In the first of a new series asking some of our Humanities and Social Sciences faculty what they are working on, thinking about, and reading, Simon Reid-Henry talks to Dr Stephen Taylor, Lecturer in Human Geography, about Pandemics, Polio, and the Plague.
IHSS: Thank you for joining us for the first of our “5 Questions” series. A full disclosure to start with: for the past two years you and I have co-run a Masters in global health policy where we take students to organisations like the WHO and GAVI in Geneva. There was no welcome glass of wine by Lac Léman this year; instead, the themes from that course have become salient the world over. But I’m curious in your personal take on the Covid-19 pandemic, and in particular how it has been portrayed. A lot of the media coverage seems to have focused on national comparative responses: with precious little understanding of what we might describe as its more properly global aspects?
ST: Well the question of representation in this pandemic is so interesting in itself given the paucity of visual and on-the-ground media reporting. For those of us locked down in our homes, the creeping case trajectories of data visualisation experts are all that we know about what is happening ‘outside.’ And yet these quantitative representations, and the politics that they birth, are presented in an atomized manner that emphasises national response at the expense of a global perspective. Hence, we compare cases in our respective cities or countries to those who have already ‘crossed the peak,’ we pore over the exhortations of those from further along the pandemic timeline who cry that ‘we are your future,’ and we see leaders impose travel restrictions and border controls to stop the virus arriving from ‘elsewhere.’ Covid-19, now a disease of everywhere, reminds us that responses which stop at the border are insufficient. If we are to meet the pandemic challenge, we need to refocus our attention to ‘the global’ as a scale of intervention, cooperation, and responsibility. That means interrogating why many national donors have underfunded global pandemic preparedness work at the World Health Organization for so long; strengthening health system capacity in the fragile, conflict and vulnerable settings where 80 percent of high-impact epidemics take place (efforts that I have recently explored in eastern DRC’s South Kivu province); as well as, in the context of our collective experience of Covid-19, reimagining global health equity, social justice, and our sense of obligation to the distant others to whom we are now radically entwined.
IHSS: In your work, After Polio, you write about what it means to come to terms with and to plan for life after major diseases – be it the curtailment of financial resources mobilised in response, or the trapping down of a wider institutional response, which is never quite ‘getting back to normal’. Such a life, as you say, is something that leaders need to “conceptualise, plan, and deliver”. Do you see lessons from this work for the present response?
ST: It's interesting that you raise polio as there are many parallels between what, we must not forget, are synchronous public health emergencies. The work that you mention involved research with the Global Polio Eradication Initiative (GPEI) in Geneva and also immunisation teams in Nigeria and Pakistan. I tried to look beyond the culture of hubris that fuels a cottage industry of papers and donor reports all announcing (on a semi-annual basis) the supposed imminence of polio eradication. Donors’ fixation on the ‘when’ of eradication, I found, drew critical attention away from ‘who’, ‘what’ and – importantly – ‘where’ ought to be prioritised in endgame planning. This tactic is a political sleight of hand that opts to gloss over the messiness of local realities in favour of a reassuring narrative around the inevitability of victory over the virus. I hope that we won’t fall into that cycle of hope and ultimate deflation with Covid-19.
IHSS: There’s an incredible global race on right now to try to find a vaccine against Covid-19. But there’s no guarantee of finding one, of course, and even the fastest feasible candidates may be some time off. In the meantime, then, is the problem that we need to be more ‘political’ – and not just technical – about our response to epidemics and their afterlives?
ST: A world without polio would have seemed a distant dream in 1955 when the church bells across America rang in the joyous news that Jonas Salk had developed the first polio vaccine. One can certainly imagine that sense of jubilation now. Yet that was a key moment in which – to borrow a phrase from Arundhati Roy’s recent commentary on Covid-19 – we glimpsed “a portal, a gateway between one world and the next.” Getting to a Covid-19 vaccine will require donors similarly swallowing huge financial risk as candidate platforms are whittled down, but it will be worth it – if we get there – to glimpse what comes ‘after.’ What I hope will happen is that the rupture caused by our collective encounter with Covid-19 will provoke new and deeper political commitments to public health and particularly immunisation. These must be far from ‘normal,’ with all the unmet needs and slow violences of illness that this word implies. Polio is a sobering reminder that not all pandemic portals are walked through and the costs of that decision have been borne unevenly for generations. Millions of children still go unvaccinated each year and, heartbreakingly, national door-to-door polio vaccination campaigns are now being suspended to transfer resources to the Covid-19 pandemic.
IHSS: Much of your work comes together around a theme of the “geographies of life” – it’s a resonant phrase in our time of social distancing and uneven access to health care. Presumably, though, it tells us something about how social forces operate that carries beyond the politics of health per se?
ST: That’s right. At the heart of my research is a concern with the production, politics, and governance of human and non-human life. With Covid-19, we see this playing out in lockdown and social distancing as attempts to regulate the socio-spatial determinants of human health. Away from the pandemic, ‘life’ is conceptualised, produced, and intervened upon by humans in a variety of other arenas, including through bioengineering, agriculture, and nature conservation. As a geographer, each of these arenas refocuses my attention on the vital connections between nature and culture, life and matter. But Covid-19 also reminds me that disease agents – and the many human attempts to control, regulate, or destroy them – have what we might term a ‘liveliness’ that lays bare the limits of human agency. This state of affairs tells us that societies need to be better attuned to the multiple ways in which we (as humans) intervene in and are shaped by other forms of life and the material world.
IHSS: Which is a lesson to bear in mind when thinking about climate change adaptation as well: something society had begun to find time to talk seriously about before all this happened. I don’t know if it will take us away from ‘all this’ (or not) but it’s always interesting to hear what people are reading for pleasure or for sustenance at the edges of their scholarly interests. Are there any books you’d recommend we try to carve out some time for?
ST: I’m actually reading Camus’ The Plague again at the moment, topical I know, so maybe that? It’s fascinating on re-reading it now how much is in there on the horrors that humans inflict upon each other – rather than the virus per se – and the place of solidarity in restoring meaning to life lived among catastrophe. For instance, there is a wonderful moment when two of the main protagonists impulsively break the strict quarantine regulations and share an ocean swim in which they are both overwhelmed by “a happiness that forgot nothing.” That felt particularly poignant in our time of lockdown! Otherwise, Solzhenitsyn’s Cancer Ward and Mann’s The Magic Mountain are personal favourites, each offering rather different perspectives on illness, politics, and isolation.This interview was conducted by Simon Reid-Henry (IHSS) and Stephen Taylor in April 2020.