James McCann's latest work is the sort of book that an academic only writes, or perhaps is only allowed to write, at the later stages of a distinguished career. Despite the inherent claims of the title, it is not really a historical ecology of malaria in Ethiopia, or at least it is not organized to be such. Rather, McCann's short book is surprisingly eclectic, employing a mixture of narrative, theoretical discursion, empirical research, biography, and autobiography. The sum total of these diverse elements is a compelling and thought-provoking case study concerning humanity's ancient and ongoing cultural, ecological, and scientific engagement with malaria plasmodia.

In this book, McCann employs two central metaphors to understanding how Ethiopians – and colonial-era Italians – related with malaria plasmodia. On one hand, McCann likens the struggle between the two protagonists to a chess game, in which well-matched opponents are constantly reacting to each other's feints and attacks with countermeasures of their own. However, McCann argues that this metaphor does not truly fit the human/malaria plasmodia relationship, since in an actual chess match the rules are set beforehand and each side knows the other's identity and capabilities. This is obviously not the case in the human/malaria plasmodia relationship, as the plasmodia has no conscious understanding of its human host, and humanity in turn traditionally perceived malaria through a decidedly anthropomorphic lens. For example, the subtitle of the book (Deposing the Spirits) refers to a cultural practice in which highland Ethiopians attempted to exorcise vengeful malaria spirits by embodying them in broken gourds and pots and then carrying them ceremoniously back to the lowlands from which they came. Consequently, McCann prefers to describe the human/plasmodia relationship as a dance, a fluid relationship between two changing entities that varied over time and space. As McCann points out, ‘Medicine and illness were … as much a matter of belief as biology.’

Over the course of the book, which is organized in a roughly chronological fashion, McCann turns more and more to the biology of malaria and mosquitoes, in particular to Anopheles arabiensis, the most deadly vector of malaria in the Ethiopian highlands. Despite this scientific turn, however, McCann never abandons the metaphor of the dance: growing human understanding of the plasmodia and its vectors may have altered some of the steps and changed the tune, but the dance continued regardless. Dance steps choreographed by malariologists in Italy, for example, proved to be missteps in Ethiopia due to lack of understanding of the local ecological context. What is more, changes to the underlying ecology could cause unanticipated disruptions to the dance. The most fascinating part of the book deals with the 1998 epidemic of malaria in the highland district of Burie, which came as a surprise to observers, as it was not presaged by significant changes in temperature or rainfall. The roots of this epidemic were eventually discovered in an unlikely source: maize, or more specifically, maize pollen. By replacing traditional crops with low pollen volume (such as millet), with the high-pollen maize, Ethiopian farmers had unknowingly remodeled the dance floor. Abundant maize pollen had fertilized the shallow puddles in which An. arabiensis gestated, leading to higher numbers of longer-living and more aggressive mosquitoes. In the epilogue, McCann notes that the dance is now changing once again. Lake-side urbanization had initially lessened the ferocity of fever in the growing Ethiopian town of Bahir Dar due to the disappearance of the An. pharoensis mosquitoes and their papyrus-plant habitat, but malaria is now returning in force as puddles and ditches created by construction and road-building are increasingly colonized by An. arabiensis. The dance continues.

I anticipate that some parts of this book might be difficult for a general reader to digest, since McCann seems to assume that his reader already has some existing knowledge about both basic malaria biology and Ethiopian geography. Clearer maps might have helped solve the latter problem, but the maps that are included in the text are low-quality photographs or photocopies of much larger maps, and thus seem to serve an aesthetic rather than informative function. Further complicating matters is the uneven nature of chapter introductions: while several of his chapters begin with a rough summary of the material to follow, others (like Chapter Four, ‘The Tragedy of the Jeep’) immerse the reader directly into an ongoing story, leaving the reader no choice but to go along for the ride. That being said, the ride McCann takes us on is a fascinating one and well recommended.