Body Politics: where history, medicine and society collide

In this last episode of the first series of Body Politics, we reflect back on the history that we have come by over the past few months. One of the regular themes thrown up by the series' episodes is what we mean by 'progress' in science and medicine, and how a critical history of science and medicine can have deep, philosophical significance for our present and future senses of how society should be organised.

In conversation with Dr Jacob Moses of Johns Hopkins University, we reflect on what progress means for medical practitioners and patients alike, and how it should be defined as part of our changing ethical sensibilities, and what they represent about broader changes in ethical and moral values, in distinction to better know definitions of progress accompanying technological innovation.

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Between the end of the Second World War in 1945 and the beginning of the 1960s, the idea of 'global health' came to be one of the key ways in which powerful, global institutions expressed their visions for how the world should be run. Drugs, poisons and other therapies came to be the materials through which humanity was to be made less prone to its oldest foes: death, disease and hunger. Of these materials, one in particular was spoken about as a particularly wondrous substance for eradicating the insects that caused terrible diseases like malaria and typhus: DDT. Between the war and 1962, DDT was viewed as a drug that embodied the greatest promises of science to improve the world, but then an American writer named Rachel Carson published a book, Silent Spring, which argued that DDT was in fact dangerously toxic to humans and animals alike when ingested in large enough quantities. The story of Carson's book has since become stock for understanding DDT's social, economic and environmental history, but this episode of Body Politics, plots a less well-known version of that history, by following the drug's deployment in British colonies across the African continent. Through a fascinating conversation with Dr Sabine Clark of the University of York, it raises pointed questions about the politics of International Development in the post-war world, and for whose benefit that development was being orchestrated. 

Over the past seventy years, antibiotics have become one of the world's most prominent and powerful technologies for reducing human suffering through infectious diseases. Some historians have even gone as far to describe this period as the 'antibiotic era'. However, in the early twenty-first century, the progressive promises of antibiotics have come under existential threat, through the ability of bacteria to become resistant to them. This problem, known as Anti-Microbial Resistance (AMR), has in consequence come to be seen as one of the existential threats to human civilisation in the next few decades, second only to climate change and ecological collapse. How did this troubling transition occur? With "guest" appearances from David Attenborough and Alexander Fleming, and in conversation with one of the world's leading authorities on the history of AMR, the historian Claas Kirchhelle, this episode offers an answer: through the industrial use of antibiotics in agriculture around the world in the decades after the Second World War. 

How do people cope on a day-to-day basis with experiences of infectious diseases?

In this episode of Body Politics, we answer this question with the help of Dr Georgia McWhinney, an historian at Macquarie University, Sydney, Australia. Dr McWhinney is an historian of the First World War (1914-1918), the conflict that defined politics and society for much of the twentieth-century. Her work recovers the strategies that the conflict's soldiers came up with to, if not cure, then contend with debilitating diseases - like typhus and trench foot - that plagued as many as 95% of them as they sat in mud-filled, rat-infested trenches, waiting to face their enemies.

This 'vernacular medicine' as she calls it represented ordinary people living with disease during one of modern history's most chaotic, destructive moments, and the ways in which they attempted to cope with the environment in which they found themselves. 

In the past twelve months, we have become acutely aware of the ways in which diseases are the products of our relationship with the natural world, by way of disease transmission between animals and humans. This process is called zoonosis, and has been identified by some commentators as 'a word of the future, destined for heavy use in the twenty-first century'. However, zoonosis is also a word of the past, whose theories and structure began to formulate 120 years ago, as the world froze in the face of another deadly pandemic: plague.  As we will hear in this episode, with the help of Dr Christos Lynteris of St Andrew's University, this third global pandemic of plague began the process of formulating epidemiological theories of zoonosis, the legacies of which still echo more than a century on. 

"Are you gonna get the vaccine?" In the past few months, this question has probably been asked millions of times in hundreds of languages, in households all over the world. For many of us, answering affirmatively is more than a response to a simple, closed question, but puts us on the "right side" of history. By saying "yes" to vaccines, we also say "yes" to science, truth, the moral high ground, and civilisation itself. In large parts of culture those who answer "no" are often ridiculed, branded mad, decadent and irresponsible in the process. 

This episode, though, should make you reflect on such simple categorisations. What do people actually mean when they resist vaccines? Are they talking about vaccines themselves, or is there some deeper form of expression at play, of sentiments about how they feel as parents, citizens, men, and women? With the help of historian Nadja Durbach, we are going to think with vaccine resistance as it emerged in relation to smallpox in early-nineteenth-century Britain, in the decades after vaccination was first used as a treatment against infectious disease by Edward Jenner. That conversation is about a specific time and place, but has resonance with our own times, and what is at stake - other than science - for regular people when they submit to medical treatment. 

N.B. This episode contains audio footage of deceased peoples from Australia's Aboriginal populations, particularly from 07mins 20 to 09mins 50. The reason for this disclaimer will be made clear on a forthcoming blog-post. 

After the hope and optimism that late-2020 brought concerning vaccines for COVID-19, the last week has seen an increasing focus on the messy and drawn-out politics that comes with establishing who gets how much of those vaccines, and when.

Wealthy nations around the world are buying vaccine doses at rates that would allow them to protect their populations against the disease several times over. Meanwhile, poorer countries have been left fighting for scraps. The World Health Organisation has been a prominent critic of these politics, labelling them ‘vaccine nationalism’.

This second episode of Body Politics puts the WHO’s critiques of vaccine nationalism into their historical context, particularly as regards its great success story: the elimination of smallpox from the human race, a disease that before 8 May 1980 had killed 300 million of us in the twentieth-century alone. With the help of two historians, Kristin Brig from Johns Hopkins University and Peter Hobbins from the University of Sydney, we hear how the history of smallpox is one of both medical triumph and political tragedy.

Whilst it was the first disease treated by way of a vaccine, invented by Edward Jenner in 1796, the suffering it caused in the decades and centuries after was divided along ethnic and racial lines, drawn as European Empires spread across the globe. We trace these stories from Britain to Australia, a former British colony that is still struggling to reconcile itself with the consequences of colonial rule for Aboriginal people, who died in disproportionately large numbers when Europeans first brought smallpox to the continent. 

This is the history that makes both smallpox and COVID-19, not just technical challenges for medicine, but moral issues for politics on a global scale.

The third decade of the twenty-first century has started with the 'worst years ever', right? For billions of people around the planet, our 'new normals' are unpleasant, uncomfortable and dangerous, made so by the pervasive effects of COVID-19. However, history tells us that our assumptions about what was normal - an absence of infectious disease - were aberrations; for thousands of years our ancestors regularly had their lives and social orders upended by an array of infections.

In this first series of Body Politics, we examine this history, particularly by way of the politics that have emerged in parallel with and because of infectious diseases over the past two centuries or so. Episode 1 takes us to the United States and its experience of a deadly tropical disease, carried by mosquitos, called yellow fever.

Although closer to our own times, this was a disease associated with America symbolising the spread of democracy around the world, not much further back in time, yellow fever was intertwined with the upholding of a brutal and pervasive slave economy, especially in the American Deep South.

In conversation with Stanford University's Dr Kathryn Olivarius, this episode traces the twin histories of slavery and yellow fever through the city of New Orleans, also known as the city where blues music was born, which in and of itself was originally an expression of the anguish that slavery caused amongst African Americans.