Neoliberal Ebola?

With an update about David Quammen’s response at the bottom.

In spite of writing a long book on diseases spilling over from animals to humans, well-regarded author David Quammen can’t seem to get his mind wrapped around the possibility Ebola has likely evolved a new ecotype, for the first time spreading into a major urban area.

The first outbreak of Flaviviridae Filoviridae Ebola in West Africa apparently began in forest villages across four districts in southeastern Guinea as early as December 2013 before spreading to Conakry and the outskirts of Monrovia, the capitals of Guinea and Liberia respectively.

The number of deaths across West Africa presently stands at 149 killed out of 242 infected. According to the WHO, with a three-week incubation period cases are likely to continue to accumulate for months.

Beware the Blob

For World AIDS Day 2012 I post an edited excerpt of a speech I gave a decade ago to the Second Scholarly Conference on Women and Work: Health and Wellness held at the Center for Worker Education in New York City. I ask whether HIV can search for the most vulnerable populations.

Identifying trends in health and disease doesn’t mean we know how these patterns came about.

Why, for instance, is HIV/AIDS so prevalent in Africa? It’s where the virus first emerged, of course. Cases have had more time there to accumulate. But at 22 million HIV cases, initial conditions are hardly explanation enough. An array of interacting socioeconomic circumstances and cultural happenstance locks millions of people to precarious fates (and, in this case, greater risk of infection). Many of Africa’s countries are the poorest in the world and the workaday people live in are channeled in such a way that the term ‘choice’, at the heart of much public health commentary, loses its connotation of free will.

We Need a Structural One Health

No one ever says to you, “Lie to me.” The enemy says, You will do and believe certain things. It is your decision to falsify, in the face of his coercion. I am not sure this is what the enemy wants, or anyway the usual enemy. Only a Greater Enemy, so to speak, would want that, one with greater objectives, and a clearer idea of what the ultimate purpose of all motion is. –Philip K. Dick (1974)

Perhaps unbeknownst even to themselves, many an epidemiologist, veterinarian and wildlife biologist confounds episodic and structural crises.

The good doctors gun from outbreak to outbreak, isolating samples, sequencing genetic markers, administering prophylaxes, and, for epizooses, culling the sickest and burying the dead. To be sure, that kind of firefighting is critical. We can’t have deadly pathogens running amok now, can we?

But the oft-difficult mechanics of an intervention do not lend credence they address the cause of the outbreak. Disease isn’t synonymous with its etiological agent or the map of its victims, whether or not either is placed within a One Health context that acknowledges the functional ecologies humans, livestock and wildlife share.