Paper presented at the Carnegie Council Fellows' Conference 2004. To access the full paper click on the "download" button at the bottom of the page.
Malaria is second only to tuberculosis as the world's most deadly killer. Yet malaria is an environmental issue as well as a health concern. Because malaria parasites are transmitted by mosquito vectors, any measure that kills mosquitoes, disrupts mosquito habitat or prevents their contact with humans has been tried alongside standard drug treatments. Human efforts to control malaria mean that wetlands are drained, rivers are channeled, and pesticides are sprayed, often through massively financed campaigns. The Rockefeller Foundation's Sardinian Project (1946-51) utilized 32,000 DDT workers to spray 10,000 tons of DDT mixture over an area the size of New Hampshire, finally liberating the island of malaria. The environmental implications were enormous.
But even as Sardinia's ecosystems were being rearranged during those post-war years, the political implications were also dramatic and far-reaching. In the days before the WHO, the Rockefeller Foundation's International Health Division was the world's leader in malaria control. If the Rockefeller Foundation felt that something might be done to rid a place of the malarial scourge, governments listened. The Foundation explained to Italian leaders that Sardinia was an ideal place to test, not the potency of DDT (for that potency had already been documented), but the combined abilities of all pesticides and all drainage projects to completely rid Sardinia of mosquitoes. The goal in Sardinia was not malaria eradication, but mosquito eradication. Yet not all Sardinians were convinced that the Foundation was doing what was needed.
Sheepherders, fish farmers, and beekeepers blamed their dead sheep, dead fish, and dead bees on DDT spraying. Other villagers maintained that malaria fevers derived from pestilential waters, not mosquitoes, and so were reluctant to let sprayers into their homes, especially when house flies that once died (the most immediate benefit of spraying) acquired pesticide resistance. Local health experts and politicians also complained that the project focused too much on mosquitoes and not enough on the disease, sometimes faulting "American" methods over tried-and-tested "Italian" methods. After the project's first director quit, secretly claiming that mosquito extermination over such an extensive area was an impossible task, the next director orchestrated a final all-out campaign before declaring malaria success while admitting mosquito defeat, and then beating a hasty retreat out of Sardinia.
By most accounts within and beyond Italy today, the Rockefeller Foundation freed Sardinia of malaria, catalyzing the island's subsequent economic miracle. But few Sardinians realize that the project was an experiment more than a campaign. Moreover, few locals realize that malaria was already on the way out when DDT-applicators began pumping their spray guns: malaria's short resurgence during World War II had followed two decades of dramatic declines. Between 1918 and 1940, 3800 malaria deaths in Sardinia dropped to just 138, a statistic not often revealed in Foundation reports. Malaria would have assuredly disappeared from Sardinia with only moderate DDT spraying--and perhaps even without DDT spraying--a fact demonstrated in other parts of the Mediterranean and acknowledged by Foundation personnel.
One suspects special treatment and special injustice when Sardinian courts absolved the Sardinian Project of all legal claims to DDT damages, especially when one realizes that Rockefeller Foundation officers were writing to each other about DDT's possible "contraindications," including fish kills and DDT-tainted cow milk. Perhaps lingering wartime hysteria and DDT's potential benefits justified lax pesticide precautions. Nevertheless, the Sardinia Project seems to have been an instance of excessive technological hubris buttressed by hegemonic institutions concerned more with their own aspirations than in the peoples their project was meant to benefit. In urging project leaders to continue spraying even when faced with the likelihood of failure, one Rockefeller Foundation officer mentioned that Foundation "prestige as well as word is involved." Another officer rejoined that "The eyes of the world are on the Sardinian Project."
By historical analogy, the Sardinia Project teaches us to be doubly cautious of any health or environmental measure imposed from afar. A case in point is the United Nations' recently ratified Stockholm Convention (or POPs treaty), which will severely restrict or ban twelve long-lasting chemicals, DDT among them. It turns out that while DDT is highly toxic to fish and birds and insects, it really isn't very dangerous to people, and so is still very useful for controlling malaria-carrying mosquitoes. After several years of debate, the treaty will go ahead and allow countries to continue using DDT under emergency circumstances, if they follow strictly monitored procedures of manufacture and application. And while such DDT stipulations suggest long-term gains for everyone, the fact remains that any restriction on this pesticide--legalistic or bureaucratic--means that it will not be as available as it might have been. While the UN's recent declaration may be true, "that no one will die of malaria because of the Stockholm Convention," others may well have lived longer, healthier lives if this treaty had never been ratified. POPs is a restrictive measure, a measure that will continue to be more popular in the malaria-free north than in the malaria-plagued south.