Plague and power relations

Abstract

Public policy and economic practice, quintessential expressions of institutional cognition, create an opportunity structure constituting a tunable, highly patterned,‘non‐white noise’ in a generalized epidemiological stochastic resonance that can efficiently amplify unhealthy living and working conditions, particularly within highly concentrated, marginalized urban populations, to evoke infectious disease outbreaks. This is especially true for the infections carried by socially generated ‘risk behaviours’ which are usually adaptations to histories of resource deprivation or marginalization. A number of local epidemics originating in such ecological keystone communities may subsequently undergo a policy and structure‐driven phase transition to become a coherent pandemic, a spreading plague which can entrain more affluent populations into the disease ecology of marginalization. We use this approach to contrast the ecological resilience of apartheid and egalitarian social systems, and apply these perspectives to the forthcoming social and geographical diffusion of multiple drug resistant (MDR) HIV from present AIDS epicentres to the rest of the United States.

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