Perspectives in Biology and Medicine

RENEJ. DUBOS AND FRED L. SOPER: THEIR CONTRASTING VIEWS ON VECTOR AND DISEASE ERADICATION SOCRATES IJTSlOS* RenéJ. Dubos was born in 1901 and died in 1982. Fred Soper, too, lived a long life: 1893 to 1977. Dubos, who was born in France, settled in the United States in 1927, where he worked as a microbiologist, eventually becoming a very popular writer and lecturer. Soper was born in the United States and spent most of his early professional life as a public health worker in the tropics. Although both were affiliated with a Rockefeller institution, there seems to have been no communication between them and no direct referencing of each other's works in their writings. Dubos developed his vision of public health over many years, during which he posed probing questions concerning the nature ofdiseases, man's relationship to them, and ecological approaches to their control. Soper, on the other hand, from the very beginning of his career practiced public health by controlling individual diseases and their vectors, preferably with the intent of eradicating them. Soper and Dubos were united in their fight for health but in almost total opposition on how best to fight that battle. Dubos saw health in broad almost spiritual terms, where individual diseases often appeared secondary, while Soper focused on the direct impact of diseases as if health could only be defined by their presence or absence. Dubos, although not a public health practitioner himself, influenced and conditioned the approach and beliefs of a countless number ofpublic health workers through his writings. Soper, too, influenced those who followed in his footsteps. To be a "Soperian ," however, you had to reject most ofwhat Dubos believed. Alternatively, starting with Dubos' beliefs virtually ruled out public health initiatives of Soper's kind. Soper's faith in the feasibility of disease as well as vector eradication was *World Health Organization, Control of Tropical Diseases. Correspondence: rue des Scies, 1446 Baulmes, Switzerland.© 1997 by The University of Chicago. All rights reserved. 0031-5982/97/4004-1026$01.00 138 Socrates Eitsios ¦ Dubos and Soper built upon more than 25 years of his own experience. He prided himself as almost single-handedly having resurrected the idea of eradication as a public health measure worthy of pursuit. Dubos' opposing views derived from a deep belief, drawn from his own research, that all diseases were so interwoven with man's environment and ecology that it would not be possible to extract a disease from nature's web through a direct, surgical-like, approach. Two aspects of Soper's legacy are used in this paper to contrast his philosophy with that of Dubos: the attempt to eradicate the malaria vector of Sardinia, A. lambranchiae, and the WHO global malaria eradication campaign . The latter is of particular interest, as it was the first major global eradication effort, one which Soper maneuvred the World Health Organization into launching in 1955 [I]. In both these instances eradication did not succeed. However, that malaria was not eradicated did not prove Dubos right; in fact, the contradictory evidence to his thesis came quickly in the form of the successful world-wide smallpox eradication campaign, which was intensified at the same time (1965) that Dubos was articulating his scepticism concerning the possibility and value of disease eradication. Nor did the malaria failure prove Soper wrong since the global campaign did not evolve as he had argued that it must. Nevertheless, Dubos' reasoned skepticism concerning this campaign played an important role in convincing many that all eradication efforts were questionable affairs. I Dubos recognized that the eradication of Anopheles gambiae from Northern Brazil and Egypt (which Soper was responsible for) supported the view that an insect vector could be completely eliminated by a concentrated effort. But he saw both situations as being "atypical" and lacking "generally convincing value," since A. gambiae had been introduced only a short time before both "species-eradication" programs had been launched [2]. Also, breeding places of the species were readily accessible and could be treated with Paris green once a week. Dubos contrasted that success with the failure to eradicate A. labranchiae in Sardinia, a vector that has been indigenous to the island for millions...