Plagues and the Paradox of Progress | Thomas J. Bollyky

Summary of: Plagues and the Paradox of Progress: Why the World Is Getting Healthier in Worrisome Ways (The MIT Press)
By: Thomas J. Bollyky


Embark on a journey through human history as it intertwines with infectious diseases in Plagues and the Paradox of Progress by Thomas J. Bollyky. Learn how the rise of agriculture and the development of human settlements have contributed to both the spread and control of contagious diseases. Observe how governments and international organizations have historically waged war against diseases such as smallpox, measles, and HIV/AIDS. Exploring the crucial role of state and community cooperation, this summary offers proven strategies to combat infectious diseases while shedding light on the advantages and risks of urban development.

Impactful Diseases

Humanity has been shaped by infectious diseases caused by microorganisms such as viruses, bacteria, fungi, and protozoa. As civilizations emerged and people settled in villages and towns, they were exposed to more contagious diseases due to increased human interactions. Although agriculture contributed to the development of infectious diseases, it also enhanced public health by providing larger quantities of food which led to better living conditions. However, the domestication of animals increased the risk of infectious diseases spreading to humans. Farming and urbanization created more waste and improper food storage practices, which served as breeding grounds for diseases such as yellow fever, toxoplasmosis, malaria, and salmonella. It was only over the past century, with declining rates of infectious diseases, that we have experienced such widespread transformative impacts on the human experience.

Infectious Diseases Throughout History

Infectious diseases have always shaped human history. When a disease attacks the immune system of a person with no prior exposure, the reaction could be severe. When Europeans arrived in the New World, diseases like smallpox and measles killed 75% of the native population within 200 years. Understanding plagues and parasites still provides key insights into the evolution of the state, the growth and geography of cities, the disparate fortunes of national economies, and the reasons why people migrate. In the past, isolated communities faced germs brought via exploration, trade, and conquest, with children being more vulnerable to diseases. At times high risk of losing children, mothers gave birth to more to compensate, which impacted societal roles and education rates. Today, controlling infections requires government action and unified effort from communities and nations, as epidemics affect all facets of a community beyond its health, including economic life and future growth.

The Dark History of Urbanization

Urbanization facilitated the spread of deadly diseases in history, from tuberculosis and cholera to the Black Death. The growth of cities led to poor living conditions, contaminated water supply, and inadequate sanitation. Public health measures were established to combat infectious diseases, but underdeveloped countries still face high rates of disease due to urbanization. However, urbanization also provides opportunities for social reform and improved government institutions.

In the past, the formation of towns and the growth of communities led to deadly epidemics of diseases in Europe, such as the Black Death. Living indoors without direct sunlight or air circulation, coupled with poor sanitation and contaminated water supply, create ideal conditions for diseases like tuberculosis, leprosy, influenza, hookworm, cholera, and schistosomiasis. The industrial revolution, textile mills, and factory jobs led to rapid urbanization, as people relocated to cities in search of work. However, the conditions were horrendous, with poor-quality air, water, and sanitation. Infectious diseases multiplied, and respiratory and waterborne infections killed many migrants seeking work.

The discovery of pasteurization in 1865 helped reduce the spread of tuberculosis through milk, while public fear of cholera led to the promotion of sanitary practices and the authorization of urban sewer systems. Public health measures were established to combat infectious diseases, resulting in fewer deaths. However, underdeveloped countries still face high rates of disease due to urbanization, as growth places people and resources close together, which facilitates not only entrepreneurship but also the spread of disease.

Poor living conditions in cities also increase the incidence of violence, instability, and uprisings. While the social disruption and violence in poor cities may be bad in the short run, they can ultimately facilitate democratic reform and improved government institutions that provide better living conditions and healthcare for citizens.

In conclusion, the rapid urbanization that human societies have undergone has facilitated the spread of diseases such as tuberculosis and cholera, as well as deadly epidemics like the Black Death. However, public health measures and improved infrastructure have led to a decrease in infectious diseases and child survival rates. Underdeveloped countries, however, still experience high rates of disease due to increased urbanization. Poor living conditions in such areas can also result in an increase in violence, instability, and uprisings, which can ultimately facilitate social reform and improved government institutions.

Malaria’s Impact on Warfare

Malaria has long affected conquests and wars, hampering troop movements and preventing expansion in China’s Yellow River and Yangtze Valley. The disease afflicted over a million soldiers during the American Civil War and impacted World War I’s battlegrounds. Better drainage systems reduced mosquitoes and the US Public Health Service developed cost-effective methods to control it. The organization also encouraged public support and communicated the benefits of draining mosquito habitats, including increased worker productivity. Federal regulations demanded changes in dam design to end standing water, and newly developed pesticides effectively eliminated malaria after the US Malaria Control program. The US eliminated malaria during the Great Depression, and the nation counted no cases by 1952.

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