Viral forecasting as a form of global health security

The New Yorker’s infectious disease correspondent, Michael Specter, recently profiled virus-hunter Nathan Wolfe as part of the magazine’s theme-issue on “World Changers.” Wolfe, as Specter narrates, is a physical anthropologist (specializing in orangutans) who has become fascinated with the possibility of tracking viral transmission among primates. He has managed to attract funding from multiple sources including Google, USAID, and the Department of Defense for an initiative on “global viral forecasting,” which involves testing bushmeat consumed by African hunters for the presence of potentially dangerous new pathogens. The background to the initiative is the hypothesis that HIV was originally transmitted to humans via the bushmeat trade; alongside the premise that another such deadly virus may be on its way into humans through the same route.

Without commenting on the scientific merits of this premise, it is worth underlining how different such an approach is from traditional public health disease surveillance, which focuses on tracking the incidence and severity of existing diseases among human populations. Viral forecasting, in contrast, imagines the future emergence of a novel and deadly virus, and puts in place techniques that are designed to detect its arrival. In Wolfe’s vision, the virulent pathogen could then be stopped through the rapid biotechnological development and global dissemination of a targeted vaccine or drug. Those (including, one would presume, Michael Specter) who have followed the travails of efforts to develop an HIV/ AIDS vaccine over the last two decades know how fictional such a scenario is in any near-term horizon.  Wolfe’s audacious claim is that his virus tracking system will be able to “stop the next pandemic before it starts.”

Viral forecasting clearly comes out of the lineage of global health security. First, it subscribes to what historian of science Nicholas King calls “the emerging diseases worldview”: the claim that ecological incursions, human-animal interactions and global circulation have led to the increasing likelihood of novel disease emergence; and that what is needed in response are technical measures that can track and contain such outbreaks before they affect wealthy countries. As infectious disease specialists allied with military strategists in response to the problem of biosecurity beginning in the 1990s, US (and more recently, European and multilateral) health agencies have invested in public health infrastructure specifically focused on disease preparedness: early warning systems, scenario based exercises, emergency operations centers, stockpiles of medical counter-measures, etc.

Given Wolfe’s orientation to outbreaks of dangerous new diseases and his willingness to set up surveillance systems to track their potential emergence around the world, it is not too surprising that he has attracted US military support. The DOD has, especially since the 2001 anthrax letters and the SARS outbreak of 2002, been very concerned about both human and non-human caused infectious disease outbreaks. What might be surprising – given the distinction I’ve drawn between global health security and humanitarian biomedicine – is what Specter calls the “pure social work” of his Healthy Hunters program to educate hunters about the perils of bushmeat consumption.

Of course there is no reason to assume the goals of alerting the globe to new outbreaks and of encouraging hunters not to eat endangered primates should be incommensurable. However, one would not want to say that the Viral Forecasting Initiative is also engaged in humanitarian biomedicine. The latter focuses not on tracking possible future outbreaks but on treating actually existing conditions (such as AIDS, malaria, TB) among populations without access to basic public health infrastructure. In a trenchant critique of the politics of viral forecasting, historian of medicine Guillaume Lachenal calls Wolfe’s project a form of therapeutic nihilism, in that “as the future pandemic is imagined, a present catastrophe is obscured and left unattended.” In other words, while the viral forecasters seek to prevent thenext AIDS from emerging from Cameroon, people there are dying from the current one.

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About Andrew Lakoff

Associate professor of anthropology, sociology, and communication at the University of Southern California. His first book, Pharmaceutical Reason: Knowledge and Value in Global Psychiatry (2005), examines the role of the global circulation of pharmaceuticals in the spread of biological models of human behavior; it is based on research conducted in Argentina, France, and the United States. His current research concerns global health and biosecurity and includes his coedited volume Biosecurity Interventions: Global Health and Security in Question (2008) as well as his edited volume Disaster and the Politics of Intervention (2010).

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