Pandemic is a time of confusion and disorder. By definition, the new pathogen is new to epidemiology and microbiology, and in the time it takes for science to understand the disease and its agent, we take comfort in narratives that give meaning to the event. The storyline is often old and predictable, frequently drawing on the trope of ‘war’ on disease. These narratives are crucial in determining public policy, and thereby social and political impacts. And, they demand critical political thinking that is sustained in the middle of the crisis, including examination of the limits of medical and epidemiological expertise in a time of uncertainty. During the Covid-19 pandemic, this has been a difficult issue, given the outrageous attempts to undermine science and rationality by the Trump administration and their phalanx of anti-intellectual assassins. We can advance a critical politics of the crisis by examining the history of past epidemic responses.
On April 3, 2020, the Boston Review published Alex de Waal’s “New Pathogen, Old Politics,” which takes the 1892 cholera epidemic in Hamburg as the lens with which to analyze the political, economic and medical controversies of then and now.
Encouraged by the response to the article, de Waal began writing a book with the similar title, New Pandemics, Old Politics: Two hundred years of the war on disease and its Alternatives, published by Polity Press.
The book explores how these scripts were drafted, and their consequences for politics and science in the gap between the outbreak of a new pandemic pathogen and the scientific discovery and application of what is needed for containment and cure. It examines three historic pandemics—cholera in 19th century Europe and India, the 1918-19 influenza pandemic, and late-century HIV/AIDS in Africa and around the world—and the preparedness plans for ‘disease X’ over the last 25 years. The goal is to help explain what is familiar and what is unexpected in the current Covid-19 crisis. The book will make the argument for a critical perspective on the politics of pandemics and in favor of a more democratic and inclusive approach to public health.
Related research and publications
Note: for more information about WPF’s program researching Covid-19 in prisons, see Tracking COVID 19 in Detention
Governance Implications of Epidemic Disease in Africa: Updating the Agenda for COVID-19
Alex de Waal, Conflict Research Program, April 22, 2020
This memo summarises some of what is known about epidemic disease and governance in Africa based on past experience and poses questions concerning COVID-19. The principal research resources include the Commission on HIV/AIDS and Governance in Africa and the HIV/AIDS, Security and Governance Initiative. In this respect it supplements recent surveys on the issue by Crisis Group and the Carnegie Endowment. There have also been extremely alarmist predictions such as that reported from the Quai d’Orsay, that the epidemic will cause African states to collapse, necessitating international interventions.
Going remote: learning from aid practices in Somalia and Sudan for the Covid-19 crisis
Susanne Jaspars, Reinventing Peace, April 16, 2020
New technologies for remote programming have enabled aid agencies to reach crisis-affected populations, but at a cost: they rarely contribute to an understanding of the political and economic processes that result in some groups controlling resources and that make others vulnerable. Remote working as the preferred aid option also changes how aid workers perceive realities on the ground, with the danger of losing sight of local knowledge, priorities and critiques. Building on recent research on food assistance in Somalia and Sudan, this blog draws out three key lessons from experience of remote programming to address this issue.
Barefoot Doctors and Pandemics: Ethiopia’s Experience and COVID 19 in Africa
Mulugeta Gebrehiwot, African Arguments, April 8, 2020
At the helm of the WHO today, Tedros should not forget the philosophy of public health that brought him to who he is. The Ethiopian Ministry of Health under the EPRDF won international plaudits for its professionalism and efficiency: a model of a well-run bureaucracy that could deliver results far in excess of most of its peers across the developing world. But those successes were built upon doctrines of community-based public health, forged in the hardships of war by a guerrilla front that knew its survival depended on the trust of the people so that it had no alternative but to deliver on effective, community-based health.
Thinking Critically in a Pandemic
Alex de Waal, Reinventing Peace, April 6, 2020
The most important moment to think critically is when there appears to be the best reason for not doing so. At the steepest incline of an epidemic curve, when lives are in danger, when scientific experts calmly insist that the evidence requires that we obey certain commands, and detestable politicians sow confusion for the most nefarious motives—that is the moment to think most carefully. The rules of responsible hygiene when threatened by contagion are not to be challenged. But we should scrutinize the motives, interests, assumptions, and tricks of language that accompany such commonsense moralities. Small, apparently imperceptible differences in how we set our compass today, can cause us to make landfall on a very different shore to that we had expected.
New Pathogens, Old Politics
Alex de Waal, Boston Review, April 2, 2020
There is a saying among epidemiologists: “If you’ve seen one pandemic, you’ve seen one pandemic.” Echoing this trade wisdom in an interview two weeks ago, Bruce Aylward, the assistant director of the World Health Organization (WHO), pointed out that each new pandemic follows its own logic, and those who rely on past experiences to draw conclusions for public health will make mistakes. With each new pandemic it is tempting to scour history books for parallels and lessons learned. But as many have stressed, the wisdom to be gained is often greatly exaggerated.
Condemned to Coronavirus?
Bridget Conley, Reinventing Peace, April 2, 2020
The largest population of detained people in the world resides in the United States. The geographic dispersion and variations of detention sites in the US work to hide the visibility of this population. If all these people lived in one place, let’s call it ‘Detentionville,’ it would form a city of around 2.3 million people, roughly the size of Houston, TX, Chicago, IL, or Paris, France. […] Whether the goal is to minimize coronavirus transmission across society, to protect detained people who are at heightened risk, or to improve the criminal justice system, we need to learn both to see the larger contours of Detentionville and the extreme variations within it. It is simultaneously national and local. While the effects of detention are not borne equally by all, the pandemic reveals that we all live near Detentionville.
COVID-19: “Know your Epidemic, Act on its Politics.”
Alex de Waal, Reinventing Peace, March 31, 2020
Every epidemic is different; government responses are usually the same regardless. Many governments apply what they think are the “lessons learned” from a previous pandemic to a new pandemic. Experts on pandemics think this is an error. A global pandemic unfolds in different ways in different countries, but governments usually adopt a standardized set of interventions regardless of their differences. One doctrine is useful in all situations: “know your epidemic, act on its politics.” This was learned the hard way.
Don’t expect the coronavirus epidemic in the US to bring down President Trump
Alex de Waal, The Conversation on March 18, 2020
The Trump administration’s mishandling of the coronavirus crisis has been widely condemned by health experts. But if the administration’s bungling proves costly to Trump in the November election, it will be an exception to the historical rule that epidemics haven’t led to political unrest or governments being voted out of office. Some kinds of health crises do have political consequences: Hunger has toppled governments. From the French revolution to the Arab Spring, food shortages have routinely caused riots and occasionally sparked revolutions. In the case of starvation, political cause and the personal result are intuitively clear to those suffering: My family has gone hungry because the government has failed to ensure there’s enough food.
Can There Be A Democratic Public Health? From HIV/AIDS to COVID-19
Alex de Waal, African Arguments, March 19, 2020
As we are re-learning with the coronavirus pandemic, the outbreak and global spread of a novel disease, which has neither vaccine nor proven cure, causes panic. More precisely, it causes political leaders and communities to resort to behaviours that intensify confusion and anxiety. Meanwhile, despite expert assurances to the contrary, public health ‘best practices’ are at best well-informed projections with the uncertainty factors on mute. At worst they can be superstitions.
Alex de Waal joins Alan Boswell, Senior Analyst for South Sudan, to discuss the international system’s ability to respond to the new crisis in Africa and the value of community-led strategies to help blunt the impact. Originally posted by International Crisis Group.
Bridget Conley interviews Fletcher School graduate Adrienne Klein, a Fletcher about the time she spent working in a makeshift morgue in New York City. Originally posted on the WPF blog, Reinventing Peace.
Related Global Health Publications
- Militarizing Global Health,’ Boston Review, 11 November 2014.
- AIDS and Power: Why there is no political crisis, Zed Books, 2011
- ‘Governing a world with HIV/AIDS,’ Cairo Review of Global Affairs, Summer 2011
- ‘Reframing governance, security and conflict in the light of HIV/AIDS,’ Social Science and Medicine, 2010. 70.1, 114-120
- ‘AIDS, Security and the Military in Africa: A Sober Appraisal,’ African Affairs, 2006, 105, 201-218
Collaborative Applied Research
Human Resources for Health: Overcoming the Crisis. Joint Learning Initiative on Human Resources for Health, Global Equity Initiative, Harvard University, 2004. (Summary published in The Lancet, here.)
Securing our Future. Commission on HIV/AIDS and Governance in Africa (CHGA), United Nations Economic Commission for Africa, 2008.
HIV/AIDS, Security and Conflict: New Realities, New Responses. HIV/AIDS, Conflict and Security Initiative (ASCI), Social Science Research Council and Clingendael Institute, 2009.
Home Truths: Facing the Facts on Children, AIDS and Poverty. Joint Learning Initiative on Children and HIV/AIDS, Global Equity Initiative, Harvard University, 2009.
Report on international expert meeting on HIV/AIDS and the police, Justice Africa, Governance & HIV/AIDS Initiative, October 2007