No. 492 July 7, 1939
Dear Dr. Sawyer:
I want to thank you especially for your letter of June 14 written at a time when you must have been terribly rushed trying to get away for your summer holiday.
The news regarding Mr. Fosdick's reiteration of the statement that budgets for 1940 must be less than those of 1939 is sad.  However, I am taking what comfort I may from the latter part of the sentence reading:
"he also spoke of the anticipated reluctance of the Trustees to dig into capital funds except for [BEGIN UNDERLINE] very important projects outside of the regular programme". [END UNDERLINE]
Were the gambiae project one which might be considered part of a "regular programme" I would never have recommended taking it over this year when so much remained to be done on yellow fever and when so few men were available for doing it.  Neither would I have asked for a budget for this year of $100,000.00 without having made some preliminary surveys covering a reasonable period of time.  The gambiae project is one which must be organized on a large scale or abandoned as impossible!
The gambiae programme is not to be considered as competing for funds with other malaria programmes.  The real gambiae problem, whether we commit ourselves to it publically or not, is one of preventing the spread of gambiae from one place to another with the hope of being able to eventually eliminate the species from Brazil.  I say this in spite of your letter of last year in which you refuse to involve the Foundation in any campaign of extermination following its experiences with hookworm disease and yellow fever.  Nothing has been uncovered so far, except the mere size of the project itself, to indicate that the elimination of gambiae from the region in which it is now known to exist, is impossible.  The stark tragedy I have seen in the gambiae infested districts leaves me no option but to insist that a real attempt be made with adequate funds and men to eliminate it before this tragedy spreads over the rest of the continent.  My suggestion that you meet me in Fortaleza for a discussion some weeks ago was based on a desire to show you certain unforgettable sights which no words are adequate to describe.
I need not go back and recite for you the history of the discovery of gambiae in Brazil.  We both felt justified in the early years of this mosquito's existence in Brazil in considering the problem, except for a short period in 1931, as one for the government authorities to solve.  But justified or not, the fact remains that I was the Representative of the International Health Division in Brazil at the time Shannon's finding of gambiae was announced and you, who had already seen what gambiae could do in West Africa, were in Brazil shortly thereafter and had an opportunity to see at first hand the results of the invasion of Natal in 1930 by gambiae.  In the light of what has happened since then we can at least be charged with a lack of vision.  (And it is as true today as in the time of Isaiah that
"where there is no vision the people perish"). (Prov. 29:18)
With the publication of the section of Anopheles gambiae in Mr. Fosdick's presidential review this year, we can no longer be charged with a lack of vision.  It only remains to get that vision across to the Board of Trustees and the necessary funds will be made available.
One item which helped give us the necessary courage to take on the gambiae problem was the statement in your letters in which you discussed the transfer of the yellow fever service back to government to the effect that the desire for this transfer was in no way related to a desire to reduce total Foundation contributions to health work in Brazil.
I have been looking over the amounts appropriated and spent by the Foundation on yellow fever study and control in Brazil alone since 1923.  I find that in five different years 1924, 1925, 1926, 1932 and 1933 over $300,000.00 was spent each year and that in 1924 $515,000.00 was spent.  Fortunately today's expenditures are much lower and those for 1940 will be even less.
The whole world was shocked at the picture of what happened in Ceylon a few years ago.  The Ceylon tragedy is being reenacted in Brazil today with the difference that it is repeating year after year and will continue to do so until a thoroughly malarialized population is built up.  Fortunately, the population of the zone so far invaded is relatively small but the population of threatened regions runs into many millions!  In considering a budget for gambiae work in Brazil we cannot take into consideration only the population of the infested zone but must also include the population which will suffer in coming years and throughout future generations if gambiae is not blocked here and now!
It is only after seeing gambiae at work in Brazil that I have come to understand why West Africa has been called the white man's grave!  Malaria has long been a serious problem in Brazil but only in certain regions are the local mosquitoes able to transmit in a way to suggest competition with gambiae.
As I have written you before I believe we should have a minimum of one million dollars in the war chest for next year.  It is possible or, I believe I may say, probable, that the Brazilian Government can be induced to furnish all, or almost all, of this amount since it recognizes the seriousness of the situation and had a high opinion of the work done by the Foundation on yellow fever.  I am wondering, however, if the Foundation would feel justified in administering a programme of this size in which it has only a ten percent interest?  I believe the Foundation should take from 30 to 50 percent of the stock in the gambiae project.  Failing to get the amount needed from the government and the Foundation, would it be feasible to suggest an international war chest with funds from other countries?  (I hope this can be avoided but mention it as just one more indication of my estimate of the gravity of the situation).
In conclusion I think we should decide first, how much should be spent on the gambiae service in 1940 without considering at all the minor question of where the money is coming from.  Having done this, the Foundation should be given the privilege of contributing a reasonable proportion of this amount without taking into consideration 1939 income or, if income must be considered of placing the needs of all other work, including the study of Jungle Yellow Fever and its control by vaccination, on a list for consideration after the gambiae needs have been fulfilled!
The gambiae problem is not one which can be attacked equally well next year or the year after or just whenever funds may become available.  The failure to spend possibly $100,000.00 or even less in 1930 has let the problem grow until now one must talk in terms of millions of dollars.  Failure to spend freely now will, at the very least increase many fold the total which must be spent, and may even make all future spending futile.  There exist at the present time very favorable conditions for working under a government which realizes the gravity of the problem and is accustomed to letting us work with a free hand.  Such favorable conditions cannot be conjured into existence with any amount of money.
Very sincerely yours,
Fred L. Soper