Mat Savelli and Sarah Marks (eds), Psychiatry in Communist Europe (Basingstoke and New York: Palgrave Macmillan, 2015), pp. xi, 222, $90.00, hardback, ISBN: 978-1-137-49091-9.

that the costs of post-eradication surveillance could dwarf initial expenditures.) If 25% of childhood mortality were attributable to malaria, reasons for caution in intervention dissipate. The concern about harm that might be done to adults whose acquired immunity could be compromised was hardly considered. Malariologists might elect utilitarianism as their chosen professional ethics, their brand of utilitarianism was certainly not of a consequentialist variety. Unfortunately, resistance developed rapidly. Every one of the synthetic insecticides, DDT and others, had a mixed record. Malaria eradication programs were closed down in the early 1960s. One lesson learned was that if malaria eradication in tropical Africa was not feasible, malaria control was feasible, provided funding were sufficient. Yet malariologists never tried to penetrate African cosmological frameworks that determined people’s understanding of the disease. They never succeeded in building a cooperative relationship with communities. As the author says, ‘the cultural gulf remained fundamentally unbridged’. No thought was given to this as one reason for the lack of success. The 1960s saw the coming an inexpensive and highly effective antimalarial drug, chloroquine, another wonder drug. Rural populations soon embraced it. In the villages, distended spleens declined precipitously, as did sickness and death owing to malaria. Chloroquine is credited to have reduced infant and early childhood mortality from malaria by 25–35%. But resistance to chloroquine was becoming widespread in South-East Asia, and it was only a matter of a few decades before it would set the foot on African soil. With no back-up drug to chloroquine, serious troubles were ahead. Vector resistance to chloroquine appeared in Africa in 1978. WHO, then, launched various strategies, of which Roll Back Malaria (1998) was the most ambitious. But the global north also became more aggressive with the creation of the Global Fund to Fight AIDS, TB and Malaria (2002), and the President’s Malaria Initiative (G.W. Bush, 2005). In 2007, the Bill and Melinda Gates Foundation announced a new campaign to eradicate malaria. The rationale – the economic rationale – was a repetition of the former campaigns of the 1950s and 1960s. A strange scenario came out. In the 1990s, intermittent preventive therapy (antimalarials) for pregnant women and infant unknowingly rediscovered the empirical findings of Belgian colonial physicians in the 1930s. Pyrethroid resistance developing in the 2000s, lowering the protection given by bed nets with insecticide, stressed the resurgence of susceptibility among those who have lost their partial immunity. These findings were treated as novel, although they were consonant with experiences dating back to the aftermath of the Second Word War. Large-scale plantations of Artemisia annua (for the artemisinin-based new wonder drug) looks like a reprise of the efforts to grow cinchona trees in the 1930s and 1940s. And the whole job of fighting malaria appeared to be, as Webb has it, a ‘Sisyphean endeavour’, as if history was motionless, and without an endgame.