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New Pandemics, Old Politics. Alex de WaalЧитать онлайн книгу.

New Pandemics, Old Politics - Alex de Waal


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Advocates for global health security found a storyline in common with the war on terror. Our fears and efforts were targeted on individual germs, and not on the ecologies that generate them or the society and economy that enable them to spread.

      Covid-19 was the least unexpected pandemic in history. Scientific and institutional preparations narrowed the uncertainties of a new pathogen to a span that should have been readily manageable. And indeed the development of vaccines in record time is testament to scientific expertise backed by public money. The best-laid plans were confounded, however. It turned out that the main agent of radical uncertainty was not a new and inscrutable microbe. Instead it was Anglo-American political leaders whose doctrine of disrupting institutions, including science, made the pandemic ungovernable. At a cost of hundreds of thousands of dead and millions impoverished, this has had the modest virtue of showing that the ‘war on disease’ is a humdrum script that cannot guide political action.

      I would have liked to have drafted a new playbook for emancipatory public health in the Anthropocene, but this book concludes with something more modest: an appeal that it’s necessary to talk about this. There are hopeful openings, such as ‘One Health’, which unifies public health with animal health and environmental sustainability, and ‘people’s science’ approaches to disease control. At the moment, however, these remain minority agendas.

      The point of etymological origin is the word ‘epidemic’. This was first used by Hippocrates 2,500 years ago. In classical Athens, an ‘epidemic’ referred to an episode of sicknesses among the people. The people (‘demos’) was not today’s ‘population’, it was restricted to free male citizens. Sicknesses included all diseases occurring at the time. In the 14th century, ‘epidemic’ got attached to named diseases, especially plague. Often used interchangeably with the noun ‘epidemy’, in the early 19th century, ‘pandemic’ was used for a geographically magnified epidemic. Cholera was its archetype. At first, it had a sibling ‘pandemy’ as well. With the demise of ‘epidemy’ and ‘pandemy’, the English language lost the distinction between a societal crisis and a much higher number of cases than normal of a disease.14 ‘Pandemic’ is best used as an adjective, to qualify a disease – thus, ‘pandemic influenza’ or ‘pandemic Covid-19’. Were these old words to be revived, speaking of the ‘Covid-19 pandemy’ would make it clear that we’re referring to the entire societal crisis. This crisis includes all the other health problems that worsen when hospitals are overwhelmed by cases of one disease, along with the psychological distress, the losses of livelihoods, and strains on communities. The concept ‘pandemy’ could also be stretched to include ecological and societal pathologies that cause pandemics. I won’t use the word ‘pandemy’ in the chapters that follow, but it will remain in the background and I will return to it in the final chapter.

      The citizen science movement has been hugely accelerated by Covid-19. Never before have so many people become epidemiologically numerate so quickly. But this hasn’t kept pace with a fast-raging pandemic. The most encouraging examples of activists setting an agenda for pandemic response are from HIV/AIDS – which I will discuss in chapter 4 – but that was a slow-burn pandemic and it took several years for the affected communities to organize and make their case, and for the health authorities to listen. In the case of Ebola in west Africa – discussed in chapter 5 – the mutual learning was much quicker and the anthropologist Paul Richards observes that the epidemic was overcome when ‘communities learnt to think like epidemiologists, and epidemiologists to think like communities’.17 This is a crucial example of public health as a people’s science, and Richards encouragingly observes that it can happen rapidly.

      Joint learning by epidemiologists and the public runs into several problems with the ‘war on disease’. The first is that war leaders give orders and expect obedience.


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