German sociologist Ulrich Beck and British sociologist Anthony Giddens propounded the idea of risk society to describe the consequence of modernity. Modernization may have heightened the risk of civilization, but risks such as pandemics have deep connections with the processes of human migration which happened through wars, expeditions, and trades. Throughout human history, the severity of global pandemics had been correlated with the speed, intensity, and extensity of globalization. Humans progressed by negotiating with the pandemics and ushered in more prosperous societies. We shall also overcome the current pandemic caused by COVID-19. What kind of society will emerge as its consequence? Let’s anticipate.
The Bubonic plague which occurred in two bouts in the 6th and 14th century killed up to 225 million people in Asia, Africa, and Europe. The Bubonic plague which occurred in the middle of the 6th century, known as the plague of Justinian in the history of public health, killed around 25 million or half of the European population. It afflicted the Byzantine Empire and the Mediterranean port cities. The Bubonic plague of the 14th century, known as the black death, killed almost 200 million people and it is thought to be originated in Asia and traveled across the continents through rats living in the merchant ships.Similar to the archaic phase, epidemics and pandemics also happened in the early modern or 'proto-globalization' era, the era of European imperial expansion, which lasted between 1600 to 1800. Many sociological and anthropological literature shows that infectious diseases such as smallpox, leprosy, and measles spread in Africa, America, and Asia during colonial rule. The neglect of subsistence economy and imposition of taxes by the colonial administration and insufficient wages from the cash economy increased poverty and undermined the quality of the diet of people in the colonies which ultimately helped increase malnutrition and susceptibility to infectious diseases.
The cholera pandemic which broke out many times in the Indian subcontinent took deadly turns twice—in the mid-19th century and the early 20th century and traveled to Europe and America, killing almost a million people each time. Among the several flu pandemics, the deadliest one, named as the Spanish flu, hit in 1918, infecting about one-third of the world population. The HIV/AIDS pandemic which reached its peak from 2005 to 2012 was first traced in Congo in 1976. Since 1981, it has killed 36 million people, and now more than 30 million people are infected by this virus worldwide. The swine flu pandemic originated in Mexico struck the word in 2009. According to the US-based Centers for Disease Control and Prevention (CDC), it afflicted 1.4 billion people worldwide and killed more than five hundred thousand. The ongoing coronavirus pandemic originated in China has so far afflicted more than four million people across the world and killed almost three hundred thousand. It also reached different parts of the world through human movements.
History suggests that global pandemics brought big changes in the health sectors. For example, biomedicine took an institutional shape in the Indian subcontinent as a result of epidemics. During the British colonial rule, the colonial administration brought biomedical physicians from Britain to treat their soldiers and officials who got infected by infectious diseases. The treatment of mass people drew their attention when the death of thousands of people almost crippled trade and commerce in the first half of the 19th century. Initially, the colonial medical facilities started to treat the patients with British doctors, but the scarcity of doctors posed an insurmountable challenge. To circumvent this challenge, gradually medical colleges were established in different parts of undivided India to produce native doctors.
The colonial administration planned to spread primary healthcare services out to the village or community level to avoid future pandemics as part of a healthcare decentralization program in the fag end of the colonial rule. The health department formed a healthcare development committee in 1943 with Sir Joseph Bhore as the chair which released its report, known as the Bhore Report, in 1946. The Bhore Report recommended radical reform of the healthcare system of the Indian Subcontinent to develop a universal health care system. It suggested extending health care services to people's doorstep.
Some provisions of the Bhore Report were implemented by undivided Pakistan in the early 1960s, following malaria and smallpox epidemics. The government initiated steps to expand the healthcare services outside the city centers.
Human civilization progressed through fighting pandemics by inventing antidotes to them. Now many remedies including vaccines to treat the coronavirus have been undergoing trials in Asia, Europe, and North America. Eventually, humans will conquer it or will learn to somehow cope with it.However, the ongoing pandemic has exposed the holes in the healthcare systems across the world. Many people have died without having treatment. The situation shows grimmer and scarier in countries like Bangladesh where health care facilities are fragile and deficient. It invokes the states to make massive investments in healthcare. And, it is time to bid farewell to the neoliberal policies of privatization and liberalization in healthcare and their local and foreign defendants.
[Dr. A J M Shafiul Alam Bhuiyan is a Professor of Film and Media Studies and Dr. Farhana Begum is Professor of Medical Anthropology and the Chairperson of the Department of Anthropology at the University of Dhaka.]