Malaria epidemics in Europe after the First World War: the early stages of an international approach to the control of the disease

Abstract

The severity and endemicity of malaria declined gradually in Europe until WWI. During and after the war, the number of malaria cases increased substantially and peaked in 1922-1924. This prompted the Hygiene Commission of the League of Nations to establish a Malaria Commission in 1923 to define the most efficient anti-malaria procedures. Additionally, between 1924 and 1930 there were several international meetings and collaborations concerning malaria, which involved the main institutes of parasitology and the Rockefeller Foundation. The Commission reports, the guidelines for anti-malaria campaigns and the scientific programs which came out of these meetings and collaborations are analyzed in the present paper.

Evidence and strategies for malaria prevention and control: a historical analysis

“…The methods were adapted to each insect and each local situation, but procedures were largely the same. The important point in the case of piccola bonifica is that it raises once more the role of social factors in combating malaria: all the proposed measures can be carried out by local communities, provided they have learned the methods and understood the benefits they could expect by applying them [3, 4, 31]. However, with the exception of isolated areas such as the island of Asinara, the long-term effectiveness of piccola bonifica was not, or rather could not be, estimated quantitatively.…”

“…Fermi declared Sassari a mosquito-free city, but the Rockefeller Foundation (RF) established one of its stations in Sassari in 1924 because it was then heavily affected by malaria. Thus, when the anti-malaria protocols used in 1924–1925 were compared, the efficiency of piccola bonifica appeared significant only locally and through permanent struggle against the vector [3, 4]. However, it is worth noting that Swellengrebel, a prominent member of the Malaria Commission of the League of Nations, in an attempt to extract from the reports which reached the Commission a set of partially efficient measures which could be applied by a majority of people in a majority of places, proposed rules very similar to piccola bonifica [32].…”

“…The place of grande bonifica among other anti-malaria procedures has been discussed elsewhere [4, 31, 70]). There had been a steady decline in the prevalence of malaria over the previous 50 years due to a multiplicity of factors, among which it was difficult to identify the specific contribution of bonifica .…”

“…Despite these apparent local successes, policy makers acknowledged the difficulty of interrupting malaria transmission, even in moderately high transmission areas. In the first comparative analyses of results in 1925 carried out by the League of Nations (the Malaria Commission of the League of Nations) and the First International Congress on Malaria, the authors concluded that none of the methods so far tested had proved efficient and stable enough to be confident that the answer to controlling malaria had been found [3, 4]. …”

The interaction of scientific evidence and politics in debates about preventing malaria in 1925

“…In March 1925, the Commission concluded that local prevention of malaria using simple methods was at that time the most effective approach, but that these would not lead to the eradication or even the control of the disease. 8,9 Other methods had to be developed.…”