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Book forum: Carlo Caduffs The Pandemic Perhaps

Book Forum:

Carlo Caduffs The Pandemic Perhaps


Raad Fadaak
McGill University

Karen Jent
University of Cambridge

Ann Kelly
Kings College London

Perig Pitrou
Collge de France

Christos Lynteris
University of Cambridge

Carlo Caduff
Kings College London
Edited by

Todd Meyers
New York University - Shanghai
Carlo Caduff's The Pandemic Perhaps: Dramatic Events in a Public Culture of Danger (University
of California Press, 2015) is a story of the influenza pandemic that never was. Caduff tells this
story from an American perspective through his encounters with scientists and other actors who
engage in the august work of preparedness, but in doing so, often draw upon and amplify an
apocalyptic imaginary that doubtless shapes scientific and public priorities (and fears). With lucid
and critical detail Caduff shows how forms of prophecy (new and old) push catastrophe towards
further and further horizons.
We have an incredible group of commentaries on The Pandemic Perhaps. We hope you enjoy.

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Somatosphere | April 27, 2016

Book forum: Carlo Caduffs The Pandemic Perhaps

Beyond Belief: The Work of Global Health Security


Raad Faraak
McGill University
Forgetting Faith and Reason
Just a few months ago, at the end of September, the US Centers for Disease Control and Prevention
(CDC) held a 'Grand Rounds in Public Health' event at its headquarters in Atlanta, Georgia. The
session, an installment in a monthly series intended to foster discussion on major public health
issues, showcased a trio of public health experts reflecting on the lessons learned from the West
African Ebola crisis, now in its final twilight. Rather than a look back at the details of the response,
however, the webcast was a look forward to the new programs and policy initiatives being
launched under the umbrella of the Global Health Security Agenda (GHSA).[1] The GHSA
announced coincidentally as the first cases of Ebola spread undetected across West Africa in early
2014is a US-led diplomatic collaboration designed to accelerate the strengthening of capacities
among low and middle income countries to prevent, detect, and respond to outbreaks of infectious
diseases, epidemics and bioterrorism.[2]
To a viewer like myself, the recent policy events around the Agenda have been fascinating
to watch for a number of reasons. It is one of the first instances where global health security has
moved outside of the realm of policy-discourse and become a mandate for public health action.
It is a framework that leans heavily on a faith in the prophetic inevitability of the next major
epidemic event.[3] But moreover, it is one site to take up Caduffs claim that there are other ways
of bringing faith and reason into balance; recalibrations that offer us other possibilities of
thinking about infectious disease (2015: 29).
Inasmuch as the GHSA is precisely such a site of recalibration, the three presenters at the
CDC came to the podium convinced of the timeliness of this Agenda, particularly following the
Ebola crisis. Now at the end of the epidemic, the torrent of lessons learned function
simultaneously as judgment about the inadequacies of the recent past and as pressing mandate to
craft a safer future. In other words, we no longer need the prophet to warn us; we must work to
prepare. Their calls to actionprimarily couched as reflections on the failures of the Ebola
responsein many ways suggest a contracting gap in Povinellis future anterior; between a
present moment of decision and a future moment of judgment, whichas Lakoff and others have
shownhas been anticipated for some time yet.[4]
Nevertheless, following Caduffs assertion that faith is never without doubt, it should
not be surprising that the doubts about this Agenda have been flooding in from all directions. There
has been a tremendous amount of skepticism, hesitancy, and outright criticism of these projects,
alongside other efforts to securitize public healthboth from within the academy and from
health and development agencies.[5] As one health systems specialist opined to me, the very idea
of global health security is decidedly anachronistic, a relic from an age of American Empire and
the War on Terror. What dramatic irony that such a timely political framework relies on such a
temporal incongruity. The spirit of the GHSA is clearly not shared by everyone in the public
health community.
For at least one speaker at the September CDC event, such critique was a topic worth
tackling explicitly. Addressing the criticisms of positioning public health capacity building as an
issue of security, Jennifer Nuzzo, Senior Associate at the Center for Health Security at the

Somatosphere | April 27, 2016

Book forum: Carlo Caduffs The Pandemic Perhaps

University of Pittsburgh Medical Center (UPMC), noted, I have heard lots of criticisms about the
GHSA from people, saying its too American-centric, its too Western[but this is about] building
core public health capacities. She concluded, suggesting that if you dont think that the GHSA
is right for you, call it whatever you want. If you want to strengthen your capacity in the name of
[tuberculosis] control, thats fine. We just have to do something.
This is no longer about the push and pull of prophecy and counter-prophecy. Forget faith
or reasonthere is work to do.[6]
Beyond Belief
For as much prickly grief, censure, and outright lamentation that the entry of security into health
issues has produced, I cannot help but be struck in equal measure by which many of its proponents
have dispensed with the language, or outright rejected it. On the one hand, it should not be
surprising that such fervent policy-discourse might be frankly dropped or sidestepped, or deployed
primarily with strategic considerationsas one architect of the early Agenda noted, you dont
have to be a believer to know that security is where the money is. With over a billion dollars
invested in programs related to the GHSA, US government offices working on global health
security dont need to be reminded of this fact.[7] On the other hand, there are some who seem
oblivious to the scrutiny, suggesting that the concept of GHS simply addresses any and all efforts
to prepare for and prevent the next epidemicsomething nearly beyond argument a year after
the peak of the Ebola crisis. Of course, prioritizing what exactly must be done in the name of
preparedness is a rather uncertain process, invoking a very broad collection of endeavors; from
health systems strengthening, laboratory capacity development, to biotech R&D reform, health
workforce trainingthe list goes on.[8] Whether these experts are believers in the counsel of the
pandemic prophets or not, its clear that they are convinced of the work that remains to be carried
out in its name.
This capricious movement between endorsement and outright disregard over the issue of
security suggests that the survival of such an idea is not (necessarily) an issue of conviction, of
belief, or even faithless a matter of a formal pact and something more like a flexible
partnership. In Caduffs incisive turn of phrase, the effort to make global health work under an
umbrella of security today seems to be more about managing ones infelicities than it is about
actually meaning what one says. Nobody understands this better than the officials at the WHO
after the tragedy in West Africa, who only seem eager to speak of global health security as an
Agenda when the Americans are around.[1] So, the question seems to be less who these actors
are or what they believe underneath their masks of strategic policy as-ifs, but rather, what kind
of work can be accomplished when they are all at once on stage.

Somatosphere | April 27, 2016

Book forum: Carlo Caduffs The Pandemic Perhaps

The Ministerial Meeting Session, September 18, 2015, Seoul, South Korea
A Culture of Danger?
Caduffs work both here in Pandemic Perhaps and in his recent review article on biosecurity
(2014) suggest that to enter a world of security is to enter a world of insecurity, a world of endless
suspicion, speculation, deception, anxiety, uncertainty, obscurity, and paranoia (110). No doubt,
in many instances, this is the mise-en-scne. However, working in global health security today
seems as much about entering a world of negotiated suggestions, fragile policy collaborations, and
political mobilizations as it is about performative promises or the perpetual politics of Fear. The
only thing one ought to feel, in other words, is urgency. Caduffs turn to the dramaturgical seems
one powerful way to address this strategic as-if that positions the ironic tone of what security
means today in the world of global health.
In some ways, this is a (by)product of the contingency of contemporary global health
projects. That is to say, GHS today does not name a set of stable commitments or projections, but
rather a number of rapidly shifting possibilities and projects. Like the radically indeterminate viral
clouds of influenza that Caduff traces at the benchside, the policy maelstrom surrounding global
health security is at once ambiguous, infectious, and powerful. Yet, it is striking that a project that
aims at such a profound reconfiguration of the coordinates and stakes of todays disease
diplomacy has not been a question of faith or belief as much as it has been of elastic iterability.
Like the diseases it aims to combat, the Agenda aspires to travel unimpeded across borders.
How might one study such an object, if the question no longer becomes about belief and
its political consequences? It is here that I find Caduffs resistance to producing an exercise in the
hermeneutics of suspicion both prudent and refreshing.[9] By refraining from an analytic bent
on debunking or revealing, Caduff is able to more carefully attend to the complex and
contradictory ways that his ethnographic object appears (or fails to appear altogether), and in
doing so, situates the possibilities within the science and politics of pandemic influenza. But it is
here we might ask: when security becomes dispensable, and the question is no longer
about believing, but getting things donewhat kind of analysis becomes possible? How might one
resist the prophetic urge itself, a reliance on the assumption that there is a truth that must be
revealed (Caduff 2015: 21)? I think it too early to declare, as the prophets do, This is how it
is.[10] In this regard, with Caduff (and James Ferguson) in mind, I would like to see more
written today about the uses rather than the abuses of global health and its various projects,
including global health security.[11]
It is clear, in any case, that Caduffs book shows us the generative and captivating force of
the dramatic and prophetic in this realm of public health preparedness; in many instances disbelief
suspended almost indefinitely by those forecasting the always-already pandemic event. Caduffs

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Book forum: Carlo Caduffs The Pandemic Perhaps

detailed analysis of the sites, practices, and poetics of scientific authority and claim-making, in
and through both uncertainties and indeterminacy, is uniquely insightful and compelling. His
attentive, detailed, and discerning ethnography performs its own variety of dramatic workthe
text itself is a delightful and gripping read. It is both an erudite collection of insights about that
which goes into and makes up the contemporary world of scientific prophecy. Caduff no doubt
goes far beyond his modest aims to see like a scientist, offering a surplus of generative ideas and
his own brand of creativity and complexity in thinking through the politics of pandemic
preparednesstoday a domain that often appears at least as fragile as the vision of a threatened
humanity it intends to protect.
References
Caduff, C. 2014. "On the Verge of Death: Visions of Biological Vulnerability." Annual Review of
Anthropology 43(1): 105121.
Calain, P., and C. Abu SaDa. 2015. "Coincident Polio and Ebola Crises Expose Similar Fault
Lines in the Current Global Health Regime." Conflict and Health 9(1): 17.
Collier, S., and A. Lakoff, eds. 2008. Biosecurity Interventions: Global Health and Security in
Question. New York: Columbia University Press.
Hoffman, S. J. 2010. "The Evolution, Etiology and Eventualities of the Global Health Security
Regime." Health Policy and Planning 25(6): 510522.
Lachenal, G. 2014. Ebola 2014. Chronicle of a Well-Prepared Disaster. Somatosphere, October
5, 2015.
Lakoff, A. 2010. "Two Regimes of Global Health." Humanity: An International Journal of
Human Rights, Humanitarianism, and Development 1(1): 5979.
Maguire, M., C. Frois, and N. Zurawski. 2014. Anthropology of Security: Perspectives from the
Frontline of Policing, Counter-Terrorism and Border Control. London: Pluto Press.
Masco, J. 2014. Theater of operations: national security affect from the Cold War to the War on
Terror. Durham, N.C.: Duke University Press.
Moon, S., D. Sridhar, M. A. Pate, et al. 2015. "Will Ebola Change the Game? Ten Essential
Reforms before the next Pandemic. The Report of the Harvard-LSHTM Independent Panel
on the Global Response to Ebola." The Lancet, November 26, 2015.
Morrison, J. S. 2014. The Global Health Security Agenda: A Snowy Promising Start.
Rabinow, P. 1999. French DNA: Trouble in Purgatory. Chicago: University of Chicago Press.
Rushton, S. 2011. "Global Health Security: Security for Whom? Security from What?" Political
Studies 59(4): 779796.
Notes
[1] It is important to add that recent increased dialogue has occurred between the US offices
spearheading the GHSA (particularly the National Security Council) and the WHO, who have
recently developed the Joint External Evaluation Toola monitoring and evaluation framework
that combines IHR compliance metrics with GHSA-related targets. Even so, the GHSA appears in
this document only through implicit reference.
[2] http://csis.org/publication/global-health-security-agenda-snow-promising-start
[3] See the recent joint Harvard-LSHTM Ebola report, Moon et al. (2015).
[4] http://limn.it/introduction-ebolas-ecologies/
[5] See Lachenal 2014, Hoffman 2010, Calain and SaDa 2015, Rushton 2011; Masco 2014.

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Book forum: Carlo Caduffs The Pandemic Perhaps

[6] Such criticisms have been rebutted by pointing to the fact that the GHSA today is endorsed and
managed by a large number of both developing and developed countries. The Steering Group, for
instance, is made up of country representatives from Canada, Chile, Finland, India, Indonesia,
Italy, Kenya, the Kingdom of Saudi Arabia, the Republic of Korea, and the United States.
[7] For an overview of the large funding increases in the United States around issues of health
security, see Boddie et al. 2015, Federal Funding for Health Security in FY2016. Health Security,
13(3): 186-206.
[8] In fact, Susan Eriksons recent piece here in Somatosphere on the Financialization of Ebola
details very succinctly what large changes are happening at the World Bank in this regard:
http://somatosphere.net/2015/11/the-financialization-of-ebola.html
[9] Originally coming from Rabinows discussion at the end of French DNA (1999), pp. 173.
[10] For a review of anthropological engagements with apparatuses and scapes of security, see
Maguire (2014).
[11] For a great example, see Alex Nadings recent piece in Limn: http://limn.it/ebola-chimerasand-unexpected-speculation/. See also Collier and Lakoff 2008; Lakoff 2010.
Raad Fadaak is a PhD candidate at McGill University, working with the Departments of
Anthropology, Social Studies of Medicine, and the Global Health Programs. His PhD research
focuses on the projects and policies designed by governments, global health institutions, and
international agencies to prepare for, respond to, and recover from public health emergencies.
Read this piece online: http://somatosphere.net/?p=11454

Somatosphere | April 27, 2016

Book forum: Carlo Caduffs The Pandemic Perhaps

Reproducing the Magic: Uncertain Science and Reason+


Karen Jent
University of Cambridge
In Carlo Caduff's brilliant ethnography The Pandemic Perhaps, we enter a world of delayed
apocalypse. The HnNn mutation of the influenza virus is on the radar of the WHO; scientists
prognosticate the next pandemic; preparedness measures are put in place by public health
organizations; a flu vaccine is ready to be shipped by the pharmaceutical company. But, once more
suspended, the pandemic does not happen today. It will take place tomorrow. Caduffs discussion
of pandemic prophecy captures the strange exchange between influenza as a matter of scientific
prognosis and of quasi-religious belief. His account thus reveals how fundamental uncertainties at
the heart of the public health message are not only subject to reason, but also faith. In the genre of
pandemic prophecy, scientific reason is augmented with faith, as scientists grapple with the
ambivalent state of not knowing what will but suspecting that the worst might happen. Despite its
sombre vision of the future, pandemic prophecy is not strictly speaking of the biblical apocalyptic
genre, Caduff points out, as "it lacks the hope and desire for another world" and predicts
"destruction without purification, death without resurrection [] dystopia without utopia" (7).
Part of what makes prophetic prognosis credible, in spite of its continued failure to predict,
is what Caduff calls the "cosmology of the mutant strain" (80). Emphasizing its incessant
mutability and volatility, scientists identify the virus as an erratic agent that constantly mutates and
shifts shape, and is hard to pin down even in the lab. Showing how pandemic prophecy roots in
the intricacies of research, Caduff powerfully describes scientists' tireless efforts to define the
elusive entity. How can a virus be defined in the dish, he asks, when even the tiniest of samples
contains millions of mutations due to microbial instability? Vividly invoking scientists' struggle
with matter that is "constantly making itself different from itself" (88), Caduff shows how the
conundrum is resolved in a statistical consensus. That is, the problem of microbial instability is
overcome by a consensual agreement that indeed the dish contains a comprehensive entity. This
makes the virus something scientists can work with, dealing with uncertainty by taking a leap of
faith.
In my research about regenerative medicine in Scotland, the stem cell is the similarly, yet
differently unstable agent that links scientific practice with public health millennialism. Like the
virus, the stem cell is said to harbor an enormous capacity for shape shifting. Unlike the virus
however, this capacity is not imminent apocalypse and doom, but instead nourishes visions of a
glorious and hopeful future for human healing, where lab-grown replacement tissues for patients
might become a salvational reality one day (Haraway 1997). Growing bodily tissues from stem
cells is often perceived as a technical issue that can be overcome, once science is advanced. And
yet, as I recently learned at a stem cell scientific conference, there is an element of "magic" to the
salvation that stems from tissue regeneration. Stem cell science too depends on what, inspired by
Caduff, might be called reason+. However, while microbial apocalypse adds faith, cellular
salvation sums up with magic.

Somatosphere | April 27, 2016

Book forum: Carlo Caduffs The Pandemic Perhaps

In September, I participated in the prestigious Hydra European Summer School on Stem


Cells & Regenerative Medicine on the Aegean island of Hydra. As the meeting began, the
participants set out to define the concept that had all brought them together. "What are stem cells?"
asked one of the conveners, and at the time, it seemed like a provocative question. Nervous
laughter, silence, reluctant replies, and at last heated arguments ensued. The discussion revealed
the conceptual complexity of the question as well as its myriad array of possible replies. A common
denominator, the group agreed, was that a stem cell is defined as the dormant cell in a bodily tissue
that, once activated, has both the capacity to differentiate into varied resident cell types, repairing
the tissue damage at hand, and also to self-renew, creating a copy of itself that goes back to
dormancy as a backup system for future damage. Together differentiation and self-renewal are
viewed as the baseline biological functions that assure the body's ability to continuously repair and
renew itself. This innate ability, stem cell biologists hope, might inform the regeneration of
damaged tissues in patients suffering from a vast array of degenerative diseases.
In practice, the Hydra discussion revealed, differentiation and self-renewal make strange
bedfellows. For instance in the bone marrow, the hematopoietic stem cell - that can give rise to all
blood cell types - is surrounded by many other cell types. It is held in place by bony connective
tissue, it is catered for by blood vessels, it is protected from harm by resident immune cells.
Enveloped in this diverse environment, the dormant stem cell is activated when it receives signals
to produce more of any one type of blood cell. Only then, the cell awakens and starts to divide,
creating two daughter cells, one differentiating for the reproduction of blood cells and the other
one self-renewing for future stem cell stock. But practically, the Hydra delegates debated, how can
mere cell division be distinguished from differentiation and/or self-renewal? Is self-renewal just
division? And, at what stage does differentiation initiate and consequently start to differ from selfrenewal? These uncertainties were not abstract questions, but of vital practical relevance for bodily
repair: It is, one eminent scientist highlighted, where the "magic" happens.
The translation of bodily topographies - where stem cells live in, and are sustained by, the
company of other cells - into the petri dish is a difficult endeavor as cells' mutual support is difficult
to model in vitro. Consequently, if magic is needed to grasp the stem cell's capacity for selfrenewal and differentiation in vivo, it might be even more magical to make it happen in the lab.
Then, how is the magic reproduced in the lab? I asked Robert, a postdoctoral researcher at the
University of Edinburgh, the same question when on a rainy day during fieldwork he offered some
advice on a cell culture that I had been growing for a few days. The first step was to assure that
cells were content. As we took the cells from the incubator, Robert looked at the flask assessing
the color of the medium. The medium looks orange-red when fresh and turns into yellow when the
nutrients are used up, suggesting hungry unhappy cells, while it turns into purple when the O2CO2 exchange in the flask is disturbed, suggesting that cells are asphyxiating, he explained. That
day, I had screwed the lid of the flask on too tightly, and by now the bright purple of disturbed gas
exchange was showing: an ominous sign. Even though the mishap could be corrected easily, it was
a bad sign, cells were not too happy and Robert - knowing how to read the minutest of cellular
signs - showed some concern.
Next, he peaked through the microscope to look at the cells, which were stuck at the bottom
of the flask as translucent dots and surrounded by the gooey gel added to mimic the feel of
connective tissue. He lamented: "They are too sparsely populated" and continued, that for stem
cell populations in particular, it was essential to get the cell density right. In vitro colonies are often
set up as monocultures, a dish with just stem cells. Compared with their bodily occurrence
however, a monoculture fails to provide the support that stem cells would ordinarily receive from

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10

the cells in their vicinity as in the bone marrow. If the colony was too sparsely populated, the cells
would die for lack of mutual support. If the cells were stacked on top of each other, they would
cause each other to differentiate losing their valued stem cell state. The trick was, Robert
suggested, to make a monoculture that wasn't indeed a monoculture, where part of the cells
spontaneously differentiated and part self-renewed.
Successful stem cell culture necessitated, in other words, the introduction of heterogeneity
from within the cells, so the culture as a whole stayed in equilibrium between simultaneous
differentiation and self-renewal. This balance could be struck - in spite of the stem cells' lack of
support from their neighbors - by regulating how densely seeded the cells were in their container.
Having observed the minute intricacies of cell density time and again, Robert is proficient in the
necessary conscientious care of 'just getting it right', a skill cell growers need to painstakingly
acquire. This magic of care amplifies scientific reason about stem cell differentiation and selfrenewal in order to deal with the uncertainties of cellular growth. If scientific uncertainties about
the virus require reason+ that is augmented by faith, ambiguities about the stem cell are partly
resolved by the addition of magic.
Taken forward into the realm of the public health message however, scientific uncertainties
about the virus have an entirely different inflection than they have for the stem cell: While faith in
the pandemic threatens with apocalypse, stem cell magic promises salvation, allowing for a
peculiar relationship with the volatile and unpredictable entity at the heart of the public health
project. With its spark of magic, regenerative medicine offers a vision of a better world with a
capricious protagonist that is not threat, but hope; not death, but resurrection; not dystopia, but
utopia. Just like pandemic influenza though, the bodily cures of regenerative medicine are in equal
temporal deferral, not quite there yet. The cure will be ready tomorrow. To further think about the
intersection of scientific uncertainty and its relationship to the millennial public health message
Caduff's The Pandemic Perhaps is just the right companion.
References
Haraway, D. J. 1997. Modest-Witness@ Second-Millennium. FemaleMan [copyright]-MeetsOncoMouse [trademark]: Feminism and Technoscience. New York & London: Routledge.
Karen Jent is a doctoral candidate in the Reproductive Sociology Research Group (ReproSoc) at
the University of Cambridge. Her PhD project explores benign and malignant growth in stem cell
therapeutic development and regenerative medicine in Scotland. During her ethnographic
fieldwork, she engaged in learning the magic of care for cells in the laboratory.
Read this piece online: http://somatosphere.net/?p=11530

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Book forum: Carlo Caduffs The Pandemic Perhaps

11

Plotting Global Health Attention through Pandemics


Ann Kelly
Kings College London
I might have mistaken my intensified attention to the wind for intensifying wind.
Ben Lerner, 10:04
In late August 2011, on the eve of the tenth anniversary of 9/11, Hurricane Irene tore northwards
up the Atlantic, its projected path fixed over the U.S. East Coast. So great was the force of the
tropical storms anticipation that flood-prone and low-lying metropolitan areas from Virginia
Beach to Providence were preemptively evacuated. New York City mayor Michael Bloomberg, in
what would later be dismissed by some as an overblown display of preparedness, closed the New
York City transit system, shut off water and electricity in lower Manhattan, and preemptively
deployed the National Guard.
It is under Irenes kinetic spell that we find the protagonist of Ben Lerners novel, 10:04,
stocking up on provisions alongside other New Yorkers enrapt by the imagination of her landfall.
Crowds effervescing sociality, groceries radiating an aura of scarcitythe city seems to rearrange
itself around the storms approach: what normally felt like the only possible world became one
among many, its meaning everywhere up for grabs (19).
It is the strange serendipity of maternity leave that finds me reading 10:04 and The
Pandemic Perhaps at odd hours and in tandem; two books for which hurricanesor, more
specifically, the preparations they precipitaterelay the condensed temporality of the coming
catastrophe, a dovetailing of past perils and precarious futures for which a New York City on the
brink provides a hyperactive backdrop. Through often-exquisite prose (Lerner is a poet; Caduffs
formulations can approximate verse) these authors explore the worlds that surface and dissolve
under the shadow of prediction and the modes of attention that give them their shape. This latenight imagined conversation turned on the performative power of engrossmenta topic that spoke
to my state of attenuated awareness, and offered an unexpected entry point to the nexus of issues
elaborated by The Pandemic Perhaps.
Global Health Attention
Global Health attention is intense, but fickle. An awkward compromise of economic interests and
geopolitics, moral and epidemiological logics, global health emergencies, as Caduff shows,
crystalize around distinct and often countervailing values. There are emerging threats and
persistent plagues; examples of gross negligence and near-triumph; devastating illness that demand
large-scale investment and mundane suffering that could be redressed with the application of
minimal resources. But whether it is HIV, Guinea Worm or obesity, the ways in which a public
health issue becomes a global concern depends on how its present danger is drawn to our collective
future. Following Caduffs deft descriptions of influenzas configuration as an object of research

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12

and policyits multi-faceted political-materialityI will offer some brief reflections on how that
connection is drawn in other corners of the ever-shifting global health landscape.
Attention to what?
Given the precarious constitution of the category and the difficulty of defining
pandemic influenza, what are the prophets of pandemic influenza actually
predicting? (Caduff, 98)
Influenza, The Pandemic Perhaps teaches us, is a quintessential moving target. Constantly
mutating and recombining, the flus identity is a statistical compromise of emerging strains and
classic pathologies, a rapprochement of laboratory practice and clinical experience. The very
concept of pandemic flu revolves around degrees of genetic difference, and the ensuing
transmissibility across populations with no acquired immunity. This future orientation of pandemic
flu, its potential to spread and spread widely, provides the ground for large-scale global health
interventionan epidemiological perhaps that governments cannot afford to ignore.
Malaria shares influenzas ontological slipperiness: whether the disease is understood as
primarily a problem of the parasite or the vector, of the clinic, the home or the field, has a
considerable impact on how it comes to matter for global health. The Global Malaria Eradication
Program (GMEP), launched in the mid-1950s, was built upon a mathematical model of
transmission that foregrounded the interaction between vector and human populationa
precarious stabilization that, with the advent of DDT, nevertheless promised massive and rapid
global health dividends. Linked to the abundance and longevity of mosquitoes and to the chemical
agency of residual insecticides, malaria became an object of technocratic intervention: with sheer
manpower and manufacturing efficiency transmission could be irreversibly interrupted within a
matter of years. In this way malaria-control became a global event, a contest between an emerging
public health internationalism and the mosquito's adaptive resistance.
The collapse of the GMEP has been etched in the annals of environmentalism and global
health policy as a parable of American hubris and of the limitations of vertical interventions. In
the last decade, however, those failures have been recast (Kelly and Beisel 2011). Malarias
persistence, we are told, was the product of the programs lack of follow-through rather than its
overreaching ambitiona tragedy of untimely abandonment that has served as the rallying cry for
the Bill and Melinda Gates Foundation.
A new eradication campaign, a new malaria: this time defined by the parasite. Doublingdown on the high risk-high reward strategy espoused by GMEP, the effort to remove the
parasites from the human population has precipitated a new arsenal of experimental vaccines and
novel drug regimens. Launched in 2013, the Foundations Accelerate to zero strategy reprises
the race against resistance, but this time its end game is not the interruption of transmission but
its preemption, assured through an ever-intensifying hail of magic chemical bullets (McGoey
2015).
Once the instrument for the West to win hearts and minds in the war against Communism,
malaria has returned to the limelight as an engine for biomedical innovation. Its eradication is no
longer driven by ideological commitmentthe disease owes its salience to the R&D opportunities
it presents.

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Book forum: Carlo Caduffs The Pandemic Perhaps

13

Salient Experiments
Once the virus was detected in the bodies of soldiers at Fort Dix, the outbreak was
considered a significant sign, announcing the event, and the fulfillment of a
prophecy. (Caduff, 71)
The swine-flu strain isolated from recruits at Fort Dix in 1976 triggered memories of overwhelmed
army infirmaries, a materialization of the past that had haunted global health since the First World
War. But this time the public health community had the tools to head off the pandemic before it
started; the outbreak therefore presented a splendid opportunity to prove the power of
preventative medicine (Caduff: 63). With ambition characteristic of the nation that spear-headed
GMEP, the 1976 National Influenza Immunization Program (NIIP) sought to vaccinate the entire
U.S. population by the end of the year, reaching over 40 million Americans in 10 weeks. That the
outbreak originated in an army base Caduff finds appositethe program was, in the rhetoric of
the time, a declaration of War.
The rally, however, quickly became a routthe campaign was, ultimately, sabotaged by
its own weapons. The strains similarity to the one that swept the globe in 1918 had been
overdrawn. Eventually only one death would be attributed to it. The vaccine became a greater
source of suffering: by the time NIIP was shutdown, 500 recipients had suffered serious side effects
and twenty-five died.
1976 was an eventful year for Global Health, albeit only in retrospect. A few months after
the virus was identified at Fort Dix, a storekeeper fell ill in Sudan, suffering from a disease that
after a second outbreak in DR Congo (then Zaire) would come to be known as Ebola. A disease of
terrifying but ultimately self-limiting virulence, for decades it was solely the province of remote
sub-Saharan villages and apocalyptic fantasy (Lynteris 2016). Classified as a potential bioterrorist
agent, Ebola took center stage in a new regime of scenario-based exercises and emergency
simulations, surveillance systems and intensive R&D investment intensified in the aftermath of
9/11 (Lakoff and Collier 2008; Keck 2014).
That the 2014 Ebola outbreak was partly the product of an emphasis on preparedness at the
expense of investments in basic clinical infrastructure is an irony that does not escape Caduff (see
also Lachenal 2014; Nugyen 2014). More telling is that Ebola became a global health problem
or formally, a public health emergency of international concern (PHEIC)neither at the point
of its detection nor even when it had devastated communities across the Mano River Region.
Rather, it crystalized into a global health emergency after an infected Liberian collapsed upon
arrival at an airport in Lagos, threatening the apocalyptic scenario of a gigantic, ungovernable
metropolis in the grip of a lethal virus. At this moment, the outbreak shifted from a humanitarian
crisis to international security threat, best contained by checkpoints and border controls and,
critically, by accumulating vaccine stockpiles.
This is where Caduffs reading of the response to flu at Fort Dix is most instructive. The
NIIP, he argues, was propelled by two opposing figures: the virus, a living fossil of a past
catastrophe, and the novel vaccine, a harbinger of hope. For previous outbreaks there had not been
enough time from initial detection to manufacture a viable vaccine on a large scale. The early
isolation of the strain in Fort Dix made population-wide immunization a possibility, but only with
considerable political and financial capital. In hindsight, nation-wide immunization was perhaps a
reckless gamblethe WHO, for instance, shifted to a wait and see policy, monitoring emerging
infectionsbut in the U.S., where the battle between virus and was closer to home, the moral
imperative to vaccinate every man woman and child quickly became a feature of its own
momentum.

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The recent Ebola outbreak has also been configured as a scientific opportunity, though the
moral logics of experimental exigency have been decidedly more complex. Unlike the 1976 strain
of swine flu, the transmissibility of this pathogen was, if anything, underestimated. By the time
the pharmaceutical companies entered the scene, policy discussions were not characterized by bold
decisions but by desperate measures. We wasted time before speaking about a vaccine and
treatments lamented Jean-Herv Bradol, the director of Mdecins Sans Frontires (MSF; Doctors
Without Borders) internal review body, back when the outbreak was at its peak: its very hard to
imagine controlling this epidemic now without a vaccine (Flynn and Bartunek 2014).
Urgency, again, provided the syntax for policy decisions: within a matter of months,
consortiums of international experts, government and industry representatives were assembled,
charitable funding was released, clinical trials designed, regulatory requirements streamlined and
indemnity funds set aside by the World Bank. But a large-scale immunization program resonates
rather differently in contemporary sub-Saharan Africa than it had in Gerald Fords America,
buoyed by the resounding success of the campaign against polio. A long and sinister history of
unethical experimentation and medical iatrogenesis, from forced sterilizations to pharmaceutical
negligence, has generated popular suspicions of vaccine as vehicles for western imperialism (e.g.
Giles-Vernick & Webb 2013; Fairhead and Leach 2012).
That legacy cast its shadow over high-level meetings at the World Health Organization
regarding design of vaccine trials, where West Africans were, at once, cast as needy patients denied
compassionate access and as guinea pigs exposed to unnecessary risks. Either way, the belatedness
of the global health response meant that the experimental delivery of the vaccine could only be
justified by the protection it would bring to future populations. As the WHO summarized in its
report of the meeting that "all efforts to develop, test, and approve vaccines must be followed
through to completion at the current accelerated pace even if transmission dynamics meant that a
vaccine was no longer neededas a contribution to global health security, fully licensed and
approved vaccines should be stockpiled in readiness for the next Ebola outbreak (WHO 2014).
Caduff reads the NIIP as the moment when the future took precedence over the present:
American experts, he writes, took rapid action, leaped over the present, and rushed forward to
the conclusion (65). The haste triggered by the Ebola outbreak carries an even heavier moral
freight: the experimental deployment of untested vaccines was compelled by the scale and severity
of the outbreak; a present that, owing to the belatedness of the response, was of global healths
own making. While efforts to enhance country capacitysetting up community care centres,
distributing home biosafety kits and training health workersmight help slow transmission only
the vaccine trials offered a way to make up for lost time, to halt the current outbreak while, at the
same time, refashioning response time oriented towards the inevitability of future outbreaks (Kelly
2015).
As the epidemic now submerges into endemicity, the apocalyptic outbreak is again
deferred, while for those populations in its immediate reach Ebola becomes an everyday reality.
Transformed from extreme event to, as Caduff puts it, an ordinary harm, it is unclear what kind
of sustained global health attention the virus will receive, other than as an object of research and
continued experimentation.
Time to Take Note
To what extent is the notion of a new regime of public health vigilance itself a
force in the making of structure and order?...to what extent such a form of analysis

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is making it easier for projects of public health vigilance to impose themselves


on populations in the global South. (Caduff, 195)
In an extended footnote to the introduction, Caduff suggests how The Pandemic Perhaps departs
from dominant critiques of biosecurity. To describe the prophetic scene of influenza demands
an ethnographic attention that goes beyond the geopolitical consequences of a thoroughgoing
securitization of health. The dialectics of faith and reason that Caduff locates at the heart of global
health expertise turn upon the failures of pandemic prediction and the structures of expectation,
interest and investment the non-catastrophe precipitates. Thus rather than marveling at the
extension of preparedness policies, our analyses would be better served plotting the points at which
the problems that do the most damage and those these initiatives anticipate diverge.
Zika is now in the global health spotlight, and there is much here to catch our
anthropological attention: the tragic spectacle of microcephaly, the uncertainty of state-collected
health statistics, the rapid dissemination of conspiracy theories. Could there be a more invasive
biopolitics than a policy dissuading pregnancy? If even Pope Francis comes close to condoning
the use of contraception, has global health reason overtaken the sovereign doctrines of faith?
As the shadow of Zika moves across the Americas, the responses it will elicit will
inevitably vary according to the ways in which global health problems have been historically
brought to light, particularly when it comes to vector borne diseases (e.g. Lees-Stephan 1997;
Nading 2014). To indicate their readiness for the coming outbreak in the US, decision-makers
there have returned to a familiar figure: The way I think about it, its just like a hurricane, said
Florida Governor Rick Scott, get prepared, hope for the best. So what were doing is we are
preparing and were doing everything we can to make sure this does not get worse. Whether the
winds will intensify or dissipate remain to be seen, but in either case, it will not be the last time
our attention is directed towards the coming viral storm.
References
Giles-Vernick, T., and J. LA Webb Jr, eds. 2013. Global health in Africa: historical perspectives
on disease control. Ohio University Press.
Fairhead, J., and M. Leach. 2012 Vaccine Anxieties:" Global Science, Child Health and Society".
Taylor & Francis.
Flynn, D., and R.-J. Bartunek. 2014. Error! Hyperlink reference not valid.. Reuters, Nov. 14.
Keck, F. 2014. Birds as sentinels for pandemic influenza. BioSocieties 9 (2): 223-225.
Kelly, A.H. 2015. Ebola, Running ahead, LIMN. http://limn.it/ebola-running-ahead/
Kelly, A.H., & U. Beisel. 2012. Neglected malarias: The frontlines and back alleys of global
health. BioSocieties, 4:71-87.
Lakoff, A., and S. J. Collier. 2008. Biosecurity interventions: global health & security in question.
Columbia University Press.
Lynteris, C. 2016. "The Epidemiologist as Culture Hero: Visualizing Humanity in the Age of 'the
Next Pandemic'. Visual Anthropology, 29(1), pp.36-53.
McGoey, L. 2015. No Such Thing as a Free Gift: The Gates Foundation and the Price of
Philanthropy. Verso Books.
Nading, A. M. 2014. Mosquito trails: ecology, health, and the politics of entanglement. University
of California Press..
Packard, R. M. 2007. The making of a tropical disease: a short history of malaria. Johns Hopkins
University Press.

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Stepan, N. L. 2001. Picturing tropical nature. Cornell University Press.


World Health Organization (WHO). 2014. WHO High-level Meeting on Ebola Vaccines Access
and Financing. Summary Report, October 23.
Ann H. Kelly is Senior Lecturer of Global Health in the Dept. of Social Science, Health and
Medicine, at Kings College, London. Her work focuses on the practices of global health research
and experimentation, with special attention to the built environment, material artifacts, and
practical labors of tropical disease control in sub-Saharan Africa.
Read this piece online: http://somatosphere.net/?p=11803

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The Many Lives of Viruses


Perig Pitrou
Collge de France
In chapter 1, Carlo Caduff aptly explains how, since Andr Lwoffs seminal 1957 paper[1], the
ontological status of viruses has remained ambiguous. Indeed, The fact that viruses can multiply
rapidly and adapt systematically to changing circumstances suggests that they are living things.
The fact, however, that they can multiply, mutate, and adapt only in the presence of living cells
suggests that they are not autonomous organisms. Furthermore, viruses are also unable to perform
essential metabolic functions (57). As discussed by Thierry Bardini, who is working on viral
life, the decision by biologists whether or not to put viruses in the category of living things was
at the beginning of virology une affaire de gotalthough, since then, the discovery of
Mimivirus, Mamavirus and Spoutnik has supported the argument to place these beings in the latter
category[2]. In any case, it seems that, instead of the quite sterile ontological questionalive or
not aliveit is much more fruitful to adopt a pragmatic standpoint on this topic, and, as I suggest
in recent papers, to study living beings within the agentive configurations where they appear, in
order to better understand both the evolution of living beings and their relations with an
environment[3]. Although the main topic of The Pandemic Perhaps is to develop a multi-scale
study of flu pandemics, I should say that I consider this book as a great contribution for the
anthropology of life and it is on this point I would like to comment. Caduffs excellent
investigation, both ethnographic and historical, offers a very convincing analysis of the material
and conceptual configurations in which viruses are engaged, hence demonstrating the value of
approaches which explore the agency of living beings and vital processes[4]. He offers insightful
ideas that shed new light on fundamental aspects of life.
First of all, the depiction of technological devices invented by scientists to observe and
manipulate the virus shows an interesting entanglement between vital and technical processes[5].
At the beginning, the aim of virology was to make the invisible agent concrete: The virus became
detectable, maintainable, manipulable, and transferable. However, what researchers revealed was
not the virus itself, but the trace it left after it had entered susceptible bodies (39). In these
conditions, after various experimental assays, microbiologists discovered that the body of a ferret
could be used as a living test for investigations into the influenza virus, Constituting the
influenza virus as a unique causative agent, as a concrete biological entity, requiredliterallythe
construction of a living test subject susceptible to the disease and capable of consistently
manifesting its clinical form (45) [6]. In The Pasteurization of France, Bruno Latour explains
how the scientific construction of microbes in the nineteenth century implies a double operation
of isolation of living material in the laboratory and of reconnection with society, through the
dynamics in vitro/in vivo. With viral entities the situation became even more complex as the
manipulation of a virus in the laboratory imply indirect actions on living beingsnamely, the
breeding of animals susceptible to show symptoms indicating the presence of a virus. Likewise,

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the fact that, for the hemagglutination inhibition (HI) assay, fertilized chicken eggs containing a
living embryo eight to eleven days old are commonly used as the primary medium to isolate and
grow influenza viruses in the laboratory (89), offers another good example of the imbrication of
vital and technical processes.
In addition to the exploration of the complexity of the inclusion of viruses in various spatial
environments, it is also their temporal evolution, which is scrutinized. Caduff shows how, instead
of the idea of regular pandemic cycles, the concept of emerging viruses has been invoked (78).
This shift in theorization has consequences for the perception of pandemic phenomena: At the
heart of the concept of emerging viruses is a particular temporality, a temporality that has left
behind the numerological hope of regular cycles and predictable patterns (78). But it also leads
to a growing complexity the conception of life as a reproductionand evolutionof forms through
linages. Phenomena such as lateral transfers, metagenomics or epigenetics, underline the
instability of the notion of individual and offspring; they also force anthropological investigation
and epistemological reflection to take into account interspecies relations[7]. In this framework, the
newness of emergent viruses is all the more complicated to understand that it could be, from
another point of view and through the transfer from animals to humans, a resurgence of a former
one. The swine flu virus appeared as a surviving agent, a living fossil [ But] the fossil,
after all, was alive, not in the humans but in swine. Thus, there was the theoretical possibility
that this type of influenza might come back one day and infect humans again (70). On another
scale, not only in the laboratory but also in the outside world, we find that the vitality of the virus
should be studied not only with a microscope but with a kind of kaleidoscope, in order to explore
the connections than can exist between a multiplicity of living beings, each of them possessing its
own temporality.
Last but not least, Caduffs work on the role of information in the modelization of the virus
tackles various important issues regarding the articulation between matter and form. In chapter 4,
he examines how biological matter has increasingly become informed matter, arguing that this
informational redefinition of biological matter has opened up new opportunities for the
understanding of a catastrophic disease (33). What is at stake here is the fact that, to a certain
extend, life can be conceptualized through the assemblage of data that can be, then, manipulated.
So, the problem is not just the question of transfer of virus between living bodies, but the possibility
of a conversion of vital processes in technical and informational devices in a context where the
biological body is a body of information. Using the work of Hannah Landecker, Caduff explains
that the biological body is circulated and exchanged in informational forms does not imply that
it is somehow not material; the body in-formation has, on the contrary, its own distinctive
materiality (115).
Even if the convergence between a biologic and informatic virus is a possibility that should
not be ruled outcf. Bardinis paper quoted abovefor the moment, the virus is a moving target
which is good to think because the cognitive and technical devices used to catch it seem to objectify
two distinct conceptions of life. On the one hand, an ecological conception, the borrowed life
(56), in which the development of each living being depends on a set of biological relations it
establishes with other living beingson this, see Latours analysis of Lovelock and Marguliss
theories in Facing Gaia. On the other hand, life can be considered as a more abstract phenomenon
that can be modelized and imitated, even using non-biological processes. In this context, we are
not in front of two separate options, but of two complementary ways of capturing vital processes.
The co-presence of these two models in scientific activity is described by Caduff as a kind of odd
assemblagein this case, the test with eggstinkering with elements belonging to various worlds

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and temporalities: In an age of supercomputers, smartphones, and reverses genetics, microbe


farmers continue to depend on chicken eggs and chicken blood, the nuts and bolts of scientific
research (89).
For millions of years viruses have lived many lives through a multiplicity of forms
connected to numerous of living beings. With the development of biotechnology, the array of
possibilities has become even more larger, since a great diversity of interrelation between vital and
technical processes is about to be explored by humans. Together with investigation on archaic
biotechnologies (Dagognet)domestication, cultivation, interpretation of signs, etc.the
anthropology of life has a lot to learn from the observations of new technologies, such as
(re)programation, modelization or gene-editing for instance. With the accurate description of all
these new ways humans experiment their engagement with materials, the aim is nothing less than
obtaining a better comprehension of the contemporary redefinition of what is life; in particular
analyzing how evolutions of life forms can be correlated with evolutions of forms of life. Along
this path, focusing on the unique sort of beings viruses are, The Pandemic Perhaps constitutes,
without any doubt, a very important work.
References and Notes
[1] Lwoff, A. 1957. "The concept of virus." Journal of General Microbiology 17: 239253.
[2] Bardini, T. 2015. "Vade retro virus." Terrain, Special Issue "Virus," Nicolas Auray and
Frederic Keck (eds,), 64, March 2015.
[3] Pitrou, P. 2015. "Life as a process of making in the Mixe Highlands (Oaxaca, Mexico).
Towards a general pragmatics of life." Journal of the Royal Anthropological Institute 21: 86105.
[4] Caduff mentions David Napier, who notes that microbiologists tend to ascribe notions of
agency, mobility, and intentionality to viruses precisely because there is no straightforward answer
to the ontological question (58).
[5] On this topic, see Pitrou, P., L. Coupaye, and F. Provost. 2016. "Des tres vivants et des
artefacts. Limbrication des processus vitaux et des processus techniques." Actes du colloque,
muse du quai Branly 9/10 avril 2014.
[6] What microbiologists revealed at the threshold of the living and the nonliving turned out to
be an organic entity with a potential for life, a creature on the verge of the vital. The nature of this
creature made it difficult for microbiologists to reproduce it under artificial conditions. The virus
did not grow in the lifeless media of bacteriologists; it could not reproduce on its own and required
the active support of a living body. Its life turned out to be a contingent on someone elses life
(58).
[7] On this topic, see my review of Ingold and Palssons book in Somatosphere.
Perig Pitrou is a researcher in the Centre National de la Recherche Scientifique, Laboratoire
dAnthropologogie Sociale, Paris. He is the author of Le chemin et le champ. Sacrifice et parcours
rituel chez les Mixe de Oaxaca (Mexique) and the co-editor of the book La nocin de vida en
Mesoamrica (CEMCA-UNAM, 2011). In 2013-14, he directed the research programme Of
Living Beings and Artefacts: The Interrelation of Vital and Technical Processes (Des tres vivants
et des artefacts - Muse du quai Branly (dpartement de la recherche et de lenseignement). He is
now Deputy Director of the interdisciplinary programme Domestication and Fabrication of the
Living (CNRS-PSL)
Read this piece online: http://somatosphere.net/?p=11850

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Pandemic Returns
Christos Lynteris
University of Cambridge
Pandemic prophecy is the prophecy not of an event, but of an eventual return or recurrence. If the
next pandemic is a biopolitical apparatus revolving around the anticipation of a 1918-influenzapandemic-like event, what needs to be noted is that the formation of this recurrence-structure is
contemporary to the systematization of the notion of the pandemic. At the turn of the nineteenth
century, in the course of what came to be known as the third plague pandemic (1894-1959,
following WHO chronology), the chain of bubonic plague epidemics striking harbors, cities and
villages across the globe was made sense of as the reappearance of a medieval scourge: the Black
Death. Yet this was always already an incomplete return. On the one hand, it was the
bacteriological anchoring of modern plague that allowed the serialization of the pandemics
preceding it. And on the other hand, though microbiologically identical to them and hence, as
Caduff would put it, the return of a fossil the mortality resulting from modern plague did not
match the apocalyptic image of the event it was supposed to replicate. What this prophetic
discourse then generated was not simply a failed pandemic, but a recursive indivisible remainder:
the successive deferment of the pandemic event in its eternal return.
Within the biopolitical context of turn-of-the-century Empire, this pandemic vision rhymed
with the overall conception of disease as resulting from decay and degeneration. By contrast, in
our times the temporal ontology of the return of the virus seems to be at odds with the temporality
underlining the biological phenomenon said to be the driver of the next pandemic: emergence.
Yet what we have here is not a move away from the former towards the latter; for rather than
displacing recurrence, emergence envelops it in what Caduff calls its constitutional temporal
incongruity. Whereas in the model of degeneration the pandemic returns through the recrudescence
of a dormant disease, in the case of emergence pandemic recurrence results from the generation of
a new virus. Rather than interrupting the eternal return of the pandemic as the eventalization of
human-extinction, emergence -- that diagram of protean viral ontogenesis -- is the condition of
its biopolitical efficacy.
For if, as Caduff notes, the definition of what counts as new forms the undecidable
arcanum of emergence ontology, that which anchors the next pandemic as an imaginable and
hence preparable catastrophe is precisely the fact that it is projected as something which is not
(at) all-new. From preparedness exercises to pandemic movies and novels, whilst the identity of
the killer virus remains speculative, its social impact is depicted in a trite way, which can only be
described as the banality of plague: a meltdown of private property and law-and-order. It is
hence less the supposed biological impact of the next pandemic than the failure of its prophets
to imagine human suffering in any other way than in the form of a rupture of bourgeois values
which is striking here. What returns in the form of the new virus is not simply the specter of
human extinction, but, even for those few who survive, the bane of life not simply without but
before capitalism; a Hobbesian dystopia where humanity is led back to an animalistic state of
mutual predation. For this prophetic regime, the only true future for humanity is the present; any
other future would be simply a return to the dark ages or the stone age. It is this pandemic

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vision, as a vision of no imaginable alternative, which sets the prophetic scene of the coming
plague.
Christos Lynteris is a social anthropologist working on biopolitical and visual aspects of infectious
disease epidemics. He is Senior Research Associate at CRASSH, University of Cambridge, and
Principal Investigator of the ERC funded research project Visual Representations of the Third
Plague Pandemic. Christos is the author of The Spirit of Selflessness in Maoist China: Socialist
Medicine and the New Man (Palgrave Macmillan 2012) and Ethnographic Plague: Configuring
Disease on the Chinese-Russian Frontier (Palgrave Macmillan, to appear in spring 2016).
Read this piece online: http://somatosphere.net/?p=11524

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A life that is not its own: A Reply


Carlo Caduff
Kings College London
It is a tremendous pleasure to encounter unforeseen readers in the process of exploring unforeseen
lines of thought. Such readers offer The Pandemic Perhaps the gift of a life that is not its own. The
thoughtful comments assembled in this collection provide occasions for escape, which honor the
book in the best possible way. They borrow ideas, extend words, gestures, and images in
unexpected directions, and thus announce in the practice of reading the pleasure of the text.
Generosity constitutes the gift as a given which demands no return. What follows is a reply; it
simply recognizes, in the form of a response, that something has been received.
A key aim of writing The Pandemic Perhaps was to explore the multidimensional
relationships between hegemonic regimes of scientific knowledge, historical processes of nationstate building, and compulsive structures of affective attachment. Analytically, the book departs
from a constructivist concern with intelligibility and the correlated fantasy of performative
efficacy. The Pandemic Perhaps troubles accounts, which assume that constructions work,
demonstrating how styles of reasoning render things unintelligible. The irony is that such failure
now constitutes a mode of operation. This has important implications not only for our analytics of
power, but also for our ability to imagine alternative social formations.
As the comments in this forum capture so well, the book cares about the social, cultural,
and historical specificity of pandemic influenza as a contemporary concern. It examines how a
particular imagination of the pandemic threat is anchored in a configuration of temporal
sensibilities and institutional anxieties that is characteristic for a specific historical moment. One
might call this analytic move a strategy of provincializing preparedness; its goal is to work against
the idea of globalizability as the hegemonic imaginary of our time.
Raad Fadaaks research on the Global Health Security Agenda takes this imaginary as its
ethnographic object. In his comments, Fadaak suggests that Americas geo-political vision of
global health security is driven not by the belief in the coming plague, but by the presumption that
something must be done to prevent the worst. The recurrent invocation of instrumental reason in
the world of policy-making finds its legitimacy in a language of urgency. As the product of an
emerging administrative-bureaucratic apparatus, the Global Health Security Agenda refers to a
number of rapidly shifting possibilities and projects. Here, actors infer powerful forms of agency
from security as an empty signifier.
Fadaaks account of the strategic as-ifa mode of speaking that doesnt mean what it
saysindicates that scholars need to reconsider the notion of belief and examine the conditions
under which an orientation to the future appears (or fails to appear) as a structure of belief. For
such a project the work of Michel de Certeau seems crucial, precisely because it presents belief
not as a form of defective knowledge, but as a promise of action. De Certeau reminds us that it
was the tradition of the Enlightenment that made belief a question of epistemology, a question of
knowing the world rather than being in the world. Belief, de Certeau insists, represents a promise

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of action; it is not, as philosophers of the Enlightenment claimed, an example of as-if knowledge.


Building on this account, one might say that belief is what makes security run.
Ann Kellys reading of The Pandemic Perhaps adds another insight to the critical analysis
of todays imaginary of globalizability. What she terms the power of engrossment refers us to
the politics of intensified attention and strategic awareness. Malaria eradication campaigns are no
longer driven by the political dynamics of the Cold-War period. The disease owes its significance
to the scientific and economic opportunities it offers to actors and institutions in the global North
and the global South. Kelly points to the question of value, and how value is constituted by virtue
of urgency, a measure of political relevance, moral significance, and economic opportunity. The
language of urgency is a powerful language, one that depoliticizes and dehistorizes an emerging
regime of technocratic governance increasingly driven by a focus on ever-shifting targets of
opportunity, in Samuel Webers sense of the term.
Not surprisingly, the language of urgency invokes the idea of magic. The latter comes with
the promise of immediacy, of making things happen instantly. In states of emergency, where action
is said to be urgent, dramatic health interventions acquire an aura of magic bullets, which promise
instant results. In so doing, they are liable to frustrations, which intensify the desire for a form of
magic that works.
In her comments, Karen Jent extends this idea of magic as promise of fantastic efficacy to
her own ethnographic research on regenerative medicine in Scotland. With its spark of magic,
regenerative medicine offers a vision of a better world with a capricious protagonist that is not
threat, but hope; not death, but resurrection; not dystopia, but utopia. The emphasis, in
regenerative medicine, is on the salvational side of things. Yet the promise of salvation acquires
significance only in relation to a certain prospect: the prospect of death and degeneration that is
increasingly haunting aging societies, so-called. In that sense, one might say that regenerative
medicine, despite its optimistic orientation to a healthy future, remains subject to the dialectics of
threat and promise that so powerfully animates scientific interest and financial investment today.
Ghassan Hage observed that our notion of hope is based on a protestant ethic of deferred enjoyment
which fits in very much with the idea of saving and deferring gratification. Jents work on the
regenerative as a site of optimistic attachment is a challenge to think hope on the side of life,
that is, hope beyond the economic, as hegemonic measure of being and becoming, and, instead, as
the affirmation of life as it emerges and in the transitions and movements of our everyday life and
relationships.
In Perig Pitrous comments we encounter a reading of The Pandemic Perhaps that presents
the book as a contribution to the anthropology of life. Viruses are frequently imagined in relation
to other bodies. The life of the microbe appears in Pitrous account as that which is contingent on
someone elses life. This notion of borrowed life animates The Pandemic Perhaps; it highlights a
more general condition of existence, one that refuses fantasies of sovereignty and self-sufficiency.
Borrowed life is an unstable mode of being that remains indebted to the other. Todays biopolitics
offers a dramatic contrast: it presents the image of a community founded on immunity, that is, on
the isolation of the self and its separation from the other. Pitrous reading suggests that the world
of microbial life is more complex than the one generated by the cultural industry and its endless
proliferation of militarized contagion movies dramatizing states of immunity under threat. What
forms of life could microbial life forms inspire? What would it mean to recognize the condition of
borrowed life?
Christos Lynteris points to the paradox of emergence ontology and its obsession with the
new. Influenza viruses change all the time, so what makes a virus new? It is this undecidability at

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the heart of microbiology that makes emergence ontology so generative. Proliferating alongside
the compulsive concern with the new and correlated attempts to define it is a failure of the
imagination: the failure to envision pandemic disaster in any other way than in the form of a
rupture of bourgeois values. Todays view of pandemic disaster frames alterity as inverted image
of a normative account of everyday life. Joseph Masco argues that this view casts the suburban
life of the white middle class as a mode of existence in need of protection. The pedagogical point
of disaster fantasy (and there is no fantasy without a pedagogical point) is to make this mode of
existence an object of desire.
As Michel Serres taught us, the penchant of the parasite is to interrupt dinner parties (the
good meal in good company in Kants phrasing). The task of anthropology is to make room for
the uninvited guest.
References
Barthes, R. 1975. The Pleasure of the Text. New York: Hill and Wang.
de Certeau, M. 1985. What We Do When We Believe, in: Marshall Blonsky: On Signs,
Baltimore: Johns Hopkins University Press.
Hage, G. 2002. On the Side of Life. Joy and the Capacity of Being, in: Mary Zournazi. Hope.
New Philosophies for Change, Melbourne: Pluto Press.
Kant, I. 2006. Anthropology from a Pragmatic Point of View, Cambridge: Cambridge University
Press.
Masco, J. 2014. The Theater of Operations. National Security Affect from the Cold War to the War
on Terror, Durham: Duke University Press.
Serres, M. 2007. The Parasite. University of Minnesota Press.
Weber, S. 2005. Targets of Opportunity. On the Militarization of Thinking, New York: Fordham
University Press.
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Somatosphere | April 27, 2016