The Unwinnable War on Disease

Published June 21, 2021 in The Baffler, read the full excerpt at, The Unwinnable War on Disease.

In my book New Pandemics, Old Politics, I tell the history of the modern world in four pandemics. It begins with cholera in nineteenth-century Europe and South Asia and continues with the Great Influenza of 1918–19 and HIV/AIDS in Africa and Western countries. The fourth case is “Pandemic X” a.k.a. “the next big one”—the feared and imagined coming plague against which we have been constructing defenses for the last twenty-five years. Those defenses failed to stop Covid-19. Doubtless the world could have done much better, especially had there not been a dedicated skeptic of science in the White House. But I worry that in choosing to “fight” infectious microbes to “defend” our way of life, we are locking ourselves into a conflict we cannot win.

I use the “war on disease” as an organizing principle to examine two centuries of scientific thinking about epidemic diseases and the politics that have shaped the responses to each pandemic. As the title of the book indicates, each pandemic is new—indeed its newness is its defining characteristic—while the political and social responses to it are dully predictable. One pattern is that no pandemic is “natural”: each killer pathogen evolves and spreads in an ecology that we ourselves have engineered. For cholera and HIV/AIDS, it was European conquest and the reorganization of colonially subjugated societies for the profit of their imperial masters. For influenza, it was the organization of total war.

The excerpt below is from the chapter on influenza. It illustrates the irony of approaching the greatest pandemic of the twentieth century through the lens of the “war on disease,” because it was in fact the war itself—and specifically the advances in military hygiene and infectious disease control—that created a unique ecology in which this exceptionally virulent strain of influenza could evolve and spread.

Photo: Battling the flu pandemic 1918, GPA Photo Archive (CC BY-NC 2.0)

Alex de Waal is a Research Professor at The Fletcher School, Tufts University, and leads the WPF research programs on African Peacemaking and Mass Starvation.

Considered one of the foremost experts on the Horn of Africa, his scholarly work and practice has also probed humanitarian crisis and response, human rights, pandemic disease, and conflict and peace-building. His latest book is New Pandemics, Old Politics: Two Hundred Years of War on Disease and its Alternatives. He is also author of Mass Starvation: The History and Future of Famine and The Real Politics of the Horn of Africa (Polity Press, 2015) Following a fellowship with the Global Equity Initiative at Harvard (2004-06), he worked with the Social Science Research Council as Director of the program on HIV/AIDS and Social Transformation, and led projects on conflict and humanitarian crises in Africa (2006-09). During 2005-06, de Waal was seconded to the African Union mediation team for Darfur and from 2009-11 served as senior adviser to the African Union High-Level Implementation Panel for Sudan. He was on the list of Foreign Policy’s 100 most influential public intellectuals in 2008 and Atlantic Monthly’s 27 “brave thinkers” in 2009 and is the winner of the 2024 Huxley Award of the Royal Anthropological Institute. Professor de Waal regularly teaches a course on Conflict in Africa at the Fletcher School, Tufts University.  During this course, students should gain a deeper understanding of the nature of contemporary violent conflict in Africa. Students will be expected to master the key theoretical approaches to violence in Africa, and to become familiar with a number of important case studies. The focus is on the origins and nature of violence, rather than policy responses and solutions. The course is inter-disciplinary and involves readings in political science, international relations, and social anthropology, while also touching on economics, environmental studies, and history. 

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