Tag Archives: biopolitics

The world needs to be concerned: Pathological lives

By Steve Hinchliffe, University of Exeter

“The diversity and geographical distribution of influenza viruses currently circulating in wild ad domestic birds are unprecedented since the advent of modern tools for virus detection and characterization. The world needs to be concerned” (WHO 2015: emphasis added).

Bird flu might be about pathological birds, spreading diseases.  Or is it about pathological lives, a sense that our economies and modes of organising life are in themselves causing concern?

This week half a million birds have been culled in Niigata, Japan in order to contain a highly pathogenic avian influenza virus (HPAIV or bird flu).  On the Friesian island of Texel in The Netherlands, 500 birds have been killed from a related strain, resulting in the closure of an important nature reserve.  Towards the end of 2016, this strain of influenza is busy circulating in 14 countries, affecting wild and domestic birds in Hungary, Germany and France.

In the UK, yet to report any HPAIV infections this year, a 30-day Avian Influenza Prevention Zone has been announced. Farmers and keepers of zoological collections are being encouraged to move birds indoors and to improve biosecurity for ‘housed’ flocks. Biosecurity suggests that housing birds on its own is not enough. Vigilance is needed as HPAIV can also move via staff, boots, equipment, rodents and so on. Meanwhile, and lest anyone should be uncertain about the ‘smoking gun’ in this matter, the Department for Environment and Rural Affairs (DEFRA) announced an enhancement of surveillance of wild birds. As a consortium of scientific experts suggests (2016), viral evolution and geographical spread (phylogeography) strongly supports the proposition that migrating wild birds are spreading the viruses. Wild bird surveillance is regarded as a necessary measure to secure domestic flocks.

Concern here is not only for the livelihoods of farmers, or even the balance sheets of national economies (avian influenzas are notifiable and trade-limiting diseases). Nor is it solely a matter for the welfare of wild and domestic birds (though generally it is the latter who are least equipped in evolutionary terms to live with infection). There are also fears for public health. These avian influenza viruses are only a few mutations away from ‘learning’ how to not only infect people (some of them already do that) but also transmit between people (not something that they have managed to do, yet). They are what are known as PPPs, potential pandemic pathogens. With the swarm of influenzas currently circulating, the chances are that the alphabet and numerical soup of ‘promiscuous’ H5-clades (H5N1, H5N6, H5N8 etc) as well as H7s (H7N9) will reassort or shuffle components. This ‘natural’ process of gene exchange and editing is the main reason that the WHO have cause “to be very concerned”.

What are we to make of this concern, what indeed is to be done about this swirling cloud of viruses and birds? The first point to note is that avian flu has been around for a long time, circulating in wild birds without too much of an issue. So current concern is undoubtedly related to recent developments in “virus detection and characterization” (WHO 2015). But this can’t be the whole story. A second point concerns changing stakes and biologies. The relatively recent explosion in global poultry numbers is both a reason for greater economic concern but also a driver of viral shifts. As inexpensively produced protein-rich diets become a worldwide norm, poultry populations, growth rates and metabolisms have changed accordingly. The result is a new set of conditions for viral selection and evolution. As any epidemiologist will tell you, a microbe can only become deadly or pathogenic if there are the right environmental and host conditions. Bird numbers and altered bodies have, in short, made the planet more ‘infectable’.

pathological

In a book just published in the RGS-IBG series, my co-authors and I call this entanglement of microbes, hosts, environments and economies ‘pathological lives’. The term allows us to investigate how these lives have become dangerous to themselves in a world of accelerated throughput and biological intensity. In contrast to the recent global consortium that reviewed the evidence on avian influenzas, we do more than focus on transmission (or the outward movement of a disease agent across space). Rather, we also investigate the conditions for the emergence, persistence and transformation of avian influenzas and other zoonotic diseases, and importantly highlight the changing intensities and enhanced ‘infectability’ of our farming and public health systems.

The result is that instead of biosecurity being a matter for segregating domestic life, ‘closing the hi-tech barn door’ so to speak, a more searching issue arises. We question the sustainability and security of the kinds of intensive protein production that are now, paradoxically, being rolled out across the planet as the solution to the problem that they may in fact have helped to generate. As we demonstrate in Pathological Lives, diseases have complex, multifactorial causes. The traffic of viruses, wild bird assisted or not, can only be regarded as a necessary rather than sufficient cause of a diseased ecology.

About the author: Steve Hinchliffe is Professor or Human Geography at the University of Exeter. His research draws together insights from Science and Technology Studies (STS), particularly actor network theory, and Geography. Steve is author and editor of numerous books and articles on issues ranging from risk and food, to biosecurity, human-nonhuman relations and nature conservation.

References

books_icon Hinchliffe S., Bingham N., Allen J,. Carter S,. 2016 Pathological Lives: Disease, Space and Biopolitics  RGS-IBG Book Series. Wiley-Blackwell. ISBN: 978-1-118-99760-4

books_icon The Global Consortium for H5N8 and Related Influenza Viruses (2016). “Role for migratory wild birds in the global spread of avian influenza H5N8.” Science 354(6309): 213-217.

60-world2 WHO (2015). Warning signals from the volatile world of influenza viruses. Influenza. Geneva, Switzerland, World Health Organisation.

Who lives, who dies, who cares?

By Izabela Delabre, University of Reading

Advances in healthcare technologies and pharmaceutical breakthroughs politicise and manipulate our lives.  An article in The Guardian last week describes how French doctors are challenging the patent of a new and highly expensive drug for hepatitis C in an attempt to bring down the price (the drug, Sofosbuvir, made by the pharmaceutical multinational Gilead Sciences, costs $1,000 (£650) a pill for a 10-week course).  It is a cure for the viral infection that can lead to liver cirrhosis, cancer and death.  The struggle against health inequality persists, with large numbers of people lacking access to healthcare.

A new biopolitical regime judges an individual’s ‘worth’ through their economic productivity

A new biopolitical regime judges an individual’s ‘worth’ through their economic productivity. Image credit: Elvert Xavier Barnes Photography via Wikimedia Commons.

Writing in Transactions of the Institute of British Geographers, Emma Whyte Laurie’s article entitled, “Who lives, who dies, who cares? Valuing life through the disability-adjusted life year measurement” provides a critique of the disability-adjusted life year (DALY) measurement. The World Health Organization defines a DALY as one lost year of “healthy” life. It is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death.  Emma Whyte Laurie argues that DALYs have ‘become normative because many health policy makers and their funding partners use the DALY as their only measure of disease impact in programmatic analysis’ (King and Bertino 2008, 2). DALYs have supported the emergence of an epoch in global health governance whereby resource allocation is justified on the premise of ‘cost-effectiveness’, ‘value for money’ and ‘good return for investment,’ and this is compounded with the global financial climate which has negatively impacted the available budget for health interventions.

DALYs are established on the conceptualisation of individuals as exclusively economic beings, but individuals may fail to live up to the economically productive ‘ideal.’  DALYs may be partly responsible for the devaluation of the lives of certain individuals, by asserting the values of individualism in relation to wider economic gain where, individuals lose humanness when they become poor, and also unproductive.  Emma Whyte Laurie states that the problem may be less associated with DALYs as a measurement in itself, but rather with the faith that has been placed in them by mainstream institutions.

The question of who benefits from health interventions is heavily value-laden. Priority-setting is essentially a political and social process (rather than a scientific one), involving deliberation and public accountability. Through the exact numbers provided by the DALY measurement, important questions of ethics and politics are omitted, potentially hindering important and difficult discussions of setting priorities in the health sector.

Emma Whyte Laurie considers the question posed by Farmer: ‘[if health is a human right, who is considered human enough to have that right?’ (2005, 206). According to Agamben (1998), throughout history, the humanity of living man has been judged by each society, which has decided whose lives have value. Today, these judgements are increasingly based on economic productivity or the pursuit of capital accumulation where certain (wealthier) lives are considered more valuable than others. DALYs reflect this, capturing the ‘disease burden’ through economic loss, but also addressing Farmer’s question as to who is valuable, or who is human enough, to be afforded the right to health.

References

books_icon   Agamben G. (1998). Homo sacer: sovereign power and bare life. Stanford University Press, Stanford CA

60-world2   Boseley S. (2015). Doctors challenge hepatitis C drug patent in price protest. The Guardian, 10 February

books_icon   Farmer P. (2005). Pathologies of power: health, human rights and the new war on the poor. University of California Press, Berkeley CA

books_icon   King C. H. and Bertino A-M. (2008). Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases. PLoS Neglected Tropical Diseases 2 e209

books_icon   Laurie E.W. (2015). Who lives, who dies, who cares? Valuing life through the disability-adjusted life year measurement. Transactions of the Institute of British Geographers, 40:1 pp. 75–87.

60-world2   World Health Organization (WHO). Metrics: Disability-Adjusted Life Year (DALY).

Transactions of the Institute of British Geographers Content Alert: Volume 37, Issue 1 (January 2012)

The latest issue of Transactions of the Institute of British Geographers is available on Wiley Online Library.

Click past the break to view the full table of contents.

Continue reading

Our fat future?

Measuring obesity: normal, overweight and obese

Model sizes: 'normal' - 'overweight' - 'obese'

By William Hasty

The world’s heaviest human being lives in the UK – Ipswich to be more specific. He weighs 70 stone and, as of this week, requires highly specialised medical care to keep him alive. His case, the Observer reports, has rekindled the ongoing debate surrounding the apparent “obesity epidemic” that lies in wait not only in the US – ‘the junk food capital of the world’ – but also in the UK. For policy-makers, attempting to mitigate the impending disaster that this trend represents, children are at the centre of the debate – they are, the report insists, “far more likely to grow up into fat adults with all the health problems that extra weight brings if they are fat as children”.

Bethan Evans, in a recent paper entitled Anticipating fatness: childhood, affect and the pre-emptive ‘war on obesity’, questions the “spatiotemporalities of obesity policy in the UK”, focusing particularly on “the role of childhood and children’s bodies within such policy”. In what is an engaging and informative article, Evans, drawing upon the work of Foucault and Massumi, details the emergence of obesity as a biopolitical problem and positions the response of UK policy-makers as a “form of pre-emptive politics”. The paper concludes by arguing for “[C]ritical engagements with the spatiotemporalities of obesity policy”, or “geography risks becoming the discipline associated with the perpetuation of this immensely problematic discourse”. ‘Our fat future’, if we are to adopt the lexicon employed by those treating the subject in both the media and policy, obviously demands attention, and Evans has done much in this paper to indicate the productive ways in which geographers can contribute,  and perhaps even steer, this concern.

60% world

Observer Read full news story: Who’s to blame for Britain’s obesity episemic?, Observer, Sunday 25th October 2009

60% world  Read full paper: Bethan Evans (forthcoming) Anticipating fatness: childhood, affect and the pre-emptive ‘war on obesity’, Transactions of the Institute of British Geographers