GLOBALIZATION, PANDEMICS AND POPULISM

Reflecting on a series of political events - including the electoral victory of Donald Trump, and the Brexit vote – commentators have argued that the current political turmoil is part of a worldwide backlash to globalization, the rebellion of “globalization’s losers”.  There is indeed a vast mass of people who feel that their life conditions are deteriorating notwithstanding, of even because of, globalization. They mostly belong to the extended middle-class that benefited from the economic boom that followed the end of World War and granted one of the longest period of economic prosperity ever experienced by industrialized societies. Now, these people see their economic conditions and social status progressively degrading, without any actual possibility to invert the trend. Their agency is nullified, vis-à-vis epochal processes such as globalization, digitalization and automation, which totally escape from their control.  They feel (not completely wrong) that the wealth of the West is going to be redistributed at global scale chiefly at their expenses. This social group is only the peak of the iceberg, because many other categories  perceive themselves as globalization losers, although they are not in absolute terms. In other words, losers of globalization are not only those who have been marginalized, but are also those who feel that they haven't profited as much as others from globalization. These people, who feel that that they got just the crumbs of the cake, are still more full of anger and resentment, because they believe they have been misled and used as “cannon fodder”  by politicians, intellectuals, journalists, who advocate globalization.   

Even public health issues, notably those related to infectious diseases, are affected by the backlash to globalization. Not only many militants of populist movements are involved in anti-vaccine movements (for instance,  President Trump appointed Robert Kennedy Jr, a prominent vaccine conspiracy theorist, to chair a commission on "vaccination safety and scientific integrity"), but it is the very cultural climate, which surrounds populist movements, to be the same that  has fed, in the recent past, suspect, skepticism, mistrust, towards global health initiatives and vaccination.  

Economic and health globalization are indeed the two sides of a same coin. Germs travel together people, animals and goods; the increasing global mobility corresponds, epidemiologically speaking, to the confluence of all germs in one world pool. In the while, advances in sequencing technologies and in bioinformatics are making possible to explore interaction between germs, people, animals, and the environment at global scale, and mapping the global microbiome (the genome of the Earth's microbial community) and its role in the biosphere and in human and animal health.  This is providing concrete foundation for the concept of One Health, which was once a purely theoretical notion, and is today a concrete research strategy. Finally, Internet based epidemiological surveillance and outbreak intelligence play more and more a pivotal role in early detection and monitoring of infectious diseases; this has led, inter alia, to blurring of the distinction between civil and military (including bioterrorism) applications of epidemiological research,  as witnessed by the new concept of biodefence field.

Three conceptual political tools emerged to deal with these profound modifications of the epidemiological context, 1) the notion of global public goods for health; 2) the concept of global health governance; and 3) the model of global public–private partnership.  These three conceptual tools are today under attack.

The idea of global public goods for health is contested by people who argue that an increased global integration is not the right answer to infectious diseases. It is obvious – they argue -  that infectious diseases do not know national borders, but it is false – they add – that outbreaks can be addressed only at global scale. Instead of relying on buzzword such as "health as a global good",  one should consider  that epidemic risks are increased by global interconnectivity, which is altering "the geographic distribution of pathogens and their hosts, causing the emergence, transmission, and spread of human and animal infectious disease". To these people, less globalization would be the right answer to pandemic risks. Migrants are often accused to bring with them germs and infections, and research shows that the public perception of risks of outbreaks is strictly associated to social acceptance of migrants among resident population.

Still the notion of global health governance is harshly criticized.  Even admitting that protection against epidemics is a global good, shared by the global human community, this would not imply – criticists argue – that such a good needs to be governed at global scale. To be sure, some kind of international collaboration is necessary, but this is a truism. Apart from that, each nation is perfectly fit to deal with infectious outbreaks occurring within and across its national borders, as it was in the past, with the advantage that national approaches can pay more attention to the national context, its economic, social and cultural specific features. The notion of global health governance would then be – according to the populist perspective - just the gimmick used by global elites to infiltrate and weaken national governments. 

Finally, also the global public–private partnership model is strongly rejected. In the view of populist movement, this formula would hide a business alliance between major industrial players, world bureaucratic and technocratic elites, and global financial capital.  They would be responsible for creating and diffusing new germs, such as HIV, Ebola, ZIKA  (conspiracy theory supporters are quite common in populist movements); for experimenting dangerous medications and vaccines on indigenous populations;   for exploiting natural resources of low income countries and biopiracy; for altering and threatening natural environment and agriculture through genetic manipulation (populist groups are often also involved in anti-GMO movements).

Bill  Gates  and Mark Zuckerberg have recently taken position in this debate.  In their praise of globalization, and explicit polemics against anti-global populism, they both play the card of infectious outbreaks. The risks of new, deadly, pandemics would provide,  in their views, one of the strongest arguments in favor of globalization.  It is difficult to predict whether Gates and Zuckerberg’ support to globalization could be effective or risk to produce opposite results. Although they advocate more globalization, they speak eventually the same language of populists. By reading carefully Gates and Zuckerberg's texts it is evident that their ideal (at least, the ideal that they both advocate)  is a communitarian ideal, as it is the ideal of most populist movements. While populists dream of national communities, Gates and Zuckerberg dream of a global online community,  yet  both parties  share the same vision of an integrated, organic, community as an answer to contemporary challenges. Should one eventually opt for the Facebook global  gemeinschaft, to avoid falling back again into a national gemeinschaft?

I am not able to answer this question, it is difficult, however, to escape the impression that infectious outbreaks are only instrumentally evoked by both parties.