Malaria and Western Colonialism are intricately involved in history, with each having a profound effect on the other. As I wrote in an earlier post, it was the fear of malaria that protected Africa from colonization for many centuries. Labeling it the "white man's grave," European colonizers shunned the continent because of the high mortality rate suffered by Europeans who were not naturally immunized against African diseases like malaria. However, with the discovery of quinine in the 1850's, the Europeans finally found a way to combat the deadly disease, and the entire continent was colonized within thirty years. Quinine had such a far-reaching effect on the African subcontinent that it is often termed "the cure that changed the world."
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| Map showing presence of malaria in Africa |
Colonization led to export of human labor from Africa, and with that, the export of malaria. Just as malaria had kept colonization out of Africa before, now colonization helped spread malaria to the far corners of the world. It also displaced Africans who had developed immunity from repeated exposure and left them vulnerable to the deadly disease to a much higher degree than before.
Sadly, the discovery of quinine allowed westerners to settle in Africa but did not provide a long lasting cure for the disease. Malaria continued to ravage the population of Africa and does so to this day, with an estimated 250 million cases in 2021, far more than covid-19. There has been no cure for malaria besides quinine and one other drug, both of which are only mildly effective. There has also been very little progress in the development of a vaccine, with the announcement of the first vaccine only coming in 2021 after 35 years of research. While there was much joy at the news that a vaccine was finally available and is endorsed by the WHO, the reality was much bleaker. Not only is the vaccine only 30% effective, but it is also very expensive and requires four doses, presenting a nightmare scenario for implementation in rural Africa. But most tragically, it exposes colonial remnants of discrimination and apathy towards the African population.
The WHO, while promoting the vaccine for wide rollout in Africa, continues to use colonial weapons of misinformation and disrespect. The WHO has been accused of conducting tests on African children, without obtaining proper consent from parents in defiance of international ethics. Consent is one of the most fundamental aspects of healthcare, and the blatant violation of this natural human right shows utter disrespect for the patients in Africa. By disregarding participants’ autonomy and ability to discern what is in their personal best interest, the WHO stands accused of using the same imperialistic attitudes that drove westerners to colonize and plunder Africa.
This concept recalls that of thinkers like Thomas Jefferson, who believed in the intellectual superiority of white people. As he reasoned in Notes on the State of Virginia that African Americans are “in reason much inferior, as I think one could scarcely be found capable of tracing and comprehending the investigations of Euclid” (Jefferson 12). This implies that black people are inherently less intelligent than white people on account of their lack of conventional education. The same idea of a lack of education is used to justify not requiring formal consent from parents of children being vaccinated in Africa. The justification for this transgression is the notion that the poorly educated people in rural Africa would not understand the information presented to them about the vaccination that is necessary for consent to be considered informed.
This is fundamentally untrue, as all people have the capability – and right – to understand what is happening to their bodies. Though they may not be educated about vaccines in the same way as westerners who learn about them in biology class, the idea that they wouldn’t be able to understand the basic idea of it is presumptuous, condescending, and arguably, racist, much like Jefferson’s argumentation.
Ultimately, this leads to an imperialistic sense of justified power over the human body, much like the colonization of the Philippines. In an age of globalized medicine and philanthropy, racist and imperialist ideology persists, threatening to degrade the integrity of international organizations like the WHO and cause irreparable harm to people's health.
In the western world, where patient consent and autonomy are valued so dearly, a violation of the sort that was experienced in Africa would have been crucified. If it were not for negative perceptions of black people, the reasoning given for not requiring consent would have been ridiculed.
Bibliography
https://www.smithsonianmag.com/science-nature/why-did-it-take-35-years-to-get-a-malaria-vaccine-180980151/
Anderson, Warwick. “Excremental Colonialism.” In Colonial Pathologies: American Tropical Medicine, Race, and Hygiene in the Philippines (Durham: Duke University Press, 2006), 104-129.
Benjamin, Ruha. “Recasting Race: Science, Politics, and Group-Making in the Postcolony” In Reconsidering Race: Social Science Perspectives on Racial Categories in the Age of Genomics (Oxford UP, 2018).
Borfitz, Deborah. “WHO Malaria Vaccine ‘Rollout’ In Africa Raises Ethical Questions” Clinical Research News, March 20, 2022.
Brown, Beatrice. “Is ‘Implied Consent’ Ethically Permissible in WHO’s Malaria Vaccine Pilot Introduction?” Bill of Health, March 11, 2022.
Duster, Troy. “Race and Reification in Science” In Science 307 (Feb. 18 2005): 1050-1.
Jefferson, Thomas. “Query 14.” In Notes on the State of Virginia (Cambridge: HS100 Edition, 2015).
World Health Organization. “Malaria: The malaria vaccine implementation programme (MVIP).” Accessed December 5th, 2022.
Brown, Carolyn. “Malaria vaccine not perfect, but still useful” National Library of Medicine (Sept 2015): 954-5.
Arrow, Panosian, and Gelband. “Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance.” National Academies Press (2004)
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