We designed this syllabus as a challenge to status quo thinking on disease. We did so with the knowledge that it would be perfectly possible to create a dozen such credible and entirely different reading lists. This particular syllabus is anchored by four goals:
Our first goal is to scrutinize narratives of technoscientific salvation. Common public celebratory stories of illness—plague, yellow fever, cholera, influenza, smallpox, and, yes, COVID-19—have been produced within power structures that often serve entrenched interests, in particular notions of universal, technological interventions and Western biomedicine as “saviors” that can ignore the politics of context. By circumscribing “public health” as a narrow domain that occurs outside larger societal currents, this status quo script has limited our ability to think bigger in our responses to all manner of health threats, everything from “ordinary” chronic diseases to terrifying pandemics like COVID-19.
Shedding light on an equally troubling narrative—a self-celebratory triumphalism that often colors accounts of public-health victories—is our second goal. This syllabus certainly catalogs some big wins of the public-health enterprise when it comes to infectious-disease control. But it also shows that “public health” is deeply rooted in xenophobic and racist ideology, which blamed disease outbreaks on contamination by foreigners or racialized outsiders; in theological beliefs, which punished moral transgression with divine retribution in the form of illness and death; and in a Victorian perspective, which views the world through the class-inflected lens of medical mandarins. Public health was rooted in a colonizing enterprise and tied to the deeply unequal operations of global capital. These priorities were affirmed, validated, and sustained through public-health research institutions, tropical-medicine laboratories, and interventions in colonized societies that segregated and contained locals; limited medical cures and therapies to saving lives in the military; offered sanitary cordons to a ruling elite; and focused on trying to keep “productive” labor in plantations and factories healthy to serve the interests of imperial trade. Put another way, public health has been the contingent story both of progress and of exclusion and stigma. And its victories have often only been partial, built on the backs of the marginalized and leaving many people behind.
Exclusion and inclusion point to a third goal: worldliness. Much of the English-language writing on COVID-19 has been provincial. One mark of that is obvious: such writings’ accelerated appearance once COVID-19 reached American shores. We have tried hard here to avoid a “West and the Rest” approach, while not ignoring the outsize importance of the United States and Western Europe in shaping—for better or for worse—the public-health agenda. Ultimately, COVID-19 underscores that a health injury to one country is a health injury to all. A reading list should reflect that.
The syllabus’s last purpose is rooted in who we are. As faculty in the Health & Societies major at the University of Pennsylvania and in the Center for the History and Ethics of Public Health at Columbia University’s Mailman School of Public Health, we teach students who aspire to all kinds of careers and approach health from a number of disciplinary angles. We’ve included bits of our own work here, so that you can get a sense of the different ways we approach things, warts and all. Our syllabus is underpinned by a strong belief that the long view effectively equips readers to leave with a sober understanding of public health’s many limitations but also a sense of positive and liberatory alternatives. Besides bringing to greater awareness what much of society—including even some public-health professionals—would rather forget, history also, in the words of historian Christopher Hamlin, allows one “to go back to the beginning, to recover possibility in the past,” and “to open our eyes to the possibilities we confront in the present.”1 Last but not least, we acknowledge that a great deal of public-health history writing still needs to uncover and pay attention to themes and issues of intersectionality of power relating to race, ethnicity, class, and gender. May these readings serve as an initial step to open up further debate on both everyday and systemic injustices relating to disease risks and access to health as these have been exposed and exacerbated by COVID-19.