In the triangle of diseases that confound modern medicine, malaria coexists with tuberculosis and HIV/AIDS. Not only are these three especially cruel in their impact on the mortality and morbidity of the poor, each in its own way is capable of eluding medical remedies, through mutations, resistances, and other slippery responses to disease control. Prepared for a series, The Johns Hopkins Biographies of Disease, the intended readership of Randall Packard’s book is not a specialized one and, while numerous books consider the quest for scientific mastery, his ‘short history of malaria’ demonstrates that malaria and poverty are mutually reinforcing. How malaria parasites are transmitted and develop through their life cycle, requiring the participation of both humans and anopheles mosquitoes, is clearly introduced here, but science attends rather than constitutes the narrative, which is more concerned with explaining why human costs have been imposed and persist than in tracking epidemics.

And yet, epidemics must be a springboard for a social history of disease. Any student of global history in the twentieth century will be familiar with upsurges of epidemic conditions in and just after times of war. Malaria may have reached its greatest extent just after the First World War, reaching the Arctic Circle in Russia. The conduct of the Second World War, especially in the malarial tropics and sup-tropics, called for a mobilization of malaria control operations that figured in the United States as antecedent to the establishment of the now-important Centers for Disease Control. The malaria eradication campaign from 1956 to 1968 threw DDT at anopheles mosquitoes outdoors and in, only to be halted and deemed a failure. New fortunes have recently been pledged to eradicate malaria, this time by a variety of means, anchored in a vaccine to disable the parasite.

Packard’s wide-ranging book contains a textured synthesis of his own prior scholarship and a comprehensive reading of the relevant literature. It is argumentative and intentionally challenges the adequacy of knowledge justifying contemporary interventions. What gives a special energy to this volume is his conviction that the history of malaria is embedded in the history of development and that the lessons of this history must be applied to contemporary development policies. Experts, students, and a wider reading public alike should be sobered by this account of malaria-prone environments that are not natural but have been constructed for good or ill in the distant as well as the more recent past.

By entitling his book The making of a tropical disease, Packard refers especially to the twentieth century, when the disease increased where colonial development entailed revamping the landscape through irrigation and other means. The theme of entwined agrarian transformation and the human ecology of disease is summarized through three ‘scenarios’: stagnating agriculture with persisting malaria, agricultural improvement and reduced malaria, and agricultural expansion with continued or increased malaria (p. 25). On the whole, changes in the global north curbed or eliminated malaria, while in the south it remained uncontrolled and risks grew.

This history of malaria is global in scope and goes back millennia to describe the spread of the disease from topical forests, across savannas, and passing far beyond Africa. Packard’s survey shows how malaria figured in the Mediterranean during classical antiquity and proved to be a scourge in the twentieth century as well, being driven from the Pontine Marshes west of Rome only after the Second World War. The disease reached the Pacific via Asia and crossed the Atlantic in the bloodstream of white colonists. Human mobility, motivated and impelled by many factors, has brought vulnerable people into contact with malaria-infected anopheles mosquitoes, and infected human carriers have, in turn, passed the parasites to susceptible mosquitoes living in areas normally marginal to their habitat. The advance and retreat of malaria has thus been at once environmental and social. As this book’s strategy dramatizes, its history must be grounded in specificities of time, space, economy, and knowledge/understanding.

After discussing the prevalence of malaria in the rural south of the United States, where its decline was largely the result of changes in methods of agricultural production (which allowed the region to outgrow malaria economically), Packard turns to twentieth-century cases from north-eastern Brazil, the Punjab in India, and the eastern Transvaal in South Africa to anchor the central chapter, ‘Tropical development and malaria’. In all of these areas, the epidemic spread of malaria occurred in circumstances of conjuncture: food shortage, if not famine, following a commitment to commercial agriculture, drought or deteriorating soil conditions, and a context of migrant and/or refugee movements. He is at his best in describing the dynamic landscapes, climatology, and economic conditions that compelled the movement of destitute people back and forth, even as the range of old and new species of anopheles mosquitoes widened. The constant of landlordism was complicated in South Africa by the measures adopted by the government to improve conditions for the poor whites, by engineering the landscape in the later 1930s to create dams – the ideal breeding places for the more ‘efficient’ vector among anopheles species, the gambiae (p. 209).

In the following chapter, ‘The making of a vector-borne disease’, the rather better-known story of malariology and its auxiliary science of entomology occupy the foreground. International organizations in the interwar years became proactive in seeking to control malaria. The League of Nations Health Organization promoted a broad, welfare-based conception, supported by the Rockefeller Foundation, with financial resources and professional staff, but this comprehensive view did not survive the 1930s. The Rockefeller Foundation led the way in narrowing investigation to a biometric set of variables, above all focused on mosquito vectors. After the war, armed with DDT, this technocracy confidently promoted the misbegotten malaria eradication campaign.

The policy-makers’ urgent prescriptions, especially when backed by the promise of radical remedies and (recently) billions of dollars, can make them impervious to lessons of history. Packard bases his criticism of the influential economist Jeffrey Sachs upon a close reading of his work, wherein he finds a methodology relying upon regression analysis proving only that poverty and malaria are closely related, not how, and why (pp. 225, 285). Indeed. We are left to hope against hope for more holistically conceived programmes, to join Packard in being haunted by empathy for those who suffer, and to wish him well as he seeks to bring impressive scholarship to bear in the arena of policy-making and implementation.