Today I’m discussing a book about possibly the most amazing progress achieved by the human race. A series of battles against sickening infectious diseases have been waged, and the outcome has been incredible. Success hasn’t been evenly distributed; health outcomes are very obviously still not equitable across the world. Still, success has been very real. Life expectancies across the world are simply unrecognizable compared to a few hundred years ago. Progress has been wonderful; we should never forget that. Still, wonderful progress brings new challenges. The battle against infectious disease is never completely won; now would be an especially foolish time to walk away from it.
I’m Beginning To Think Nature Doesn’t Like Us
Kyle Harper’s Plagues Upon The Earth has immense detail on the various unpleasant diseases human beings have suffered from, and often still experience. It can be a bit grim to be honest as Harper runs through one nasty disease after another. Many diseases blend into each other but just leave you grateful you don’t have any of them.
Other diseases seem notably different. Growing up in England and living in North America I haven’t, thankfully, had any experiences of hookworms. Indeed, the US made significant progress against hookworm in the early twentieth century through a public health campaign.
The [hookworm] larvae invade the skin, but once inside human tissue, they must pass through a stage in the lungs, whence they will be coughed up, only to pass back down the throat and enter the intestines, where they mature and reproduce.
Harper, 2021, page 301
Nature is amazing! Yet, sometimes I do wonder if it hates human beings given the incredibly convoluted ways bad things can happen to people.
Wonderful Progress
European history often discusses the Black Death. You might have thought it was truly awful, but Harper is there to tell you that it was worse than you think.
Although many a textbook still claims that the Black Death carried off a third of the continent [Europe], in reality, the best estimates are closer to half.
Harper, 2021, page 232
We are lucky that people in the past advanced public health and medicine which means that we haven’t seen anything quite that bad recently. (Not to say that there haven’t been devastating outbreaks with very real consequences for communities).
We can see this wonderful progress in life expectancies. One thing to note it that the incredible progress hasn’t just been in the richer countries. Being rich still gives very significant health benefits, and in the early days of medical advances these relative benefits got bigger. Yet, the relative benefits have declined, and even poorer countries have now seen major progress. There is still clearly much to do, but incredible progress has been made.
Wonderful Progress Brings New Challenges
I’m a big believer in progress. In many ways it is the modern world of shared information, impressive machines, decent living conditions, and medical breakthroughs that have pushed back the scourge of infectious diseases.
A challenge is that the same things that allow much of the progress in our interconnected world, are also the things that create their own problems. Wonderful progress brings new challenges. Diseases can fly round the world, joining people on planes. The battle against infectious diseases is likely never going to be won. Diseases morph to take advantage of any weaknesses. As such it is vital we don’t get complacent. Of course, this is exactly what human beings like to do. When things are going well, we ease up on the efforts that led to things going well in the first place.
Let’s Avoid Backsliding
Smallpox, a devastating disease, was beaten back in England throughout the early 19th century.
But progress skidded off the tracks in the middle of the nineteenth century, mostly because compulsory vaccination rules were not matched by adequate enforcement. In England, this backsliding resulted in an epidemic in 1870-72 that killed more than forty-four thousand people…
Harper, 2021, page 484
Hard-earned wins can be lost if people stop doing the right thing by society. Could this happen in modern times given that we have much better information, safe vaccines, and even stronger governments?
Err, yes.
What Do We Need To Do?
We should be optimistic about achieving a better world — as long as we are willing to put the effort in to achieve this. Humans can make progress. There are plenty of horrible stories about the past but there are also many heroes who sacrificed to make the world better. Sometimes their sacrifice was hard work, sometimes their personal wealth, sometimes even putting themselves in physical jeopardy. We need more of that going forward.
Harper leaves us with the thought that in our modern interconnected world, the way to keep ourselves safe is to help other human beings. Recent devasting cuts to public health and assistance to poorer countries are incredibly short-sighted. These cuts are not just by the US — I’m especially ashamed of the UK Labour government’s actions on international development given my past connections there.
Even if we don’t care about other people, and of course we should, it seems to be the height of folly to think that we will remain immune if devasting outbreaks rip through any other part of the world.
For more on progress see Progress Exists And Is A Good Thing, Are We Making Any Progress On Sustainability?, Recognizing Trade-offs Is Critical To Progress, Are Only Stupid People Positive?, and Denial, Doom, Or Informed Optimism
Read: Kyle Harper (2021) Plagues Upon the Earth: Disease and the Course of Human History, Princeton University Press
