Malaria and the Political Economy of Public Health

Abstract

After more than a decade when the disease was under increasing control, malaria has been making a dramatic resurgence in the 1970s. Even more troubling has been the inadequacy of government response despite appeals by public health officials and despite the availability of adequate resources. This article seeks an understanding of this decontrol in the history of the political economy of public health and in an analysis of the current international economic crisis. An examination of several episodes in the history of malaria control and related public health programs shows how they have played a role in and been defined by a series of social and political conflicts. These conflicts have included agrarian unrest in the American South, colonial expansion in the Third World, peasant revolution in China, the Cold War, and a whole series of urban and rural upheavals for and against development in the post-World War II period. An examination of the current world crisis suggests that it is another such period of social conflict—one in which various sectors of business and various governments are trying to restore the conditions of growth and accumulation which were ruptured in the late 1960s by an international cycle of social instability. Allowing malaria to spread, like allowing drought and flood to turn into famine, thus appears as a de facto repressive use of “nature” to reestablish social control. Such circumstances raise hard questions both for the public at large and for public health workers as to the most effective means of reversing these trends.