Dying a natural death: Ethics and political activism for endemic infectious disease

This chapter addresses the representational politics of endemicity, arguing provocatively that viruses don’t kill people-people kill people. In pursuit of this claim, the authors develop a framework derived from historical studies of public health and from contemporary research in Structural One Health to argue that endemicity is not a natural phenomenon but is rather produced by social and economic policies. The authors argue that causal relations of endemic disease must be restructured in the popular imaginary. This chapter uses epidemics with isolated examples of “endemic” instances (tuberculosis in particular) to consider hierarchies and levels of cause, how these relate to global political economy, and with what implications for preventive and responsive action.