Epidemic Illusions

In Epidemic Illusions: On the Coloniality of Global Public Health (MIT Press, 2020), physician-anthropologist Eugene T. Richardson explores how public health practices—from epidemiological modeling to outbreak containment—help perpetuate global inequities.

This book questions the Global North's "monopoly on truth" in global public health science, making a provocative claim: that public health science manages and maintains global health inequity. Richardson, a physician and anthropologist, examines the conventional public health approach to epidemiology through the lens of a participant-observer, identifying a dogmatic commitment to the quantitative paradigm. This paradigm, he argues, plays a role in causing and perpetrating public health crises. The mechanisms of public health science--and epidemiology in particular--that set public health agendas and claim a monopoly on truth stem from a colonial, racist, and patriarchal system that had its inception in 1492.

Deploying a range of rhetorical tools, including ironism, “redescriptions” of public health crises, Platonic dialogue, flash fiction, allegory, and koan, Richardson describes how epidemiology uses models of disease causation that serve protected affluence (the possessing classes) by setting epistemic limits to the understanding of why some groups live sicker lives than others—limits that sustain predatory accumulation rather than challenge it. Drawing on his clinical work in a variety of epidemics, including Ebola in West Africa and the Democratic Republic of Congo, leishmania in the Sudan, HIV/TB in southern Africa, diphtheria in Bangladesh, and SARS-CoV-2 in the United States, he concludes that the biggest epidemic we currently face is an epidemic of illusions—one that is propagated by the coloniality of knowledge production.

Eugene T. Richardson, MD, PhD, is Assistant Professor of Global Health and Social Medicine at Harvard Medical School, Visiting Faculty at the University of Global Health Equity in Butaro, Rwanda, and Chair of the Lancet Commission on Reparations and Redistributive Justice.

Catriona Gold is a PhD candidate in Geography at University College London. Her current work concerns the politics of travel in Cold War US; she has previously published on US intervention in the 2013-16 Ebola epidemic. She can be reached by email or on Twitter.