite a few focused books like Cod or womens studies books where authors filter world history through a myopic lens based on their topic or beliefs. By the end of their tight focus, it seems that all of human history hinged on the topic (In the Cod example civilization would have been held back if not for a fish.) This author avoids this and gives a broad historic overview of how human events and conditions affected the disease of Malaria. The writing is balanced, somewhat academic, and well researched.
There is an underlying thesis that poverty and social upheaval are very core to the disease's natural history. This is bearing out in headlines today and the author is not heavy-handed in the politics but academicly lays out the facts and points out that our current programs should take this point more to heart.
The book helped clear up a lot of misconceptions I had about the disease. It was eye-opening to find out that New England has had epidemics of malaria in the past. Malaria is not limited to the tropics, it is opportunistic and just needs the correct conditions; Anopheles mosquitos, the pathogen, and available, vulnerable humans.
The book was well worth the time, it gave a wonderfully rich and full understanding of the disease. I had only had a vague understanding of the disease. The description of the life cycle of both the pathogen and the mosquito explained a lot, like why Malaria symptoms come and go in cycles. If you have any interest in malaria, pick up a copy. It will be well worth your time.
April 17, 2008 | |
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