The interplay between socio-economic factors and medical science: yellow fever research, Cuba and the United States.

Abstract

This paper examines the reasons for the lag of almost twenty years between the publication m 1881 of the Cuban physician Carlos J. Finlay's substantially correct theory of the mosquito transmission of yellow fever, and its eventual confirmation by the US Reed Board in 1900. The major thesis is that political and economic factors were more important in the lag than any supposed shortcomings in Finlay's science. In the period discussed, no politically or economically powerful institution in the US was threatened by yellow fever, so that support for yellow fever research was erratic, while within Cuba the prolonged war of independence prevented an attack on the disease The US army's occupation of Havana altered three critical dimensions of yellow fever research: (1) yellow fever was reclassified from a 'low threat' to a 'high threat' disease; (2) funds for researcn were sharply increased; and (3) military occupation of Havana allowed systematic application of research results. in the new political and economic conditions of 1900, the Reed Board confirmed the mosquito theory in two months, and yellow fever was eradicated in Havana in six months.