In a special section of their newest issue, entitled “Epidemic Events and Processes,” the journal Cambridge Anthropology presents a series of articles and commentary arising from the 2013 conference ‘Epidemic Crisis: Dialectics of Event and Process,’ which was held at the Centre for Research in the Arts, Social Sciences and Humanities (CRASSH), Cambridge. In his introduction, conference organizer Christos Lynteris writes:
This special section of the journal hosts five anthropological articles on epidemics and epidemiology and a response by a world-leading epidemiologist. Rather than simply providing more case studies of infectious disease outbreaks or prevention and containment measures, however, these articles respond to an analytical question that has remained neglected in medical anthropology and the medical humanities as a whole: what is the relation between the epidemiological reality of outbreaks as conditioned by long-term social, political, economic, demographic and ecological factors, and the empirical reality of outbreaks as ruptures of the social, political and economic continuum?
Introduction: The Time of Epidemics
The introduction to this special section of the journal argues that while it is widely accepted today that infectious disease epidemics are the result of long-term and complex social, ecological, economic and political processes, outbreaks are, more often than not, experienced on the ground as unexpected eruptions. This introduction defends the position that the dialectics between the evental and processual aspects of epidemics are good to think with anthropologically, and points to the consequences of this for an analysis of epidemic temporality in the context of emergent infectious disease discourse and intensifying biopolitical surveillance aimed at averting the ‘next pandemic’.
The main concern of this article is with the ways in which technologies of data-mining and crowd-sourcing have made it possible for citizens to contribute to the expansion of infectious disease surveillance as both a concrete practice and a compelling fantasy. But I am less interested in participation as such, and more concerned with the epistemological effects that this technological mediation might have for the possibility of epidemic events to become shared objects of knowledge. What happens with epidemic events when they become targets of data-mining and crowd-sourcing technologies?
This article discusses Paul Rabinow’s notion of ‘form/event’ in the light of the current management of Avian Influenza in Hong Kong. While this notion allows the study of how life sciences produce events by turning scarcity of material into abundance of information, Paul Rabinow applied it to the scene of biotechnologies where values about life are suspended in what he calls purgatory. I suggest that, for the anticipation of epidemics from the animal reservoir, the form/event is not a suspension of values but a communication by signs in what I call, following Hong Kong microbiologists, a sentinel. Moving from purgatory to sentinel in the field of biosecurity opens a plurality of scales at which events happen, and transforms the model of subjectivity, from pastoral care to hunting relationships. This theoretical shift sheds light on the ethnography of Avian Flu in Hong Kong, where birdwatchers have allied with microbiologists to practise animal surveillance.
This article draws on Alain Badiou’s notion of the event and on Michel Foucault’s critique of the notion of crisis in comparing two pneumonic plague outbreaks in Manchuria. It is argued that the two epidemics, although apparently involving the same pathogen and geographical region, cannot be treated as analogous. The article approaches the Manchurian pneumonic plague epidemic of 1910–11 as an event, and the Manchurian pneumonic plague epidemic of 1920–21 as a crisis, stressing that the crucial difference between the two lies with the way in which they produced and reproduced biopolitical subjects.
Epidemic Projectification: AIDS Responses in Uganda as Event and Process
Lotte Meinert and Susan Reynolds Whyte
This article explores the responses to the AIDS epidemic in Uganda as events and processes of projectification. AIDS projects became epidemic. Prevention and treatment projects supported by outside donors spread to an extent that made it hard for some to see the role of the Ugandan state and health-care system. We describe the projectified AIDS landscape in Uganda as projects make themselves present in the life of our interlocutors. We argue that the response in Uganda was syndemic; many different factors worked together to make an effect, and the epidemic of responses did not undermine the Ugandan state but played a crucial part in rebuilding the nation after decades of civil war. A problematic consequence of the projectified emergency response to epidemics such as HIV/AIDS, which is a long-wave event, is that projects have a limited time frame, and can be scaled down or withdrawn depending on political commitment.
Directly Observed Treatment – Short-course (DOTS) has been promoted by the WHO globally as the preferred standard approach to tuberculosis control and treatment since the mid 1990s. In India, DOTS has been gradually implemented as a national programme since 1997, covering the entire country by 2006. DOTS is a highly complex healthcare intervention that involves universal monitoring of all patients, access to high quality drugs and the adoption of an individually supervised drug intake by patients through a system of DOT-providers. This article discusses the gradual implementation of DOTS in India as an intervention based on politically agreed ‘truths’ that create ‘successful treatment stories’ and ‘defaulters’, and it explores dimensions of temporality linked to the understanding of ‘event’ at different ontological scales from the perspectives of ‘defaulters’ and the health care system respectively.
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