Our collective ability to deal with infections has impacted human development for over 5,000 years. Through unprecedented advancements in hygiene and medicine, humanity has been able to break free of epidemic cycles, which has resulted in a world that is urbanized, globalized, and unimaginably wealthy. Global trade, however, made us more vulnerable to newly emerging diseases. Today, there is a strong demand from the whole world to work together on sustainable health programs, such as the global effort to produce Covid-19 vaccine, which poses a risk to millions of lives and trillions of dollars of global output.

In this episode, Charles Kenny talks about his timely book, The Plague Cycle, which examines the relationship between civilization, globalization, prosperity, and infectious disease over the last 5,000 years.

Listen as Charles and Greg discuss the causes and vectors of epidemics, the human toll of deaths and suffering, and our progress in battling communicable diseases.

Episode Quotes:

What are the main things that we can be proud of when it comes to human development?

If you look at global trends, even in income, but even more in health, worldwide the average life expectancy a century ago was around 30 years. Now, it's up around 70. If you look at education, that was the reserve of a small minority a century ago. And now, even in the poorest countries, we're seeing 80- 90% of people in primary school at least. There is a long way to go but they’re at least in school for some time. Sometimes even learning!

If you look at global trends in violence, at least in warfare, they've been on the decline at least sort of since the middle of the last century, at least since the second world war. Democracy, if you go back a century, obviously most of the world we're living in. Now we've seen backsliding, in democracy over the last ten years. If I were to update the book today, I'd be a little less confident on democracy than I was ten years ago. But still, huge progress over the last century.

How closely tied are our health outcomes to expenditures and investment in healthcare?

The best way to keep populations healthy is not to have them get sick in the first place. So, it is things like vaccines, bed nets. It’s things like clean water, and sanitation. These technologies have really created a global health revolution, and they're not terribly expensive, most of them. There are sanitation systems can get up there. Building a sewage network in a large city is a multi-billion dollar operation, but still, comparatively, they're pretty cheap.

Thought on putting monetary and statistical value on human life?

And it's interesting, the way we come up with a statistical value of life, you know? To use in calculations about how much are we willing to pay to rid the risk of death in various ways. We do it by looking at human behavior. How much people are willing to pay in their everyday life to reduce their risk of dying. We take their decisions, and add them up, and we say, ‘that's the value of life we're going to use’. The problem with it is, that richer people are willing to spend more on saving their lives than poorer people. So, if you follow that approach to the end of the line, you get values of life in developing countries that are a fraction of the value of life in rich countries. And frankly, you get values of lives of poor people in rich countries that are fractions of values of life of rich people.

Why do you think pestilence and disease as fields of history were never really given a lot of attention? Why are we only paying attention to it now?

I think maybe it's been historically ignored because it was just such a given. You know, it was such a background of everyday life and pretty much was an inevitability. Most people were dying of infectious diseases for most of history. Every year, year in, year out. And the pandemic strikes an interest because, you know, eight times as many are dying of infectious diseases in a single year. But, the sort of background deaths from smallpox and measles and so on go unnoticed because it's the way the world is. And that's why, if you look for historical sources, writing anguished reports on smallpox deaths. You won't really find very many of them, and it's because, well, you know, of course, it's God's will. It is the way things are. Unlike battles, regicides, or the kind of thing that fills your average history book. Those were noted at the time and reported on at length, and infectious disease wasn't. It was just part of the life of the household, if you will.

Do you think that people from the 20th century had an overly optimistic view of the potential of science and were able to become completely oblivious to epidemics that have been eradicated, like measles? At least until the onset of Ebola and HIV?

The combination of improved sanitation and better housing and so on, followed by vaccines and antibiotics, made infection a bit of a distant force in people's lives for much of the 20th century. And frankly, I think that was one of the reasons that the anti-vaxxer movement gained steam. It was quite easy to worry about the risk of vaccinations when for most people, they'd never seen a case of measles, certainly never seen smallpox. So, you know, the very success that we've had against infection made it seem like a bit of a distant threat. The advantage, if you will, for public health professionals worried about that kind of thing is that infection has been such a major part of human evolution. That we actually have a bunch of evolved responses to worry about it. Even in the period pre-Covid, we had periodic mass hysteria almost, about the risk of infection. I mean, the extent to which the market for antibacterial goods expand that, you could get antibacterial everything in 2000s, when we were going through one of the latest spikes of infection.

Time Code Guide:

00:05:04 Why do international agencies focus so much on market economy, output indicators? Are there other better metrics on the indicators of the quality of life?

00:07:47 Thoughts on the intellectual history of how developed countries inject capital in developing nations and improving life condition

00:14:55 The relationship between income and health

00:29:33 Aren't we going to return to an era where pathogens and microbes are going to be much more, dangerous?

00:32:19 Other inexpensive ways communities can improvise and solve diseases

00:34:49 How can medical information and materials can be made more accessible

00:38:26 Disparity on the impact of coronavirus in highly developed countries and less developed countries

00:41:41 Institutional architecture of society imprinted in history

00:45:32 Plague as disease of trade and product of Globalization

00:47:43 How other countries around the world responded to SARS

00:52:55 Will the current pandemic and vaccine development affect education and literacy

00:56:37 What inspired the author to write a kids’ book

Show Links:

Guest Profile

His Work

The Plague Cycle: Better Healthcare, Battling Epidemics, and Building Economies feat. Charles Kenny

unSILOed with Greg LaBlanc