Birn A E
New School for Social Research, New York, NY 10011, USA.
Parassitologia. 1998 Jun;40(1-2):137-47.
Malaria's epidemiological importance in Mexico greatly exceeded that of hookworm, but the Rockefeller Foundation (RF) paid far more attention to hookworm. Although the RF collaborated with malaria campaigns around the world, malaria was only incidental to the RF's activities in Mexico. The hookworm campaign, on the other hand, involved the RF at every stage, from conceptualization and design to financing, hiring, and day-to-day administration. This paper seeks to understand why the RF's involvement in Mexico differed for the two diseases and what the organizational, political, and health implications were for these divergent approaches. Beginning in the mid 1920s the Mexican government developed a modest anti-larval service, periodically draining and filling ditches and swamps, dusting Paris green, petrolizing stagnant water, and administering quinine. Following the RF's 1927 shift towards scientific investigation, it began to sponsor small-scale malaria research, collecting climatological, entomological, epidemiological, and clinical information. The Mexican government eagerly petitioned the RF to join a national effort, but it was reluctant to become involved. A National Malaria Campaign was established in 1935 under President Lázaro Cárdenas to coordinate education, sanitary engineering, and treatment. The popular Campaign followed RF strategies even without its direct participation. Meanwhile, the RF avidly pursued modest malaria research in Mexico, funding U.S. investigators to conduct experiments on pesticides, mosquito-trapping, and controversially, watering methods for rice. These efforts culminated in the world's first field trial of DDT against louse-borne typhus and later as a residual spray for malaria. In the end the RF used Mexico as a convenient locale for scientific research that had global implications but only an incidental relationship to Mexico's own Malaria Campaign. Likewise, the RF's much more active hookworm program was more a means than an end, leading not to eradication of the disease, but to Mexico's commitment to modern public health organization and methods.
疟疾在墨西哥的流行病学重要性远远超过钩虫，但洛克菲勒基金会（RF）却对钩虫给予了更多关注。尽管该基金会在全球范围内与疟疾防治运动开展合作，但在墨西哥，疟疾只是其活动的附带事项。另一方面，钩虫防治运动在各个阶段都有该基金会的参与——从概念形成、设计到资金筹措、人员招聘以及日常管理。本文旨在探究为何该基金会在墨西哥对这两种疾病的参与情况有所不同，以及这些不同做法对组织、政治和健康方面产生了何种影响。从20世纪20年代中期开始，墨西哥政府开展了一项适度的灭幼虫服务，定期排干并填埋沟渠和沼泽、喷洒巴黎绿、用汽油处理积水以及发放奎宁。1927年该基金会转向科学研究后，开始资助小规模的疟疾研究，收集气候学、昆虫学、流行病学和临床信息。墨西哥政府急切地请求该基金会参与全国性努力，但它却不愿介入。1935年，拉萨罗·卡德纳斯总统执政期间设立了全国疟疾防治运动，以协调教育、卫生工程和治疗工作。即便没有该基金会的直接参与，这场广受欢迎的运动也遵循了其策略。与此同时，该基金会在墨西哥积极开展适度的疟疾研究，资助美国研究人员进行杀虫剂、诱捕蚊子以及颇具争议的水稻灌溉方法等方面的实验。这些努力最终促成了世界上首次使用滴滴涕防治虱传斑疹伤寒的实地试验，以及后来将其作为疟疾残留喷雾剂的试验。最终，该基金会将墨西哥作为一个便于开展具有全球影响的科学研究的场所，而这与墨西哥自身的疟疾防治运动仅有附带关系。同样，该基金会更为积极的钩虫防治项目更多是一种手段而非目的，其结果并非根除这种疾病，而是使墨西哥致力于现代公共卫生组织和方法。
