Unprepared : Global Health in a Time of Emergency

Recent years have witnessed an upsurge in global health emergencies—from SARS to pandemic influenza to Ebola to Zika. Each of these occurrences has sparked calls for improved health preparedness. In __Unprepared,__ Andrew Lakoff follows the history of health preparedness from its beginnings in 1950s Cold War civil defense to the early twenty-first century, when international health authorities carved out a global space for governing potential outbreaks. Alert systems and trigger devices now link health authorities, government officials, and vaccine manufacturers, all of whom are concerned with the possibility of a global pandemic. Funds have been devoted to cutting-edge research on pathogenic organisms, and a system of post hoc diagnosis analyzes sites of failed preparedness to find new targets for improvement. Yet, despite all these developments, the project of global health security continues to be unsettled by the prospect of surprise. "This book tells the story of how the fragile and still-uncertain machinery of global health security was cobbled together over a two-decade period, beginning in the early 1990s. It is neither a heroic account of visionary planning by enlightened health authorities, nor a sinister story of the securitization of disease by an ever-expansive governmental apparatus. Rather, it is a story of the assemblage of disparate elements - adapted from fields such as civil defense, emergency management and international public health - by well-meaning experts and officials, and of response failures that have typically led, in turn, to reforms that seek to strengthen or refocus the apparatus. The analysis centers on the ways that authorities - whether public health officials, national security experts, life scientists, or other privileged observers - conceptualize and act on an encroaching future of disease emergence. This uncertain future can be taken up and made into an object of present intervention according to multiple rationalities: as an object of probabilistic calculation, as a specter that must be avoided through precautionary intervention, or as a potential catastrophe that cannot be evaded but can only be prepared for. In the chapters that follow, we see how these various logics come into tension or combine in response to actual and anticipated disease emergencies."--Résumé de l'éditeur "This book tells the story of how the fragile and still-uncertain machinery of global health security was cobbled together over a two-decade period, beginning in the early 1990s. It is neither a heroic account of visionary planning by enlightened health authorities, nor a sinister story of the securitization of disease by an ever-expansive governmental apparatus. Rather, it is a story of the assemblage of disparate elements - adapted from fields such as civil defense, emergency management and international public health - by well-meaning experts and officials, and of response failures that have typically led, in turn, to reforms that seek to strengthen or refocus the apparatus. The analysis centers on the ways that authorities - whether public health officials, national security experts, life scientists, or other privileged observers - conceptualize and act on an encroaching future of disease emergence. This uncertain future can be taken up and made into an object of present intervention according to multiple rationalities: as an object of probabilistic calculation, as a specter that must be avoided through precautionary intervention, or as a potential catastrophe that cannot be evaded but can only be prepared for. In the chapters that follow, we see how these various logics come into tension or combine in response to actual and anticipated disease emergencies."--Provided by publisher Recent years have witnessed an upsurge in global health emergencies—from SARS to pandemic influenza to Ebola to Zika. Each of these occurrences has sparked calls for improved health preparedness. In Unprepared, Andrew Lakoff follows the history of health preparedness from its beginnings in 1950s Cold War civil defense to the early twenty-first century, when international health authorities carved out a global space for governing potential outbreaks. Alert systems and trigger devices now link health authorities, government officials, and vaccine manufacturers, all of whom are concerned with the possibility of a global pandemic. Funds have been devoted to cutting-edge research on pathogenic organisms, and a system of post hoc diagnosis analyzes sites of failed preparedness to find new targets for improvement. Yet, despite all these developments, the project of global health security continues to be unsettled by the prospect of surprise. Contents Introduction 1. A Continuous State of Readiness 2. The Generic Biological Threat 3. Two Regimes of Global Health 4. Real Time Biopolitics 5. A Fragile Assemblage 6. Diagnosing Failure Epilogue Acknowledgments Notes Bibliography Index