Title: Rebounding Malaria and the Ethics of Eradication:
the WHO Campaign in Zanzibar, 1957-1968 and Contemporary Implications
Abstract: This paper chronicles the history of malaria elimination attempts in Zanzibar, taking a close look at the World Health Organization’s failed elimination attempt between 1958-1968, and the epidemic of rebound malaria that struck the island afterwards. The paper argues that the WHO scientists recognized from the very beginning that Zanzibar’s elimination attempt was unlikely to succeed but publicly blamed Zanzibar workers, institutions and community members for the many problems that arose. Drawing on internal and confidential WHO documents, the paper also shows that scientists recognized the risks of rebound malaria early on, yet did not responsible plan for measures to lessen the burden to local people. A particular focus is on the ethical questions emerging around the loss of acquired immunity, how local communities understand the potential risks, and how international global health groups plan responsible exit strategies. The historical case study is framed in light of Zanzibar’s current malaria elimination activities, led by the Gates Foundation. The paper is based on extensive work in the Zanzibar National Archives and the WHO archives in addition to interviews and observations in Zanzibar.
Bio: Melissa Graboyes is a historian of modern African, and currently an Assistant Professor in the Clark Honors College at the University of Oregon. She’s the author of The Experiment Must Continue: Medical Research and Ethics in East Africa, 1940-2014 (Ohio University Press, 2015) which is being used by global health and development workers and taught with at multiple universities. She received her Ph.D. in History and a Master’s in Public Health from Boston University. She worked in the United States as a health educator with Planned Parenthood, and led health outreach and advocacy programs in Botswana and Tanzania while working for global health organizations. Graboyes is currently working on a new book project related to the history and ethics of malaria elimination attempts. In her research, she draws on a variety of historical and anthropological methods including archival research, interviews and participant observation. She is currently leading an edited book volume, Everyday Life in Africa, which will be published by Ohio University Press in fall