Andrew Tucker and Gerry Kearns have co-authored a paper entitled Scientific hubris and a squeamish necropolitics: tracing continuities and discontinuities in AIDS discourse from the perspective of COVID-19, in Social and Cultural Geography.
As geographers have long been aware, the impact of epidemic disease reaches beneath the smooth surfaces shown as pathogenic diffusion into the social world, where pre-existing inequalities exacerbate infection risk and shape how diseases are discursively constructed and experienced (Brown, 1995; Gatrell, 2015; R. R. Kearns, 1993). Scholars working on the COVID-19 pandemic have revisited this truth, showing how a range of social inequalities exacerbate sickness, marginalisation and discrimination (Ho & Maddrell, 2021; Kokkola et al., 2022; Schillinger et al., 2022).
To help support new theorising to match the emergent social realities that COVID discloses, scholars have also looked to other pandemics, and especially the AIDS pandemic (Edelman et al., 2020; Garcia-Iglesias et al., 2021; Mkandawire et al., 2021; Whiteside et al., 2020). By looking at another pandemic it becomes possible to see what continuities (Braksmajer & London, 2021) and discontinuities (Guta & Newman, 2021; Hegarty & Rollins, 2021) exist between pandemics; to consider both what is new and what can be learnt from recent history. Yet, this assumes that the significance of the AIDS pandemic has already been fixed, whereas, such interpretations are always subject to the way hindsight newly directs our attention.
This provocation, therefore, asks instead how the COVID pandemic might direct the ways we think about the longer history of the AIDS pandemic. We ask this question to highlight to scholars that the present has as much to tell us about the past as the past does about the present. This distinction has been known to historical geographers as the contrast between looking from the past to the present as the retrospective method and from the present to the past as the retrogressive method (Baker, 1968). It raises normative issues (G. Kearns, 1998) as an injunction to reworking understandings of the past (MacLeavy et al., 2021). While this may sound axiomatic, it nonetheless has particular resonance for our study of pandemics due to proliferation of socially-mediated meanings engendered by epidemic disease (Sontag, 2001; Treichler, 1999). In this short provocation we give two different, yet connected, examples. The first considers how COVID has invited historical revisionism about AIDS – defined by scientific hubris – which at best side-lines social relationships and at worst discounts them. This revisionism recirculates discourses which proved harmful during the AIDS pandemic. The second example considers how the COVID pandemic requires of us to refine our notion of necropolitical state neglect against certain bodies (commonly deployed during the AIDS pandemic in relation to certain ‘risk groups’) to consider how a form of socially-mediated ‘squeamish’ necropolitics can limit eugenic state policies. In the first example we highlight how historical revisionism loses sight of social relations in its tale of scientific progress. In the second example we consider how the social can be more forcibly brought to bear on existing theorisations about the relationships between states and disease.
In turning in this way to the ‘social’ in conceptualising health we intend three sets of relations: the ways that values influence the perception of disease, the social construction of health (Arnowitz, 1991; Conrad & Barker, 2010); the ways that socio-economic inequalities (Marmot & Allen, 2014) and stigma (Hatzenbuehler et al., 2013) influence morbidity and mortality, the social determinants of health; and the ways that policies to address health must resist the privatisation of costs and benefits, the socialisation of health (Kelman, 1975, 1980). In other words, the understanding of disease is not the product purely of objective science, the health outcomes for individuals are not solely a question of personal behavior, and matters of health should not be left to unregulated market forces. These three threads are intertwined in the discussion below.