Stateville Penitentiary Malaria Study

Demand for malaria research The circumstances of World War II resulted in an urgent need for the development of new malaria treatments. First, U.S. soldiers were deployed to areas of the Pacific with extremely high rates of malaria infection. The U.S. Army estimated millions of man-hours lost due to malaria throughout the war; thus it was critically important to mitigate the effects of the disease in the interest of the military. Second, the conventional treatment for malaria, quinine, was largely unavailable throughout the war. Japanese control of the Philippines and Indonesia cut off the supply of quinine to the United States, adding to the need for alternate treatments. Follow-up evaluations were possible for virtually all subjects of the study, since all had long-term sentences. Offers of parole reevaluation, as well as financial incentives, typically $25–100 for an experimental trial (adjusted for inflation, $460–1,860 in 2021), which yielded an exceptionally high availability of subjects willing to participate. ==Malaria Research Project==

In 1944, the U.S. Committee on Medical Research formed a contract with the University of Chicago to test novel malaria treatments at the Stateville Penitentiary. Alf Alving, a nephrologist from the University of Chicago, directed the research and oversaw the formation of a clinical research division of the prison hospital. Alving worked with Ray Dern and Ernest Beutler, two physicians also from the University of Chicago. The Malaria Research Project was primarily conducted on a floor of the prison hospital in the Stateville Penitentiary. The study aimed to understand the effect of various antimalarial drugs on relapses of malaria, primarily from the 8-aminoquinoline group of compounds. The study marked the first human test of the antimalarial drug primaquine. For the experiment, doctors from the University of Chicago bred Anopheles quadrimaculatus mosquitoes. The mosquitoes were infected with a Plasmodium vivax malaria strain that was isolated from a military patient. All five malaria strains are in the genus Plasmodium, protozoan parasites. Experiments performed The study considered the Chesson strain of P. vivax, sourced from a military patient infected in the Pacific. == Legacy of the study ==

The experiments were widely publicized, though in a controlled manner. In 1944, Life magazine documented the experiments with a photo series. Accounts of prisoner subjects were included, though these were allegedly scripted. Andrew Ivy, a physician from Chicago, testified as an expert witness in the trials. He was asked to differentiate Nazi malaria experiments at the Dachau concentration camp and the Stateville Penitentiary malaria experiments. There were key distinctions, such as a higher rate of subject fatalities and lack of voluntary consent in the Nazi experiments. However, the procedures, motives and premise of the studies were arguably similar. The U.S. supported Ivy's claims of fundamental differences and publicized them as a justification for continuing the Stateville experiments. The international Nuremberg Code of human experimentation ethics, which resulted from the trials, contained clauses directly violated by the Stateville experiments. The U.S. never formally ratified the code, however, calling into question the ethics of prisoner experimentation and the Stateville Penitentiary malaria experiments in particular. Effect on prisoner experimentation Public opposition to medical experimentation on prisoners was scant during the war. The Green Report was published in the Journal of the American Medical Association and opened the door for legal, ethical experimentation on prisoners in the United States. Until later in the century, the medical community in the United States largely regarded the Nuremberg Code to be applicable to war criminals and not to the practices of U.S. researchers. ==See also==