Until the late Nineteenth century, endemic malaria was a serious public health problem in Sardinia, as in much of Southern Italy. As the poorest region of the new Italian nation, Sardinia was characterized by poor health, very low population densities, low agricultural productivity, and weak state authority associated with banditry. In this context, however, malaria was singled out as a key underlying problem for the situation of "internal underdevelopment." This paper describes the Italian scholarly literature about the relationship of malaria and economic productivity as a cultural model that can be labeled as "malaria blocks development" (MBD). Anti-malaria programs, including the state control of the distribution of quinine as well as land reclamation projects, played a major role in the decrease of malaria mortality in the first part of this century. Based on the logic of the MBD model, the decrease in malaria was expected to decrease an obstacle to "natural processes" of economic development. During the Fascist era, scientifically based antimalaria efforts formed a key element in centralized attempts for agricultural intensification and encouragement of immigration from over-populated parts of the country. Immediately after W.W.II, Sardinia was the site of a successful American-sponsored eradication project that represented one of the first uses of DDT against an indigenous anopheles vector. Hypotheses based on the MBD model about the nature of economic change after the removal of malaria are not supported. Nevertheless, variations of the MBD cultural model continue to be used in the field of International Health to the present day. pg 240 It was argued that endemic malaria effects people in different ways: 1) general health 2) demographic structure 3) economic productivity 4) quality of life (Warshaw 1949). pg 243 malaria was considered a geographical disease that was theoretically controllable. pg 244 shift in eradication methods from death to mosquitos to death of malaria pg 245 during the first half of the 20th century, malaria was considered a political problem because of its association with rural poverty and underpopulation. by attacking malaria, social planners hoped to encourage population growth and resettlement shemes in historically marginal zones. pg 247 By placing the ultimate explanation for poverty and poor health on geographic environment, the MBD model ignores social issues- both social class inequality on the local level as well as macro-economic inequalities between regions. \bBoth malaria and \imiseria\i are therefore seen as the cause of inequalities rather than as the results of competition.\b pg 247 It is important to note that "enemy" diseases were identified after medical cures and effective preventive measures were identified. The identification of the problem, therefore, was predicated on the discovery of the solution.