The Malaria Manhattan Project

The investigation started with a mislabeled box.

Karen Masterson M.A. ’04 was at the National Archives in College Park, expecting to review records on World War II blood plasma studies by the famous chemist Linus Pauling. An experienced reporter, she had recently finished her master’s in journalism and was doing an assignment for an extra course on navigating the labyrinthine system of the archives.

She was handed the wrong box. Frustrated by the mix-up, she randomly pulled a file from it and scanned a letter inside.

“I literally turned cold,” she said in an interview. “I couldn’t believe what I was reading.”

The Dec. 6, 1943, U.S. government letter to the Massachusetts surgeon general outlined a frightful research scenario: Mental and end-stage syphilis patients would be infected with malaria so researchers could test new drugs critical to the war effort.

That letter propelled Masterson into research that produced her new book, “The Malaria Project: The U.S. Government’s Secret Mission to Find a Miracle Cure,” which tells the story of the soldiers, scientists and researchers who embarked on a frenetic—and, by today’s standards, ethically questionable—quest to stop the ravages of one of the most difficult diseases on earth.

The story pulls in some of the most important developments of the 20th century, such as the New Deal efforts to remake the infrastructure of the American South and the burgeoning reliance on technology and medicine to fight disease, and even has cameos from Dr. Seuss and Nathan Leopold of the infamous crime duo “Leopold and Loeb.”

Joel Achenbach, a Washington Post science reporter, describes the book as “an absorbing tale of the many scientists and doctors who, from the nineteenth century on, tried to figure out and contain this devious enemy once and for all.

“‘The Malaria Project’ is a fascinating story of the hunt for a killer as medical science emerges from its own dark ages.”

TROUBLESOME TRIALS

By the beginning of World War II, the United States had effectively rid itself of malaria through a combination of economic development and public health solutions. With programs such as the Tennessee Valley Authority, the most vulnerable parts of the South received electricity and more sophisticated water management techniques that led to proper dams.

When Americans landed in places including Guadalcanal, Italy and North Africa, however, the disease spread and jeopardized the war effort. In those environments, a single boot print, let alone shell holes and the more damaging effects of war, could become a breeding ground for malaria-carrying mosquitoes. Marines and soldiers slept with tent flaps open and took in outdoor movies, further endangering themselves when they went to the bathroom or snuck out for late-night trysts.

“They needed an emergency-level response to a mosquito problem they had never seen before. The ecosystems are just shredded,” Masterson says. “There is no public health (response) that could have brought it under control.”

By October 1943, the equivalent of six divisions—as many as 100,000 soldiers—in a single theater had been incapacitated, making the mosquito responsible for more casualties than the enemy.

The problem for the federal government and its teams of researchers was that malaria was a very hard disease to study, let alone defeat. Parasites couldn’t survive in a petri dish or solution, making malaria “extremely resilient and robust in the wild, but impossible to culture and cultivate in a lab,” Masterson writes.

That gave rise to the troubling letter she discovered in the archives. For years, malaria research revolved around hosting the disease in patients already ravaged by syphilis, partially with the hope that the resulting fevers and chills would help cure the initial problem. (Results were mixed.) The wartime effort to find a cure amplified the need for such patients and eventually grew to include mental patients like schizophrenics.

“The complicity (in the medical community) seemed driven by this increasingly convenient understanding that the work, on the whole, was mutually beneficial,” she writes. “The potential benefit to humanity, should the work result in a magic-bullet cure for malaria, far outweighed any downsides to giving different forms of malaria to dying people.”

Unlike today, Masterson says, there were few guidelines for researchers to follow other than their own consciences.

“This was an era where the standards for using people in experiments were not established,” she says. “It was left to the moral compass of the individual.”

Less troublesome was researchers’ shift to experimenting on prisoners, she says, since that had been long approved in the medical community. Nathan Leopold served as an effective, if unsettling, assistant in these experiments while serving time for the infamous murder of a 14-year-old.

By 1943, more than 7,000 different drugs had been tried and failed. Rather, serendipity played a large role in obtaining the answer. A French doctor in Tunisia had been successfully testing a drug made in the 1930s by chemists for the German company Bayer. When the Allies captured North Africa, he turned his findings over to them and ushered in years of malaria treatment through a drug called chloroquine.

Educational Journey

Ira Chinoy, associate professor and associate dean of the Philip Merrill College of Journalism, teaches the class on the National Archives that led to Masterson discovering the telltale letter. His students have to produce a project like a paper, website or documentary on a subject researched from the voluminous records.

“It’s probably our greatest cultural treasure here in College Park,” Chinoy says.

He remembers talking with Masterson about the initial find and saying, “My God, that’s the project and an amazing piece of history.”

“She had the perseverance and skills to pull it off,” Chinoy says.

Masterson came to the story with some scientific knowledge, having covered environmental issues in southern New Jersey while working for the Philadelphia Inquirer.

While pursuing the story, she also got a Knight Foundation fellowship that allowed her to work for three months in the Malaria Branch of the U.S. Centers for Disease Control and Prevention. In a hot and humid room filled with mosquitoes (“I got eaten alive”), Masterson did the painstaking work of dissecting the insects and examining their salivary glands.

“I felt like I was a tourist in a really cool country,” she says. “I kept thinking, ‘I missed my calling.’ I enjoyed the tedium of it.”

The very fact she could work in a malaria lab is evidence of how fleeting success has been against the disease. Although chloroquine was effective for a long time, malaria developed resistance to the drug and is doing the same to all new products at an even faster clip.

To Masterson, what’s even more damaging than malaria’s adaptation is the insistence on fighting it with drugs instead of the public health and environmental management techniques that worked in the American South.

“This project explains how we focus so heavily now on drugs and vaccines,” she says. “Because of that, we aren’t doing the sort of on-the-ground prevention.”

She believes that the public awareness campaigns educating soldiers on using repellent, wearing long sleeves and other basic methods were more effective than any insecticide or pill during World War II. Theodor Geisel, most commonly known as Dr. Seuss, did illustrations for a pamphlet on stopping malaria, complete with a Who-esque mosquito named Ann (a pun on the mosquito genus anopheles).

“We’re chasing these parasites with technology that’s not up to it,” Masterson says. “We do know public health works, economic development works. Education alone helps.”

As she wrote in Time magazine recently, she believes the response to the Ebola outbreak is the most recent example of this misguided mindset. Masterson says the United Nations’ attempt to get $1 billion to fight the disease includes just $45 million for public outreach.

“If we walk away from this and don’t change anything,” she says, “we will experience it again.”