Following in Soper's footsteps: northeast Brazil 63 years after eradication of Anopheles gambiae.

Sub-Saharan Africa has long suffered under the yoke of the Anopheles gambiae mosquito, but for northeast Brazil (figure 1) its arrival over 60 years ago was a new and horrifying experience. This African mosquito is an exceptionally effective malaria vector because it is well adapted to feeding upon people and to exploiting aquatic habitats associated with our daily activities. Anopheles gambiae sensu lato probably accounts for most of the world's malaria deaths and socioeconomic burden. Fortunately, the Brazilian experience had a happy ending. The prospect of A gambiae spreading across much of the Americas motivated a ruthlessly effective response that deserves a special and heroic place in the annals of public health. Building on the successes and infrastructure of the Yellow Fever Service for Aedes aegypti elimination, the Rockefeller Foundation and Brazilian government collaborated to form a new Malaria Service of the Northeast. This new entity rolled the invader back into oblivion with an aggressive eradication campaign, focusing primarily upon larviciding of all potential habitats. The driving force of this endeavour was an enigmatic man called Fred Soper whose sheer will and determination was a key element in this success, and a source of inspiration today (see Killeen GF, et al. Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa? Lancet Infect Dis 2002; 2: 618-27). I recently took an opportunity to fulfil a long-held dream and follow in some of Soper's footsteps. Tired of gazing at yellowing maps like figure 1, I went to see the northeast of Brazil for myself.