Recent years have witnessed an upsurge in global health emergencies—from SARS to pandemic influenza to Ebola to Zika. Each of these occurrences has sparked calls for improved health preparedness. This book addresses the question, how did we become “unprepared?" Emerging disease has only recently come to be understood as a problem of preparedness. Andrew Lakoff follows the history of health preparedness from its beginnings in 1960s Cold War civil defense to the early twenty-first century, when international health authorities carved out a global space for governing potential outbreaks. Alert systems and trigger devices now link health authorities, government officials, and vaccine manufacturers, all of whom manage the possibility of a global pandemic. Funds have been devoted to cutting-edge research on pathogenic organisms, and a system of post hoc diagnosis analyzes sites of failed preparedness to find new targets for improvement. Yet, despite all these developments, the project of global health security continues to be unsettled by the prospect of surprise.
Andrew Lakoff is Associate Professor of Sociology and Communication at the University of Southern California. He is the author of Pharmaceutical Reason: Knowledge and Value in Global Psychiatry and coeditor of Biosecurity Interventions: Global Health and Security in Question.
"From the Justinian plague to the Victorian cholera, epidemics have challenged both scientific knowledge and political action. Revisiting a series of recent outbreaks labeled 'global health emergencies,' Unprepared shows how, despite considerable epidemiological and biological advances, international agencies and national governments each time face similar issues, dilemmas, controversies, criticisms, and failures. It is an important contribution to the anthropology of contemporary anxieties and uncertainties."—Didier Fassin, author of When Bodies Remember: Experiences and Politics of AIDS in South Africa
"An original, penetrating, and highly readable account of the rationalities and tensions involved in governing global health emergencies in the twenty-first century. Essential reading for all those interested in global health, health security, and emergency preparedness. Prepare to discover how we became unprepared!"—Stefan Elbe, Professor of International Relations and Director of the Centre for Global Health Policy, University of Sussex
"Lakoff lucidly dissects efforts to anticipate, recognize, and respond to global emergencies, exposing an expanding anxiety over preparedness beneath both crisis and failure. In an era where appeals to health increasingly measure both hopes and fears, this is a vital book."—Peter Redfield, author of Life in Crisis: The Ethical Journey of Doctors without Borders