Robert Koch's dubious legacy in Africa

Scientist Robert Koch tried to cure to tuberculosis and sleeping sickness while working with African patients in what he called "concentration camps." His 19th-century techniques still fuel debates about his fame.

The scientist Robert Koch (with tropical helmet) on his East African expedition around 1906

Who was Robert Koch — a revered top researcher or a colonial physician without a conscience?

A winner of the Nobel Prize in medicine and one of the most important microbiologists of the 19th century, Germany's renowned federal institute for infectious diseases bears his name.

But during the coronavirus pandemic — throughout which the Robert Koch Institute (RKI) reports daily COVID-19 infection figures and calls its namesake to mind — critical voices have piled up, even more than 110 years after Koch's death.

Some are even calling for the RKI to be renamed. 

What's Robert Koch accused of?

The celebrated physician of infectious disease not only did good in Germany's African colonies, but also conducted research at the expense of human lives. Critics say more focus is needed on the subjects of his work, while others say he should be held to the standards of his day.

Medical historian Christoph Gradmann at the University of Oslo thinks the debates about Robert Koch's legacy in Africa go too far, although they do need to take place.

"You have to place Robert Koch's actions in their time. I find the condemnation of his person — representative of colonial medicine — in 2022 banal," he told DW.

Former chancellor Angela Merkel pays the president of the Robert Koch Institute, 

Lothar Wieler (left) a visit in 2021.

Robert Koch's 'darkest chapter'

His colleague Jürgen Zimmerer, Professor of Global History at the University of Hamburg, takes a different position.

Zimmerer has emphasized in reports the "unscrupulous" side of Koch, who was commissioned by the German colonial administration to research sleeping sickness in Africa.

The illness is caused by microscopic parasites transmitted by the tsetse fly and spread in Africa around 1900.

Koch was responsible for numerous health experiments in what are now Tanzania, Togo and Cameroon to find a cure for sleeping sickness. 

Most of Koch's patients were housed in what he himself called "concentration camps," a model he borrowed from the British administration in South Africa, and treated with atoxyl, a substance containing arsenic and already known to be highly toxic in large doses.

Koch accepted the pain and agony of thousands of patients, even to the point of death, say his critics, including the Haitian-American historian of science Edna Bonhomme.

His intentions probably cannot be conclusively clarified, Bonhomme conceded in an October 2020 commentary for the Arabic news network Al-Jazeera. 

"What we do know is that Koch's actions directly contributed to the colonial oppression of African populations," wrote Bonhomme.

The research camps he founded, she said, solidified inhumane treatment and hierarchies in medical experiments.

Robert Koch at his microscope in his laboratory in Kimberley, South Africa, in 1896

What does the Robert Koch Institute say?

The agency, founded in 1891 as the Royal Prussian Institute for Infectious Diseases and headed by Koch until 1904, declined to be interviewed by DW.

However, its website has references to Koch's use of atoxyl.

It describes his last major research trip from 1906–1907 to East Africa as the "darkest chapter" in Koch's career.

By using atoxyl, Koch "initially achieves successful results in the treatment of the sleeping sickness," the RKI states.

But the parasite could only be suppressed in the blood of the patients for a short time.

"Koch doubles the dose — even though he is aware of the risks of the drug," according to the RKI's website.

"Many patients begin to suffer from pain and colic, some even go blind. Nevertheless, Koch remains convinced of the benefits of atoxyl in principle."

Pressure to succeed and fame

Koch held on to the medicine atoxyl for too long; he was under pressure to succeed, Gradmann commented.

But the historian doesn't believe Koch's practices at the time influenced today's skepticism about drug trials and vaccinations — not in Africa, and not in the Global North.

Tanzania is very open to Western medicine, he said, and that medicine cannot be reduced to one of its representatives.

Koch experimented with Atoxyl to find cure against the sleeping sickness transmitted by the tsetse fly

In 1880, Koch identified the pathogen of tuberculosis in 1882 — a discovery that established his worldwide fame and earned him the 1905 Nobel Prize in Medicine for his discovery.

"If we apply these standards of today to historical persons without circumstance, then just about everyone comes off badly. But that would be wrong in the case of Robert Koch. Because he is also regarded in Africa and by Africans as the discoverer of the tuberculosis bacterium and in this sense is seen as a role model," Gradmann told DW.

No connection to vaccination skepticism

In Tanzania, Richard Shaba can confirm this, at least for a small part of the people: the experts.

"Koch's research on malaria and tuberculosis is well known in the circles of scientists, but it is not an issue among ordinary citizens," Shaba said in the DW interview. He represents the German office of the Konrad Adenauer Foundation in Dodoma.

Health care in Tanzania: a COVID-19 vaccination is given to prevent virus infection

"It would be wrong to try to make a connection between the dark side of his experiments and the resistance of Tanzanians and Africans to COVID vaccination," Shaba said. There are other reasons for this that have nothing to do with Koch's work.

There's more skepticism there, he said, because people are getting sick after the vaccines are developed quickly, so they believe they are not safe. "It's a luxury today to look critically at Koch's behavior, but what researcher at the time did not do bad experiments in the name of science in Africa?" asked Shaba.

Koch, according to the ideology of the time, would likely have considered himself — like many others — some kind of superhero to Africans.

Edited by: Keith Walker