There is great historical and practical value in looking at the successful attack on malaria in Italy during the past century, and then going ahead to plan for the attack on malaria in Africa during this century.
Some of the most dramatic stories about malaria control in Italy concerns Dictators and Wars, namely Benito Mussolini, Adolf Hitler and the Second World War. Why is this relevant for Africa? Because any realistic attack on malaria in Africa will have to contend with the multiple dictators and recurrent warfare on the continent. None of the African dictators or wars can compare to the horror of Hitler and the Second World War, but the lessons are useful, nonetheless.
Mussolini became very popular in Italy about 1932 because he drained the Pontine Marshes near Rome, thus eliminating malaria from the area, and making it possible to establish stable and profitable agricultural communities. So he became a popular hero, and used that popularity to take over Italy with his fascist dictatorship. Mussolini simply had his troops dig drainage ditches to the sea, and put in some big pumps to lift the salt water out, letting fresh water come in from the rivers, and thus cleanse and irrigate the land.
Unfortunately for him, Mussolini then made friends with the Great Fascist, Adolf Hitler, who sent German troops into Italy as part of his Grand Strategy to take over Europe. When those plans started to fall apart, Mussolini broke off with Hitler. Adolf did not like that.
Adolf had a mean streak, don't you think?. So as his troops moved North out of Italy in the face of the advancing Allied army about 1943, Hitler had them turn Mussolini's drainage pumps around, and pumped salt water back into the Pontine agricultural zone, turning it into a marsh once again. And back came the mosquitoes and malaria.
It was not until after the war, when Italy established a democratic government, that the marshes were drained again, and malaria was finally eliminated from Italy, in 1962..
So the lesson is; you are wasting your time fighting malaria if there are dictators around.
Could this be true in Africa too? Yes, I'm afraid so. I helped establish a 10-year program for malaria control in Africa which was highly successful for the first 9 years, bringing the malaria parasite prevalence below 1% for the last 5 years of the project. Then a military officer pulled a coup. The first thing he did was go to the national bank and steal about $50 million in hard currency which we had borrowed from the World Bank for drainage pumps. It was our exit strategy, similar to Mussolini's. But the new Dictator wanted the money for fuel and ammunition to conclude a civil war, so he didn't care much about malaria control.
So unlike Hitler, this guy didn't reverse the pumps, he just stole them! And the next year, our project area had the worst malaria epidemic ever, with lots of cerebral malaria in children because they had never developed immunity.
Thus we formulated the Third Law for Fighting Malaria in Africa., namely, you better remember that the dictators are as bad as the mosquitoes.
Bill, a believer in encouraging democracy everywhere