Microbial insurgency: Theorizing global health in the Anthropocene/

Several recent international health crises have revealed significant vulnerabilities in global pandemic preparedness. The 2014 Ebola fever epidemic expanded into an international threat far more quickly than experts anticipated, and the 2018 Ebola fever epidemic continues to expand, even with new technological innovations designed to control the disease. The 2015 yellow fever outbreak in Angola exhausted global vaccine supplies and put millions of people at risk. This article argues that global health authorities failed to anticipate the magnitude of these outbreaks because the field has not been updated to address the ways recent changes in international political economy are combining with environmental instabilities of the Anthropocene to increase epidemiological risks. Many public health textbooks and teaching materials continue to rely on variants of 20th-century modernization theory to explain and predict global health trends. Since the end of the Cold War, however, there has been a dramatic reconfiguration of governance in many parts of the world, and these macro-level changes are accelerating ecological destruction and fueling armed conflict in ways that will reduce the range and effectiveness of public health methods and prevention technologies that were successful during the 20th century. The combined effect of these institutional and environmental changes will increase global pandemic risks in the Anthropocene, even for infectious diseases that are easily preventable today.