Are we all looking for immunity? About the material content of sociotechnical imaginaries*
*This text is translated from French by Raphaele Von Koettliz of Ecole Normale Supérieure of Lyon
The Global Quest for Immunity
The debate on herd immunity has strongly marked the political and scientific management of Sars-Cov2, as has been widely reported in the media. The language of immunity between gambling and speculation for a time, was tempered by oracles, when Imperial College models predicted the disaster in Britain. However, the wager on natural herd immunity did not disappear from scientific and political discourse. It was in a way the starting point of what is at stake today in the quest for a vaccine, as well as in the counter current of anti-quests and what it brings into play in terms of narratives in the global North and South.
The quest for herd immunity through non-confinement was widely advocated at the beginning of March, as a viable preventive strategy that could curb the predicted fallout of the virus. Boris Johnson in the UK and Donald Trump in the US largely relied on rapid spreading throughout working class people to pacify the virus. On the 4th October, the Great Barrington Declaration translated into 43 languages and signed by researchers from Stanford, Oxford and Harvard Universities argued in favour of slackening the restrictions in order to expose people to the virus in the attempt to build up immunity and ultimately save jobs and the American economy. In Senegal, a report entitled “The Senegalese Miracle of Magal”, signed by a parasitologist and clinician from the Institut de Recherche pour le Developpement (IRD), stated that the religious pilgrimage to Mourides1 of Touba did not cause any extra cases of Covid-19. On the contrary, there was a decline in Sars-Cov in Senegal, which could be attributed to herd immunity among other factors. This is what the political scientist Ariel Colonomos described as the “strategy of states that pay with lives as opposed to states that pay for lives”. The argument for natural immunity existed before the birth of bacteriology at the beginning of the 18th century2, its revival today puzzled and even shocked epidemiologists who do not wish to think about immunology outside of its medicalisation. Various percentages have been circulated concerning the required infection rate to achieve herd immunity, in particular by those who have taken risky gambles, like in Sweden, to not confine its population. Herd immunity, whether natural and/or vaccinated, is a metaphor for governance, the most familiar demonstration today being the one being played out by the “cargo deities” of the pharmaceutical industry. Indeed, vaccines are at the heart of the pandemic, are THE solution to the crisis and the hope of a return to “normal life”.
An unequivocal quest for a vaccine
The vaccine is presented as a synonymous of the end of the pandemic, without which we won’t be able to turn the page on this extraordinary story. The quest for a vaccine has become an issue of sovereignty and state governance but also lies at the heart of the lessons to be learnt from the pandemic and its aftermath. It is through the vaccine that Western leaders are trying to reconquer their undermined legitimacy. The vaccine has become a symbol of revenge on unpreparedness. some leaders have clearly banked on pharmaceutical measures. Angela Merkel and Emmanuel Macron later joined by Donald Trump ordered and secured billions of vaccines from pharmaceutical industries such as Astra Zenaca, Moderna, Gilead, or GSK/Sanofi, to protect their electorate. Pharmaceutical firms have bet on immunity through vaccination, thanks to the biotech companies that are fond of risky innovations,. In just a few months, several hundred of vaccines were under development, 11 of which are now in phase 3. Never before has the race for a vaccine been conducted with such frenzied eagerness as for the Covid-19 vaccine, reinforcing the relationship between biotechnology, finance and national interests, and in the process, transforming protocol for clinical trials by skipping over several key steps.
The narrative of salvation through a vaccine, representing the only way out of the crisis has resurfaced in Africa, as has often been the case in recent years of vaccine development, with narratives that reframe memories and the impacts of past experiments that have taken place there. Rooted in both people’s imagination and raw facts that have been widely documented by history and law, there are many people across Africa especially young people, that are against the quest for immunity. This stance is not merely symbolic, but in fact underpins historical and political processes that are profoundly reshaping the Western hegemony of medicine and is part of a wider critique of Western neo-colonialism.
Irrational refusals of vaccinations?
Some communities continue to have an ambivalent relationship with vaccines and vaccination, which is understandable given the traumatic medical history in Africa. Vaccination, a medical technology, is associated with necropolitical power, eugenics and feminicide, framed by wider concerns around power relations, extractive strategies and occult knowledge3. Mostly interpreted as “resistance” to vaccines, this complex relationship to vaccination has been constructed through numerous dark episodes. In 1995, the tetanus vaccine was associated with the desire to sterilise girls in Cameroon, as was the polio vaccine in Northern Nigeria4. We might suggest that what anthropologists have often described as “resistance” to vaccinations is conjunctural, and therefore historically located and directed against one vaccine and not against all vaccines or against vaccination in general. For example, in Kano (Nigeria) Pfizer’s infamous trial of trovafloxacin during the meningitis epidemic, influenced the refusal to be immunized against polio years later in Northern Nigeria. Every African country has its own vaccine trauma; in South Africa, Dr. Wouter Basson’s eugenics and racist projects remain anchored in the memories of the black population. Whilst South Africa is the first African country to embark on a vaccine trial against Covid-19, promoted by the university of Oxford, we are reminded of the horrors of abusive medical practices. However, this story is not simply based on an imaginary past, made up of colonial or postcolonial medicine, since it continues and is reconfigured in more contemporary times. In the context of the fight against Ebola, vaccination campaigns were heavily militarised in Guinea ; in the DRC, a veritable race took place to get the Ervebo® vaccine accepted (manufactured by the firm Merck Sharp and Dhome), while disputes erupted between ministerial authorities to impose a second vaccine candidate in the midst of an epidemic. All these phenomena reinforced the less than reassuring image of vaccines. Therefore, the quest for immunity via vaccination technology is not universally shared. How is the Covid-19 vaccine received in non-Western countries? What do other positions represent in relation to this relentless race for the vaccine?
At the beginning of the Sars-Cov2 pandemic, many anxious social media users spotted that a vaccine had arrived in Africa. A person of the Senegalese diaspora settled in New York called for murder if a vaccine were to be offered by Westerners. The polemic raised on the French television channel LCI by a doctor from a Parisian hospital proposing, not without contempt, to test a vaccine on “African prostitutes” was enough to throw fuel on the fire. The President of Burkina Faso posted a communiqué immediately after the Parisian doctor’s comments, denying any link to vaccination trials against Sars-CoV2 in Burkina Faso. Expressions of interest in favour of future vaccine trials on the African continent, such as that of Professor Muyembe, a key figure in the fight against Ebola in the DRC, were badly received by the highly suspicious population. According to African youths on social media, Africa is seen as guinea pig territory, exploited by its own elites and by the West.
Furthermore, the European response to the coronavirus has become symbolic of the discredited West, in disarray and suffering the loss of its hegemonic power. The European power play during the Ebola epidemic, where the West imposed itself as the saviour of West Africa, is being called into question against the backdrop of the calamitous management of Covid-19 in Europe. Particularly as the coronavirus is perceived as less dangerous and Sars-Cov2 is treated as a public health issue when is to denial. Guy Marius Sagna, a Senegalese activist who has been imprisoned several times and is also the secretary of FRAPP/ France Dégage (front for a Pan-African Anti-imperialist Revolution), said in a very popular television broadcast: “doesn’t it bother you with the number of deaths and the number of doctors’ deaths in France, that they come and offer us a vaccine? Europeans are so helpless that they are accepting help from pariahs like Cuba, Venezuela and even China! Today it is France, Italy, Spain who need help”. The rejection of the Covid-19 vaccine in Africa has become nested in neo-colonial criticism, the struggle against monetary sovereignty and Emmanuel Macron’s Malthusian discourse are regularly drawn upon in popular discourse and by the local media.
The fact that the West has had to deal with an epidemic without available means of treatment ultimately mirrors the fate of African populations who have been forced to develop alternative organisational and social solutions with regard to epidemics. Rather than culturalising this ambivalence towards the vaccine, can we not see it as part of a different quest from the one undertaken by the rest of the world since the arrival of the coronavirus? A quest that takes the disease seriously, understanding its contagious nature, but also a social quest, recognising the fact that not everyone is equal when faced with the virus. Beyond the quest for vaccination, which ultimately amounts to a new form of ambiguous biopolitics at the junction of national interests and humanity’s unequivocal biological interests, resistance to vaccination can therefore embody another vision that gives us an understanding of a special relationship to immunity and identity.
As the gemo system among Uganda’s Acholi people illustrates, other care policies rooted in socio-cultural realities are possible5. The gemo system, which already existed in the pre-colonial period, is based on an effective system of quarantine and care managed by individuals that have recovered from illness or elderly people perceived as immune or with less to lose than the younger population. The majority of care for the sick and the treatment of dead bodies is facilitated through this network. In addition to vaccines, systems of care that have been tried and tested in the past and that are culturally and socially justified because they are tailored to a network of solidarity, can provide services to meet human needs and reduce the inequalities experienced by vulnerable people.
The recruitment of field epidemiologists and community workers is one of the rarely recognized forces in the field of global health. This strategy, coupled with care, is possibly one of the factors in the success of some African countries in the management of Covid-19, as was the case for the management of Ebola in Nigeria, for example. Senegal is ranked second best prepared for pandemic management after New Zealand. There is therefore another more inclusive quest of immunity possible by shifting away from the narrow vision of the quest for the covid-19 vaccine. A collective immunity project can therefore take on different characteristics, depending on the temporality and contexts; the Pasteurian warrior approach (which ends up in espionage 2.0 by means of tracing) is not unanimous, as David Napier6 reminds us. People are mobilising to counterbalance the biopolitical vaccine project. If we are to take their discourse and their visions seriously, we might consider not only that vaccination is not desirable everywhere in the same way, but also that sustainable alternatives do exist, that take into account collective relations to the social and ecological environment.
These alternative quests show that there are other ways to respond or prepare for epidemics. Indeed, by avoiding conspiratorial or anti-vaccine analyses, alternatives to vaccines can also be understood as ways of breaking the link between the economy and the living world that the COVID-19 vaccine has come to enshrine. This could, moreover, appear paradoxical at a time when this pandemic may be recognised as a disease of the capitalocene since it is precisely this link between the economy and the living world that has created this situation7. Divergent quests are therefore possible ways of escaping from what Achille Mbembé calls brutalism8, which allows us to think about the politics of forcing bodies and minds, and about the dehumanisation of health that the pandemic lays bare. Brutalism is marked by the interweaving of several figures of reason, among which the economic reason and the biological reason. Mbembe defines brutalism as “the apotheosis of a form of power with no external limits, which has renounced to the myth (…) of another world to come”, precisely founded on the “conviction that there is no longer a distinction between living things and machines”. The Covid-19 vaccine and its world of national hegemonies and financialised investments is also at the source of the problem it claims to solve. In this sense, the quest for a vaccine in the global North and its associated expectations seem to be at the root of an inability to imagine any other future than that of an ever more devastated world, where epidemics and pandemics become opportunities to demonstrate techno-financial resilience, promoting hybridisation between the economy and the living.
- The Mouride brotherhood is a large tariqa (Sufi order) most prominent in Senegal and Gambia with headquarters in the city of Touba, Senegal, which is a holy city for the order. Followers are called Mourides.
- Moulin, A.M. Le dernier langage de la médecine: histoire de l’immunologie de Pasteur au sida. Paris: Presses universitaires de France, 1991.
- Fairhead, James. « Understanding Social Resistance to the Ebola Response in the Forest Region of the Republic of Guinea: An Anthropological Perspective ». African Studies Review 59, no 3 (décembre 2016): 7‑31. https://doi.org/10.1017/asr.2016.87.
- Feldman-Savelsberg, Pamela, Flavien T. Ndonko, et Bergis Schmidt-Ehry. « Sterilizing vaccines or the politics of the womb: retrospective study of a rumor in Cameroon ». Medical Anthropology Quarterly 14, no 2 (2000): 159–179.
- Hewlett, Barry, et Bonnie Hewlett. Ebola, Culture and Politics: The Anthropology of an Emerging Disease. Cengage Learning, 2007.
- Napier, David. The Age of Immunology. Conceiving a Future in an Alienating World. University of Chicago Press, 2010
- Wallace, R. (2020). Dead epidemiologists: On the origins of COVID-19. Monthly Review Press.
- Mbembe, Achille. Brutalisme. Paris, La Découverte, 2020.