As a malariologist interested in the history of treating this disease, I approached Ms. Rocco’s book without high expectation. After all, what can be added to an important story that unfolded several hundred years ago? The writer answers this question unambiguously: truth, humanity, historical context, humor, irony, and wonder. This is an informative and enjoyable piece of work that contributes substantially to our understanding of the emergence of malaria chemotherapy.
The author is not a scientist. She is the literary editor for the Economist. She nonetheless has a personal history tied to malaria. She is the great-granddaughter of Philippe Bunau-Varilla, the chief engineer of the French effort to build the Panama Canal. Also, Ms. Rocco was born and raised in western Kenya where she and her family became well acquainted with the disease. She tells us of these impacts upon her personal history. More importantly, she successfully paints the conspicuous fingerprint that malaria and the search for its cure has left on our collective modern history.
Quinine of course came from the bark of several species of Cinchona trees native to Andean Peru, Ecuador, and Bolivia. Ms. Rocco brings this dry fact to vivid life by introducing the characters living in colonial Lima who gave us the drug. She presents the emergence of quinine therapy squarely in the murky context of the breathtaking ignorance of medicine and the deep religious hatreds of the 17th century. She brings us into the Age of Empire and walks us through the conspiracies and tragedies that got Cinchona out of South America. She introduces us to the skilled Bolivian peasant, Manuel Incra Mamani (of whom I had never heard before reading this book) who collected the seeds that would create the vast quinine plantations of Java. The authorities beat him to death for this perceived betrayal – the man probably saved the world supply of quinine because the South American trees were being harvested to extinction.
At the outbreak of the Second World War, almost all of the world’s quinine production occurred on Java, which the Imperial Japanese Army occupied in early 1942. Understanding their strategic predicament, the United States mobilized chemists who managed to make synthetic quinine by 1944, and also mobilized a massive scientific and clinical effort that delivered chloroquine and primaquine. And yet, commercially viable quinine plantations remain in business today. Rocco takes us to Bukavu in the Congo where descendents of the seeds gathered by Manuel Incra Mamani flourish and yield natural quinine.
Rocco does commit a couple of minor technical errors, but these do not diminish the great satisfaction that even a malaria expert may gather in reading this masterfully executed piece of nonfiction.