On the Coloniality of Global Public Health
A physician-anthropologist explores how public health practices—from epidemiological modeling to outbreak containment—help perpetuate global inequities.
In Epidemic Illusions, Eugene Richardson, a physician and an anthropologist, contends that public health practices—from epidemiological modeling and outbreak containment to Big Data and causal inference—play an essential role in perpetuating a range of global inequities. Drawing on postcolonial theory, medical anthropology, and critical science studies, Richardson demonstrates the ways in which the flagship discipline of epidemiology has been shaped by the colonial, racist, and patriarchal system that had its inception in 1492.
Deploying a range of rhetorical tools, including ironism, “redescriptions” of public health crises, Platonic dialogue, flash fiction, allegory, and koan, Richardson describes how epidemiology uses models of disease causation that serve protected affluence (the possessing classes) by setting epistemic limits to the understanding of why some groups live sicker lives than others—limits that sustain predatory accumulation rather than challenge it. Drawing on his clinical work in a variety of epidemics, including Ebola in West Africa and the Democratic Republic of Congo, leishmania in the Sudan, HIV/TB in southern Africa, diphtheria in Bangladesh, and SARS-CoV-2 in the United States, he concludes that the biggest epidemic we currently face is an epidemic of illusions—one that is propagated by the coloniality of knowledge production.
A brilliant text that learns from our great thinkers in the Global South. Epidemic Illusions decolonizes global public health, and it should be required reading for every course on outbreaks and pandemics.
Agnes Binagwaho, Vice Chancellor, University of Global Health Equity
The COVID-19 pandemic has exposed and exploited stark global inequities. But those inequities have long histories, histories that the medical community has barely acknowledged, let alone addressed. Eugene Richardson shines light on one of the darkest corners of global health. In doing so, he provides a radical manifesto for revolutionary change.
Editor of The Lancet and author of The COVID-19 Catastrophe
Eugene Richardson has written a powerful and timely book on the complex and intimate connections of white supremacy, science, and public health. We badly need it in these catastrophic times.
Cornel West, Harvard University
The game is up for global public health. Richardson delivers a withering critique of a discipline that has too long systematically ignored the real structural and political drivers of disease. If our analysis doesn't account for class, race and colonial power, then we've missed the point. Fresh, creative ,and even trickster-esque—don't miss this book.
Jason Hickel, University of London; author of The Divide: Global Inequality from Conquest to Free Markets
Far too many of our efforts to achieve equity in health outcomes for everyone everywhere are underpinned by dangerous but unexamined assumptions and premises. Eugene Richardson shows us how to recognize them, take them apart, one by one, and commit them to the dustbin of coloniality where they belong. This book is set to become a prime text for our efforts to decolonize global health.
Seye Abimbola, University of Sydney; and Editor in Chief, BMJ Global Health
An impressive deconstruction of global health's colonial roots. This fine book is as sophisticated in social theory and history as it is in infectious diseases and medicine. The author doesn't just talk the talk of anthropology, public health, and clinical medicine; he walks the walk, and is as much at home as an ethnographer in West African Ebola settings as in the seminar room discussing postmodern theory, African history, and the imperial background of global health institutions. A telling contribution!
Arthur Kleinman, author of The Soul of Care