Malaria Is Still Thriving, and It Tells a Saga of Human Tragedy : THE MALARIA CAPERS, More Tales of Parasites and People, Research and Reality, <i> by Robert S. Desowitz;</i> W.W. Norton; $21.95; 288 pages

Although known today as a blight in what has come to be called the “Third World,” malaria so afflicted George Washington’s troops that the Continental Congress had to allocate the grand sum of $300 for quinine. Later, during the Civil War, half of the white troops and four-fifths of the blacks in the Union Army were hit by the fever. Until the 1940s, malaria was the American disease.

Malaria has the distinction of being the only disease for which the U.S. Congress (alone in the world among all nations’ governing bodies) passed a special act permitting the use of human volunteers for research. The reasons for, and the consequences of, this act, as well as the history of the disease and its current status (thriving), are the heart of “The Malaria Capers.”

Robert S. Desowitz, a professor of tropical medicine, medical microbiology and public health at the University of Hawaii, visited tropical clinics in India, Africa and Southeast Asia in 1970 and again last year. From his experiences in the field he published two fine collections, “New Guinea Tapeworms and Jewish Grandmothers” and “The Thorn in the Starfish.”

But “The Malaria Capers” surpasses his earlier books because each chapter builds on the next to make the whole a good deal more resounding than each of its well-wrought parts. Every example is well chosen, including the remarkable footnotes that reveal the reaches of Desowitz’s intelligence.

Like a novelist, he draws the reader into the human tragedy of disease. In Thailand we meet 23-year-old Amporn Punyagaputa, a pregnant villager whose death from malaria illustrates the still unexplained risk that the disease presents to pregnant women (who are four times more likely to die of it than other people).

Searching for malaria’s origins, Desowitz tracks the migrations of early humans from Africa to China, India and back to Africa, where they took the sickle cell gene. This mutation, when passed on by a single carrier, protects the individual from the disease; when inherited from both parents, it condemns double gene carriers to sickle cell anemia.

The sickle cell trait is prevalent in Africa, which Desowitz calls “the continent of sorrows.” Here “one disease feeds on another and it is where malaria is bringing AIDS to its children.” This is because poverty precludes the testing of blood for transfusions, often the only treatment for malaria.

Although malaria leaves no fossils for medical paleontologists, there are plenty of references to malarial fevers in the historical record. So many that Desowitz implies that humans could be defined as the health-seeking species. More than 6,000 years ago, he points out, people “left a record of their medical complaints. They kvetched on tablet, papyrus and parchment.”

“The Malaria Capers” is rich in historical-medical detective stories. Moving from ancient Rome to the 20th Century, Desowitz delineates the national rivalries that fed the search for the causes of diseases spread by third parties, or vectors. In the case of malaria, the vectors are Anopheline mosquitoes.

Once identified, the race to exterminate the mosquitoes is a story of gross incompetence. Twenty years ago, Desowitz recalls, the World Health Organization and the U.S. Agency for International Development predicted the eradication of malaria, largely through the use of DDT. Today it is more prevalent than ever, with new strains resistant to old medications.

Desowitz blames the drugs-for-profit-pharmaceutical industry that gives low priority to diseases of poor people. He blames farmers who overused DDT, accelerating the selection of resistant mosquito populations. Not forgotten are the “Silent Springers,” modern Luddites who hate all chemical insecticides, not recognizing that DDT in small quantities used for medical disinfection “never killed an osprey.”

Desowitz does not hide his outrage as he notes that today malaria infects more people than any other disease. Every year between 100 and 200 million people get sick, and at least a million die. The American Malaria Vaccine Project was the largest, most lavishly funded program ever mounted to deal with malaria--yet from it, Desowitz tells us bitterly, have come, so far, “six indictments against the managers, scientists and affiliates, of theft, conspiracy, criminal solicitation and tax evasion.”

Human frailty notwithstanding, the saga of the fight against malaria has heroes, too. One of these is Desowitz himself, a humanitarian who bears witness to the heights and depths of medical science vis-a-vis a microscopic menace.

Next: Jonathan Kirsch reviews “The Justice From Beacon Hill” by Liva Baker (HarperColins).