Malaria in Africa and Asia

Even if Jared Diamond is relatively restrained in his book about how far he wishes to push his argument into the present, he is less so on T.V. Last night I watched the third and final episode of the PBS series on Guns, Germs, and Steel, and it ends with an explicit discussion of how his theory applies to the present.

Jared Diamond: I’m now in the centre of the African tropics, and I’m in Zambia, one of the poorest countries in Africa and really in the whole world. The average annual income here is a few hundred dollars, and the lifespan, average lifespan of a Zambian is 35 years, so I myself have now lived nearly two average Zambian lifetimes. What goes through my mind here is, what can history and geography and guns, germs and steel tell us that would help us understand the plight of Zambia today? In modern Zambia I see few signs around me of the great native civilizations that once flourished in tropical Africa. What I see instead is a country shaped by colonization. I see towns and cities that grew up next to the mines and railroads established by Europeans, and built on the European model. What about the great forces that originally shaped this continent and its people? The forces behind its conquest by Europeans. Where are guns, germs and steel in modern Africa?

There is actually no discussion of guns and steel, but instead the discussion focuses on germs. Specifically, malaria.

Professor Nick White, Centre for Tropical Medicine, Oxford University: It’s been estimated by eminent economists that the 1% negative growth each year in Africa over the last half a century can be attributed entirely to malaria.

Voiceover: The immunities and antibodies that Africans had developed over thousands of years to protect them from malaria no longer provide sufficient protection. The strains of the disease are mutating, and standard drugs are becoming less effective. In the high malaria season, up to seven children a day die in this hospital.

But the Africans aren’t simply poor because of their germs, we are told. They are poor because they are ignorant!

Voiceover: Malaysia and Singapore are among the richest and most dynamic economies in the world. Like Africa, they are tropical countries, with the same problems of geography and health, the same endemic malaria. But both transformed themselves by understanding their environment. Fifty years ago, these countries realized the burden that geography and germs could be. Through concerted effort, they managed to almost entirely eradicate malaria from their land, transforming their economies and way of life.

The story of Malaysia and Singapore shows what an understanding of geography and history can do.

Jared Diamond: Explanations give you power, they give you the power to change.

They tell us what happened in the past and why, and we can use that knowledge to make different things happen in the future.

It seems to me that people don’t need a lot of explanations to learn that people are dying of malaria. Nor are the solutions to fighting Malaria that complicated. Sure, we can develop new vaccines, but relatively inexpensive campaigns focused on treated bed nets and public health can do wonders:

Insecticide-treated nets (ITNs) are a low-cost and highly effective way of reducing the incidence of malaria in people who sleep under them, and they have been conclusively shown in a series of trials to substantially reduce child mortality in malaria-endemic areas of Africa.

The problem is that even such “low cost” solutions are unaffordable for most affected families! Something else is going on here. I won’t denigrate such complex question with a simplistic answer, but as I suggested in my earlier post on Yali’s question, I think the extraction of resources from these countries by their own elite is part of the issue. A new book by Matthew Lockwood, makes an interesting comparison between development and corruption in African and Asian countries:

The problem is not an inefficient civil service or lack of local government. Nor is it just about corruption. The governing class in Asia was often corrupt too. But they ploughed back their money into their own countries. In Africa, an estimated 40 per cent of privately owned wealth—about half the value of Africa’s debt stock—is held outside the continent.

Nor will I discuss the problems I have with Diamond seeing contemporary developing countries as nothing more than a failed copy of Europe … I think Fred and Deborah are doing a good job on that front.

3 thoughts on “Malaria in Africa and Asia

  1. Yay! I complete agree with everything you’ve said here. He comes to Zambia and he wants to talk about malaria. But malaria’s in Botswana and South Africa, too: look at the differences in contemporary circumstances.

    Somebody says to me, “I want to understand why Zambia is the way it is now”, I might eventually say, “Ok, let me talk a little about the longue duree and material conditions”, I might want to talk about tsetse fly and pastoralism, and so on. But what I’m going to talk about first is colonialism. No, scratch that. I’m going to talk about that second. What I’m going to do first is toss the person asking a copy of Ferguson’s Expectations of Modernity, because then the questioner would understand that the way Zambia is now is actually in significant contrast with the way it was in 1965, that very short-term, highly contingent issues carry more explanatory weight than talking about malaria does.

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