Nomos, nosos and bios in the body politic
In the eighth book of The Republic, the discussion between Socrates and his interlocutors on the ideal political society turns to the types of ‘imperfect societies.’ A central concern throughout The Republic is the constitution and maintenance of political order, the order of sovereignty and law (nomos). Plato has Socrates devote a significant portion of this discussion to the deleterious effects of democracies. No doubt intended by Plato as a critique of the kind of democratic polis found in fifth and fourth century Athens, Plato — through Socrates’s exposition — suggests that the greatest danger in democracy is in fact the excess of opinion in matters of governance. In a remarkable passage, Socrates employs a medical analogy to talk about the ‘illness’ of democracy:
Just as a sickly body needs only a slight push from outside to become ill, and sometimes even without any external influence becomes divided by factions within itself, so too doesn’t a city that is in the same kind of condition as that body, on a small pretext — men brought in as allies from outside, from a city under an oligarchy, by the members of one party, from a city under a democracy, by members of the other — fall sick and do battle with itself, and sometimes even without any external influence become divided by faction? (1991: 235 [VIII, 556e])1
This passage assumes a number of other analogies made earlier in The Republic. Primary among them is the notion of the ‘body politic,’ or the view of the state in terms of the human body (2003: 55 [II, 368e-369b]; 153-54 [IV, 444a-e]). Though Plato never uses the term ‘body politic,’ the idea of comparing the natural body of the human being to the body of the polis was not unknown to the Greeks. In the Timeaus, one of Plato’s later texts, a relationship is set up between the macrocosm of the natural world and the microcosm of the human body. As Plato had done in earlier dialogues, the human being is described as containing three parts: a rational part, a spirited or passional part, and an appetitive part (2003: 141-49 [IV, 435a-441c]). But in the Timeaus Plato takes this tripartite division of the human being and proceeds to anatomize it: the rational part residing in the head, the passional part residing in the chest or heart, and the appetitive part residing in the nether regions of the abdomen and groin (1977: 58-61). This same tripartite division seems to echo the division of social classes in The Republic: the rational ‘head’ of the philosopher-king, the passional ‘heart’ of the auxiliary class (e.g. soldiers), and the appetitive organs of the workers, farmers, and peasant classes (2003: 54-63 [II, 368a-374e]). This basic method of analogizing the body politic from the body natural would influence later iterations of the body politic in Aristotle, Cicero, John of Salisbury, Marsilius of Padua, Johannes Althusius, Jean Bodin, and of course Thomas Hobbes, and it plays a central role in the increasing secularization of the ‘body politic’ concept during the 16th and 17th centuries.
But the ‘life’ of the body politic does not follow a straight, progressive line from Plato’s Republic, to Henry VIII’s denial of Papal Supremacy, to the beheadings of the French Revolution. In fact, it is filled with fits and starts, filled with strange, confused, hybrid anatomies (e.g., an almost cannibalistic body politic in the Medieval Eucharist, a ‘two-headed’ body politic in debates between Church and State, a clockwork body politic in Hobbes). More importantly, the discourse of the body politic in political philosophy is always accompanied by a reflection on the illness and diseases of the body politic. The passage above from The Republic is but one example. As Socrates explains, the body politic is threatened by democracy; it is threatened from within by disorder caused by an uneducated, untrained multitude making decisions of governance and driven by the dark regions of appetite or desire.
Earlier, in the fourth book of the Republic, Plato has Socrates provide the basis for the body politic analogy by suggesting that there is a further link between justice and health. Socrates asks, How do we know what justice is? Presuming that the polis somehow follows from the individual, Socrates suggests beginning with an analysis of justice in the individual, and then taking the polis as an individual ‘writ large,’ to consider justice in the polis itself (2003: 55 [368e-369b]). Again, his model is the human body: ‘there is an exact analogy between these states of mind [justice in the individual] and bodily health and sickness’ (2003: 153 [IV, 444c]). As Socrates notes, ‘health is produced by establishing a natural relation of control and subordination among the constituents of the body, disease by establishing an unnatural relation’ (2003: 154 [IV, 444d]). If the polis can be viewed in terms of the human body, then those things which threaten the unity of the polis can be viewed as sickness in the polis, as diseases in the body politic.
What is interesting is that the Timeaus, in which the tripartite division of the body is introduced, also contains a number of chapters on disease in the body. Plato has this to say: ‘The origin of disease should be obvious. The body is composed of four elements — earth, fire, air and water; and disorders and diseases are caused by an unnatural excess or deficiency of any of them’ (1977: 111-12). The dialogue of the Timeaus not only mirrors the general trajectory of The Republic, in that it moves from a consideration of the constitution of the dissolution of the body politic, but Plato is also careful enough to maintain consistency in his use of Attic declensions of the noun nosos (sickness, illness, epidemic). When he argues in The Republic that good government is analogous to health in the human body, it is this term that he uses. Similarly, when, in Book VIII, he describes democracy, oligarchy, and tyranny as illnesses in the body politic, it is again nosos that is used. Plato’s ‘medical’ view of the body in the Timeaus is most likely derived from the works that compose the Hippocratic Corpus. The three books that are titled Epidemics in the Corpus use the term nosos to broadly describe disease. The physician should take into account ‘the nature of man in general and of each individual and the characteristics of each disease’ (Lloyd, 1983: 100). In Hippocratic medicine disease arises as much from an imbalance in natural conditions (e.g. weather) as it does from an imbalance in the constitution of the individual’s body. While not espousing a unified theory of epidemic disease, the books on epidemics in the Hippocratic Corpus roughly outline a set of analogies between the natural world and the human body, a medical view of the body natural that Plato indirectly extends into a political consideration of the body politic.
In fact, the entire second half of Book VIII and all of Book IX of The Republic can be understood as a single argument: the greatest threat to the body politic comes from within. Surprisingly, Plato spends relatively little time discussing war or foreign invasion, other than to comment on the characteristics of the auxiliary or guardian class. What is of primary concern are the elements that may threaten the body politic from within, the political disorder brought about by diseased forms of government. That is, of central concern for Plato is the relation between the order of law (nomos) and the various elements that would threaten law with disorder or ‘disease’ (nosos). What is at stake in this tension-filled relation between nomos and nosos? In one sense, it is nothing less than ‘life itself,’ a social bios that is at once more than mere animal, organismic life, and yet never quite separated from its naturalistic base. Perhaps it is in the space between The Republic and the Epidemics, that we can begin to identify a specific type of ‘life itself’ taking shape, a life (bios) that is always undone from within by a disease (nosos) that threatens order and law (nomos), be it in the shape of an actual epidemic, or the diseases caused by the imperfect societies of democracy, oligarchy, and tyranny.
Nomos, nosos, and bios in U.S. biodefense initiatives
The triangulation of nomos, nosos, and bios is still with us today, but, of course, in a markedly different historical context. The U.S. ‘war on terror’ is but one example. On one level, we are witnessing the development of a social, political, and military consciousness surrounding bioterrorism. Although bioterrorist acts had certainly been committed prior to 9-11, it has only been recently that bioterror has become a central issue in national and homeland security. The first letters containing weaponized strains of anthrax were dated September 11th, and, presumably, were to be seen as part of a larger attack on the U.S. infrastructure – air travel, postal system, news, government offices (Cole, 2003). The FBI’s investigation into the anthrax attacks has turned up little in the way of meaningful evidence, but the investigation has been made more urgent in light of reports by the Washington Post that the particular strain of anthrax used in the 2001 attacks (the ‘Ames’ strain) matches the strain held at the Fort Detrick military base in Maryland (Cohen et al., 2004; U.S. Government, 2002). While the anthrax letters resulted in far fewer casualties than the World Trade Center attacks, they nevertheless put the specter of bioterrorism on the covers of Time, U.S. News, and Newsweek, as well as in the popular television dramas 24 and Medical Investigation. These and subsequent attacks by unknown perpetrators (e.g. a series of ricin attacks in Washington, D.C. in the fall of 2003) follow a common pattern: (i) the use of a toxic substance, usually in a powdered or airborne form, which does not cause death but mild to severe illness, (ii) the use of the postal system as a largely untraceable network for delivering the weapon, and (iii) an accompanying message with ideological content. If this is a pattern, then the medium is indeed the message. The aims of such bioterrorist attacks seem to be geared more towards disruption than destruction. A news feature and heightened public anxiety are as important as the actual contagion of individuals.
Alongside this emerging consciousness of bioterrorism, the late twentieth and early twenty-first centuries have seen a drastic increase in the prevalence of ’emerging infectious diseases’ (Garrett, 1994; Lashley, 2004; U.S. CDC, 2000). While AIDS, tuberculosis, and malaria continue to impact many individuals and populations worldwide, there has also been the emergence of a range of diseases which are, arguably, of a different sort. Mad cow, West Nile, monkey pox, bird flu, and SARS have, at one time or another, made headlines. These diseases are highly unstable — in some they cause the flu, in others death — and they also display erratic patterns of contagion. But what is perhaps most noteworthy of such diseases is that they have been known to rapidly mutate, enabling them to cross species barriers (including the human-animal boundary), and they are often spread via modern means of transportation (airplanes, cargo ships). In the case of SARS in 2003, the condensed run of the disease (some six months) has become emblematic of the nature of these types of epidemics (Bell et al., 2003). Poor sanitation conditions in rural poultry markets may have provided the conditions for the virus’s mutation, enabling it to jump from animals to humans. An extended incubation period in humans meant that infected individuals had time to travel by car, rail, and plane to other parts of China, southeast Asia, and Canada. Urban hotels and airports may have provided a further site for opportunistic infection as well. In response to what was quickly becoming a global health issue, the World Health Organization (WHO) made use of computer networks to coordinate patient data, gather reports from selected hospitals, and issue air travel advisories to selected airports. That is, the WHO made use of information networks to counteract an epidemic network, information transmission to counteract biological contagion and technological transportation. The rapid spread of SARS from mainland China to Canada illustrated the tight relationship between contagion, transportation, and transmission.
Both bioterrorism and emerging infectious disease present us with unique instances in which the tension-filled zone between nomos and nosos is displayed in a new light. Specifically, the concurrence of bioterrorism and emerging infectious disease provides us with a biopolitical situation in which biology, information, and war all play a role. Consider the U.S. responses to these twin ‘threats.’ On the issue of bioterrorism, the U.S. Public Health Security and Bioterrorism Preparedness and Response Act (2002) significantly increases the monitoring of a wide range of ‘suspect’ biological materials in the U.S. — including those used in legitimate, federally-funded, university-based biology labs (Kevles, 2003).2 Likewise, the U.S. Project BioShield, which was announced in 2003, offers unprecedented funds for three key areas: the development of ‘next-generation medical countermeasures’ (some $6 billion over the next ten years), NIH funding for those research projects that show promise in the development of vaccines and drugs to counter bioterrorist attacks, and new legislation which gives the U.S. Food and Drug Administration (FDA) the ability to designate ‘fast track’ drug candidates and speed up the FDA approval process (the ‘FDA Emergency Use Authorization for Promising Medical Countermeasures Under Development’) (U.S. White House, 2003). All in all, in 2002 the U.S. dedicated nearly $6 billion to biodefense initiatives for the 2003 budget – a 300% increase from the previous year (U.S. DHS, 2004). Even the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) – a program that has traditionally dealt with non-defense-related initiatives – was awarded $85 million under Project BioShield for research into ‘human immunity and biodefense’ (U.S. NIH, 2003).
In programs such as these, we see several themes coming together which characterize the post-9-11 era of national and homeland security. One of these is the emphasis on bioscience research, especially in the areas of genetic engineering, immunology, and the possible linkages to the emerging fields of genomics, proteomics, and genetic diagnostics.3 The ability to sequence the genomes of pathogens is seen by many scientists as the important first step to understanding how those pathogens are able to mutate and infect healthy cells. But alongside this there is also an equal emphasis on the technological infrastructure that enables federal, state, and local health officials to communicate and make decisions in response to possible health crises (U.S. DHS, 2004). This infrastructure includes computer databases and networks (e.g. hospital informatics, up-to-date diagnostic technologies, emergency communications systems), as well as drug production and distribution systems, and the training of health care personnel. In the broadest sense, ‘information’ plays a key role in enabling the communication of health-related data, be it via teleconferencing, via patient-specific data being uploaded to a server, or via the rapid distribution of drugs from the U.S. Strategic National Pharmaceutical Stockpile.
Yet, from the U.S. perspective, an emphasis on biology and information is only part of the equation. At all levels, the ability of government to respond to an emergency is crucial for the biological and informatic components of biodefense to operate in an effective manner. This is where the particular philosophy of war adopted by the U.S. has come into play, and it is a philosophy in the sense that, at the same time that familiar Cold War concepts are deployed (a pharmaceutical ‘stockpile’ or scenarios involving a ‘dirty bomb’), U.S. policy has ontologically redefined war along the lines of terrorism; that is, terrorism as precisely a series of non-catastrophic but highly threatening events. In this sense not only is all terrorism bioterrorism, but we may be witnessing a new definition of ‘life itself’ in which terror exists virtually in relation to life. What might this mean, for terror to exist virtually in relation to life? For one thing, it means that the use of the metaphor of war to talk about disease has ceased to be a metaphor, and that the biological affair of intentionally causing or of fighting disease is literally, in bioterrorism, a form of war. A 2003 NIAID progress report outlines some of the results of its research, which has had an added benefit for diseases not related to bioterrorism. It notes that the ‘increased breadth and depth of biodefense research not only is helping us become better prepared to protect citizens against a deliberately introduced pathogen, it also is helping us tackle the continuous tide of naturally occurring emerging infections such as SARS and West Nile virus’ (U.S. NIAID, 2003).
In short, the U.S. response to the twin phenomena of bioterrorism and emerging infectious disease has been to treat the latter in terms of the former, and to define the former — bioterrorism — in terms that efface their differences in cause, and only focus on their unanimity in effect. U.S. policy articulates this in three ways: through an emphasis on biology, through an equal emphasis on information as the inverse of biology, and through enabling an ontological redefinition of war to contextualize the links between biology and information.
Biology, code, and war: Foucault’s Collège lectures
Often, such encounters between politics and life are described as ‘biopolitical.’ But, at the same time that the term has gained a degree of widespread use, it has also lost much of its specificity. What is biopolitics today, in an era dominated by concerns over terrorism, world poverty, national security, genocide, and global health? Is all politics also biopolitics? How shall we understand the bio- of biopolitics? Equally important is the question, What is not biopolitical?
Undoubtedly, the work of Michel Foucault has done the most to theorize the notion of biopolitics. The passages most often referenced from Foucault in this regard are those that appear near the end of the first volume of The History of Sexuality. There, in proposing a shift in the nature of power relations from the sovereign ‘right of death’ to the modern ‘power over life,’ Foucault suggested that modern power relations functioned in a more bottom-up, coercive, distributive fashion, rooted not in the absolutism of the monarch but in the pervasiveness of institutions and modes of governance (1978: 135-45). Central to Foucault’s thesis is that a key shift occurs in 18th century Europe, in which the function of power becomes the ‘taking charge of life, more than the threat of death’ (1978: 143). In essays written during the same period, Foucault considers specific historical examples as indices of an emerging biopolitical era: the changes in the English Poor Law and development of labor medicine, the reformation of the hospitals in Paris along with public hygiene programs, and the theory and implementation of a ‘medical police’ in 18th century Prussia (2000: 134-56). In these and other instances, ‘biological existence was reflected in political existence’ (1978: 142), and the medical often dovetailed into the governmental.
However, it is in a series of lectures delivered at the Collège de France during 1976 that Foucault gives us what is perhaps the clearest and most thorough description of biopolitics. Entitled ‘Society Must Be Defended’ (Il faut defendre la société), the lectures take place a year after the publication of his study of prison institutions, discipline, and ‘docile bodies.’ Thus they follow upon the specific kind of ‘disciplinary power’ Foucault identified in social institutions such as the prison, the school, the military barracks, the hospital, the asylum, and so on. Foucault’s aim in these lectures is not only to account for the emergence of a disciplinary power, a power that operates through training, habit, routine, and coordinated bodily movements, but to also account for another type of power that has, as its focus, human bodies en masse, the mass bodies of human species, human populations, and human nations. Foucault calls the former type of power an anatomo-politics, focusing as it does on the individual human body and operating through disciplinary institutions. In turn, Foucault comes to call this second type of power biopolitics, which tends to focus on collective human groups or populations, and operates through governmental practices involving public health policy, statistics, demographics, and political economy. Near the end of the lecture series, Foucault offers a concise summary:
One technique is disciplinary; it centers on the body, produces individualizing effects, and manipulates the body as a source of forces that have to be rendered both useful and docileÂ… . And we also have a second technology which is centered not upon the body but upon life: a technology which brings together the mass effects characteristic of a population, which tries to control the series of random events that can occur in a living mass, a technology which tries to predict the probability of those events (by modifying it, if necessary), or at least to compensate for those effects Â… . Both technologies are obviously technologies of the body, but one is a technology in which the body is individualized as an organism endowed with capacities, while the other is a technology in which bodies are replaced by general biological processes. (2003: 249)
For Foucault, biopolitics involves three main processes, working in concert. The first is a redeployment of medical knowledge concerning the biology of populations. Here the notion of population becomes the bearer of all medical and social specificity. Biopolitics ‘tends to treat the “population” as a mass of living and coexisting beings who present particular biological and pathological traits and who thus come under specific knowledge and technologies’ (Foucault, 1997: 71). But this process of accounting for the population as simultaneously political and medical implies a certain quantitative sophistication. Thus, in addition to a medical view of the population, there is a second element, which is the development of a set of numerical, statistical, and informatic means of defining and thus managing the population. This is the biology of large numbers, which has its beginnings, for instance, in the regular use of mortality tables kept by parishes in 17th century England (Porter, 1997: 236-38). Its aim is ‘to rationalize the problems presented to governmental practice by the phenomena characteristic of a group of living human beings constituted as a population: health, sanitation, birthrate, longevity, race’ (Foucault, 1997: 73). Finally, a last element is required for biopolitics to function, and that is an infrastructure for performing this ongoing statistics of the population. This is where what Foucault calls governmentality, or the art of governing, comes into play, in which ‘the movement that brings about the emergence of population as a datum’ provides the conditions for ‘an objective of governmental techniques’ (Foucault 2000: 219). The concerns of population characteristics in light of political economy — the mercantilist view that the health of the population equals the wealth of the population — is but one example of governmental management of biopolitical concerns.
But it is in this last element that Foucault’s points about biopolitics have the most resonance for our current context of bioterrorism and emerging infectious disease. In his Collège lectures, Foucault says more about the governmentality specific to biopolitics. He asks, ‘How can a power such as this kill, if it is true that its basic function is to improve life, to prolong its duration, to improve its chances, to avoid accidents, and to compensate for failings?’ (2003: 254). In other words, what is the relation between older forms of sovereignty and the emerging, modern biopolitical practices of public health policy, hospital reform, the professionalization of medicine, and the methods of statistics and demographics? Foucault offers one response, which is that ‘the acquisition of power over man insofar as man is a living being, that the biological came under State control, that there was at least a certain tendency that leads to what might be termed State control of the biological’ (2003: 239-40). But how is the exceptional character of sovereign power instantiated in such decentralized systems, in which the bureaucratic management of numbers and bodies takes hold?
There must be some set of principles for allowing, in exceptional circumstances, the introduction of sovereign power. In other words, there must be some set of conditions that can be identified as a threat, such that a corresponding state of emergency can be claimed, in which the formerly decentralized apparatus of biopolitics suddenly constricts into the exception of sovereignty. ‘It is at this moment that racism is inscribed as the basic mechanism of power, as it is exercised in modern States’ (2003: 254). But I would argue that Foucault means ‘racism’ here in a specific, medical and biological sense. Racism in this sense is a biologically-inflected political relation in which war is rendered as fundamentally biological:
Wars are no longer waged in the name of a sovereign who must be defended; they are waged on behalf of the existence of everyone; entire populations are mobilized for the purpose of wholesale slaughter in the name of life necessity: massacres have become vital Â… the existence in question is no longer the juridical existence of sovereignty; at stake is the biological existence of a population. (1978: 137)
In a curious turn of phrase, Foucault later calls this a ‘democratization of sovereignty,’ a condition in which the sovereign state of emergency emerges through a widespread and generalized threat to the population (2003: 37). In such conditions, both a medical-biological view of the population, and a statistical-informatic means of accounting for the population, converge in the identification of potential threats and possible measures of security. In a sense, it is war that acts as the hinge between population and information, but a war that always puts at stake the biological existence of the population (and thus nation). The body natural, even as it serves as an analogy for the body politic, is always what is fundamentally at stake in the body politic.
Consider, for a moment, plague. The Black Death, which first ravaged Europe between 1347-51, made its way into Southern Italy via ships traveling along trade routes from North Africa and the Mongol region. Carried in fleas attaching themselves to rats, themselves numerous on the ships, the plague quickly spread among various Italian city-states. In a matter of five years the plague would take its toll on a quarter to a third of the European population (Porter, 1997: 122-24). Reactions and responses to the plague varied, from mass processionals of repentance, to the persecution of the poor, the non-plague-infected sick, and in some cases the persecution of Jews and Muslims (McNeill, 1988: 192-96; Watts, 1999: 8-12; Ziegler 1971: 40-62). However, amidst such responses, historians of medicine note that the first medical actions against epidemic emerge during this time (Hays, 2003: 52-61; Watts, 1999: 15-24). In 1347 the Duke of Milan ordered extreme actions to be taken, which included the forced exclusion and abandonment of plague-infected citizens from the city, as well as the barricading of the city’s walls (Carmichael, 1998). The first quarantine of ships arriving into Southern Italian ports was enforced during this period, and Florence had set up a temporary Board of Health to addresses the intermittent health crises of epidemics (Carmichael, 1986; Calvi, 1989). Health officials were responsible for overseeing the cleaning of streets, the disposal of trash, and the burial of corpses. As the plague made its way north, the sparse but noteworthy attempts first undertaken in Italy began to be followed. By the late 15th century Venice had a permanent Committee of Public Health with elected officers, an example followed by Florence, and, by the beginning of the 17th century, by many European city-states (Hays, 2003: 55-57). Within the generalized political consciousness of early modern Europe, a notion of public health began to take shape, though it was a concept fraught with internal tensions, ambiguities, and discontinuities.
Nevertheless, when plague broke out in London in 1665, public health response was significantly different from the situation of Milan or Florence in 1348. But it was not necessarily better. The Great Plague of 1665 killed an estimated one in eight Londoners in a single year (Slack, 1991). The primary public health responses were the enforced segregation of households (effectively imprisoning whole families within their homes), the placement of guards outside such segregated homes (‘Watchmen’), strict monitoring of people and goods entering the city, selected quarantine of ships entering London, and the deployment of special officials to oversee these wide-ranging policies (Slack, 1985; 1991). Although England was comparatively late in adopting official public health policies related to plague, London’s Privy Council began to formalize anti-plague policies by the 1570s, summarized in the Book of Orders (Slack, 1991). The Book of Orders compiled the mostly informal, scattered anti-plague procedures of local authorities under the auspices of a centralized government management of public health as it pertained to plague. It organized, in a pyramidal-like fashion, the transmission of information related to plague from local witnesses or ‘Searchers of the Dead’ in each parish and county, to constables, health officers, and justices of the peace. It also provided a set of protocols for taxation (for sick relief), anti-plague sanitation (which included the burning of clothes and goods belonging to the deceased), and the creation of ‘pesthouses’ outside of the cities. It even outlined procedures for how the infected should identify themselves, if they were allowed outside (adopting a policy begun in the early 16th century, the infected were to carry white rods in their hands when in public).
Daniel Defoe’s A Journal of the Plague Year (published in 1722) combines history and fiction to depict the plague in London. Foremost in his account is the tension in the text between the tragic accounts of the impact of plague on London’s poor, and the numerous tables of vital statistics that accompany the text. Such methods of accounting for the infected were in fact used, and had some precedent in pre-plague England. For instance, though records of deaths had been routinely kept by London parish clerks, it was not until John Graunt published his Natural and Political Observations upon the Bills of Mortality (1662) that information could actually be generated from such records. Graunt’s early study of demographics used basic arithmetic to show patterns in birth and death rates. However studies such as Graunt’s were not anti-plague measures, for they simply took account of plague. By the time of the Great Plague, opinions widely and vociferously differed as to the medical cause of the disease, with debates raging between Hippocratic theories of constitutionalism, theories of miasmas or ‘bad air,’ and largely speculative, unproven theories of contagion. As might be expected, attempts to counter the spread of the plague by health officials had limited success. While individuals in families might be quarantined, the effects of poor sanitation, the relative lack of hygiene practices, and the limited scientific understanding of the disease meant that most — if they could afford to — adopted the motto of ‘flee early, flee far, return late’ (Porter, 1997; Slack, 1991).
However, despite the limited effectiveness of plague measures, there are several things worth pointing to in these biopolitical contexts. First, while scientific and medical discoveries had little impact in preventing plague, the various attempts to account for its aftermath had an influence on the political economy of public health in England. Graunt’s work had shown that, if not in a medical sense, then in a political economic sense, meaningful information could be generated through demographics and statistics. His work was extended during and after the Great Plague by Sir William Petty, who used the term ‘political arithmetic’ or ‘political anatomy’ to describe such studies (Porter, 1997: 236-37). A member of London’s Royal Society, Petty gathered and analyzed information on population, trade, manufacture, diseases, and revenue that was much in line with mercantilist ideologies of the health and wealth of the population. Petty’s work was put into an equally mathematical and informational form in Edmond Halley’s ‘life tables’ in 1693, which used arithmetic to project expectations regarding life-span, and then correlated life-span to annuities (the first life insurance companies in London made use of Halley’s tables). On a general level, then, demographics and statistics began to formulate, through the numerical accounting of epidemic, a notion of population that was at once medical, political, and economic.
Along with the impact of the plague on political economy, it is also worth noting that England was beset by plague before and after the Civil War. Plague had a major impact in England in the period 1616-24, and then in the period 1654-64 (Slack, 1991). Between these two periods, the rising unrest concerning Charles I’s ‘Ship Money’ controversy led to the Long Parliament of 1640, and to some twenty years of civil strife before the Restoration (Sommerville, 1992). In this context, it is interesting to see Thomas Hobbes compare the absence of an absolute and secular sovereignty in the body politic to the ‘Infirmities’ and ‘Diseases’ of the body natural: ‘Amongst the Infirmities therefore of a Common-wealth, I will reckon in the first place, those that arise from an Imperfect Institution, and resemble the diseases of a naturall body’ (1968: 363-64). ‘I observe the Diseases of a Common-wealth, that proceed from the poison of seditious doctrines; whereof one is, That every private man is Judge of Good and Evill actions Â… . Whereby the Common-wealth is distracted and Weakened‘ (1968: 365). Hobbes goes on to make more specific comparisons between different forms of civil strife, dissent, and disobedience to a range of illnesses, from epidemics, to fevers, to parasites, to mental health, and even demonology. In doing so, Hobbes was, of course, carrying on a long tradition in political and theological discourse about the nature of the relation between sovereign and subjects, in which those elements which challenged sovereign rule were viewed as not only weakening the body politic as a whole, but were also the cause of internal discord between body and ‘head.’ Hobbes’s view was despised both by revolutionaries as well as by staunch royalists, but his rigorously secular, modern view of absolute sovereignty remains one of the central texts on the topic today. As Hobbes notes, 1640 had England ‘burning with the questions of the rights of rulers and the duties of subjects, forerunners of an approaching war’ (1991: 19). His basic message is very similar to the one expressed in The Republic: that the greatest threat to any body politic comes from within the body politic itself.
It is interesting, then, to situate Hobbes’ political etiology within the context of plague and public health in England. While the Great Plague saw actual disease impact a mercantilist view of the population, we see Hobbes responding to actual civil war in England by analogizing disease and civil discord. In this sense, Foucault’s threefold aspects of biopolitics – a medical-biological view of the population, a statistical-informatic means of accounting for population, and a political condition of war and security with regards to population – can be witnessed in the case of mid-seventeenth century England. Perhaps we can rephrase Foucault’s formulation of biopolitics, and suggest that biopolitics is the condition in which population, information, and security become intertwined in a set of practices, responses, and preparations. Biopolitics is the nexus of biology, code, and war, in which the distinction between disease and disorder is made indistinct.
Curing machines; respecifying biopolitics
Since the time of the publication of The History of Sexuality, the concept of biopolitics has been introduced into a range of fields, including the history of medicine, medical sociology, science studies, gender studies, and political theory. In some cases, the usage of the term has become so generalized that it is made to describe any situation in which political issues impact social life as a whole. In order to sort out some of these trends, it is worth pointing to recent commentaries on the concept of biopolitics.
The concept of biopolitics is playing a key role in recent writings coming out of the Italian autonomia tradition. Maurizio Lazzarato (2000), for instance, identifies the shift from ‘biopower’ to ‘biopolitics’ as mediated by a new, political-economic view of the family as part of a larger laboring body. For Lazzarato, modern biopolitics moves from the traditional political-economic concern with life and labor, to a more widespread concern with labor contextualized within a whole social body. Indeed, Lazzarato’s notion of ‘immaterial labor’ — the labor performed in the postmodern society by the service, communications, and information technology sectors — can be understood in this light as a twist in the biopolitics of labor. Along these lines, Paolo Virno (2004) has commented upon the role of biopolitics in relation to labor, and specifically in relation to Marx’s notion of labor-power. Virno warns against an unreflective, over-generalized use of the term biopolitics, and argues that its ‘logical core’ can only be understood in the context of labor. In this Virno reiterates a point Foucault has made in short essays such as ‘The Birth of Social Medicine’: that biopolitics emerges alongside the concerns of mercantilism and political economy, and in this sense the healthy population is inseparable from a laboring population (Foucault, 2000: 134-37). Virno amplifies this component of biopolitics; in his model, biopolitics acts in the service of the concerns of labor, where any biological concerns are only concerns with the physical capacity to perform work (and to be able to sell that physical potential, that dynamis, as a commodity).
Michael Hardt and Antonio Negri’s use of the term that has echoed these points. They borrow and extend Lazzarato’s notion of ‘immaterial labor’ and, like Virno, they emphasize the material components of labor power today, even as it becomes more ‘informationalized.’ But they also extend the notion of biopolitics to include the production of social life itself: ‘The great industrial and financial powers thus produce not only commodities but also subjectivities Â… they produce needs, social relations, bodies, and minds — which is to say, they produce producers’ (2000: 32). Biopolitics, in their view, cannot be comprehended without reference to that which impels biopolitics: the expansion of modes of production to include not only the production of commodities, but of services, signs, concepts, and subjectivity itself. Negri, in his own works, locates the unique character of this biopolitical production in the way it restructures time. ‘What is biopolitical control?’ Negri asks. ‘It is measure (that is, organization and limit) of the time of life’ (2003: 257). For Negri, it is not just social ‘life itself’ that is at stake, but an ontology of time and thus of measure in relation to life: ‘Measure subordinates the plurality of singular powers to a schema of organic mediations and distributes them in a hierarchy of functions’ (2003: 227). Negri acknowledges, along with Lazzarato and Virno, the instrumental aspects of biopolitics. But he also attempts to suggest something further: that biopolitical production is also radically open, in that it implies a level of cooperation, a premise concerning ‘the common,’ and a view towards an immeasurable, indeterminate future, a political future ‘to-come.’ Negri’s strategy here is less critical theory, and more in the line of a manifesto: ‘It is the biopolitical that determines all production of the world by affirming the consistency of being in constituent power and by opening the constitutive arrow of time to the innovation of the eternal’ (2003: 229). Thus, in Negri’s view, one does not simply resist biopolitics; rather, biopolitical production is the terrain on which the expansiveness of biopolitics to the production of social life is fundamentally transformed itself into a generation of ‘the teleology of the common’ (2003: 233).
However, in all these examples the very expansiveness of ‘biopolitical production’ makes it difficult to differentiate between the different meanings given to ‘life’ in the domains of immaterial labor. The ‘life’ that Foucault spoke of as being biopolitical — defined by population, statistics, and security — disappears here into a generalized social production of life as subjectivity. In this regard, Giorgio Agamben’s book Homo Sacer provides another viewpoint on biopolitics. While Agamben makes little mention of the political economic aspects of biopolitics, he does patiently reconstruct the relation between sovereignty and ‘bare life’ that, he argues, is at the heart of biopolitics. Agamben counters Foucault’s claim that sovereignty is waning in the face of an emerging biopolitics. Instead, he argues that a concern with life itself, or ‘bare life’ is found in the earliest political formulations of sovereignty in the West. The sovereign, Agamben notes, is defined not by the ability to exercise total control, but by the unique capacity to claim an exception to the rule. The sovereign is at once inside the law (in that he is the ‘head’ of the state) and at the same time outside the law (in that he has the ability to suspend the law). The sovereign’s unique characteristic is to be able to claim a state of exception (a suspension of the law that is law). The sovereign does this not arbitrarily, but in the name of something, something that is both under threat and fundamental to the existence of all. This something is a notion of bare life, life that is, like the sovereign, at once inside the political order (in that the basics of life itself are protected within society) and also outside the political order (in that biological life serves as the natural basis for social and political life).
The sovereign and the figure of bare life exist in a sort of mirror reflection of each other, at once inside and outside the political order. But this is, of course, an asymmetrical reflection, for it is the sovereign that claims the state of exception — the state of emergency — on behalf of the bare life of its population. This state of exception creates what Agamben identifies as the dangerous, volatile ‘zone of indistinction,’ where anything is possible: wars are carried out in the name of nation and population, groups are persecuted within a society in the name of the protection of other groups, those at risk are identified apart from those that they risk, and whole populations are forced from their country of origin in a massive zone of indistinction that separates population from nation. For Agamben, the euthanized life, the refugee, the figure of ‘human rights,’ the comatose patient, and the detainee in time of war, are all figures that exist in this intermediary state. Sovereignty is for him the very condition for biopolitics, for it is the sovereign’s ability to identify a state of exception, a zone of indistinction between right and violence, law and life, that results in the very figure sovereign power is supposed to protect: bare life. Thus, ‘it can even be said that the production of a biopolitical body is the original activity of sovereign power‘ (1998: 6).
While Agamben’s work does much to develop our understanding of the political and philosophical mechanisms of biopolitics, something is left out, something which is also absent in the work of Hardt and Negri: the role of medicine in relation to the ‘life itself’ of biopolitics. For Agamben, medicine is just one particular form that biopolitics takes in the broader meeting of sovereign power and homo sacer (thus Agamben traces the beginnings of biopolitics to Roman law). For Hardt and Negri, biopolitics is primarily the relation between social life and labor, with medicine or bioscience not being a factor at all (although even Marx commented on the transformations of the ‘species being’ in labor power). In these interpretations, one cannot account for the way that a hegemonic science articulates ‘life itself’; one cannot account for the character of the bio– part in biopolitics. Recall that, for Foucault, it was precisely the role and historically-changing meanings of medicine that mediated between politics and life. It was Foucault’s general claim that biopolitics does not happen without the requisite medical, biological, and scientific infrastructure to identify the possible threats to the population, or, indeed, to identify ‘population’ itself as a biological and medical concern. ‘Medicine is a power-knowledge that can be applied to both the body and the population, both the organism and biological processes, and it will therefore have both disciplinary effects and regulatory effects’ (Foucault, 2003: 252). This is not simply a doctrine of ‘medicalization,’ but a recognition of a condition in which medical and political concerns always fold in upon each other.
Unfortunately, Foucault never produced a sustained historical analysis of biopolitical practices in the way he did for the biopower of criminality, sexuality, clinical medicine, or madness. One exception is the dossier he produced, along with several colleagues, on the origins of the modern hospital in France during the 18th and 19th centuries. Published in 1979 under the title Les machines à guérir (‘Curing Machines’), this collection of essays, chronologies, historical documents, and notes outlines many of the concerns Foucault expressed in his essay ‘The Politics of Health in the Eighteenth Century’ (an essay included in the publication). Denying a strict split between a private, ‘liberal’ medicine and a state or governmental medicine, Foucault notes the strategy common to both in 18th century Europe: a ‘noso-politics’ centered around the imperative of health of social groups: ‘The eighteenth-century problematization of noso-politics correlates not with a uniform trend of state intervention in the practice of medicine but, rather, with the emergence at a multitude of sites in the social body of health and disease as problems requiring some form or other of collective control measures’ (Foucault, 2000: 92). Foucault identifies an inward-turning and an outward-turning trend in this regard: an increasing medicalization of the family, not just as a matter of private life, but as a unit connected to a larger labor force and social body, and, at the same time, an increasing ‘dehospitalization’ of medical care in public hygiene programs, public order measures (pertaining to beggars, the poor, criminals, vagabondage), dispensary programs, and an urban medicine dedicated to monitoring the always-immanent ‘pathogenic city.’ These trends form not just a private or public medicine, but a whole ‘curing machine’ in which security, population, and information are intertwined:
The hospital must function as a ‘curing machine,’ First, in a negative way: all the factors the make the hospital dangerous for its occupants must be suppressed Â… . Second, in a positive way, the space of the hospital must be organized according to a concerted therapeutic strategy, through the uninterrupted presence and hierarchical prerogatives of doctors, through systems of observation, notation, and record-taking. These make it possible toÂ…globalize the data that bear on the long-term life of a whole population. (Foucault, 2000: 103-104)
The Les machines à guérir dossier focuses on the proposals and plans for the construction of hospitals in France, including the renovations proposed to the Hôtel Dieu, infamous during the preceding era for being a hotbed of infection. Foucault and his colleagues show, through documents, architectural plans, and statistical records from the period, how the intersection of population, information, and security transform the modern hospital. As the authors note, ‘the healthiest (sain) country is the country where one lives the longest; the most unhealthy (insalubre) hospital is that which loses the most ill in proportion to those that have recovered; it loses more men, because it sets more obstacles in the way of their healing, because it brings together more of the causes of unhealthiness (insalubrité)’ (1979: 78). In this sense, the healthy body natural is also a healthy body politic, but a healthy body natural understood not simply as an individuated sick person, but as a healthy population, one accounted for numerically and modulated through a set of political-economic means insuring the security of the population.
War as biology, biology as war (a digression)
One always makes an exception for ‘life.’ Is there any other way? In this regard biopolitics is precisely the articulation of ‘life’ as an exception. There is no better cultural expression of this than the films, novels, and games that constitute the ‘zombie-epidemic’ genre. Having gained a great deal of popularity recently with films such as 28 Days Later, Resident Evil: Apocalypse, the slapstick Shaun of the Dead, and an un-ironic remake of Dawn of the Dead, the genre has also expanded into comics (Criminal Macabre) and video games (the Resident Evil franchise).
But the figure of the zombie — the living dead, the mass of living corpses that are only bodies, that are only bare life — is much older than this. ‘In 1179 the Third Lateran Council formalized a leper’s separation from the community into an awful ritual. The leper knelt before the church altar under a black cloth, with a black veil over his face. An office for the dead was pronounced over him, and the priest threw spadefuls of earth from the cemetery on him’ (Hays, 2003: 22). The priest would then read aloud what became, in much of Europe of the middle ages, the dictates of the leper laws, forbidding lepers any interaction whatsoever with communal and social life. The leper was, to the community, as good as dead, a living death walking on the outskirts of social life. ‘The only two organs really affected and injured by the plague, the brain and the lungs, are both directly dependent upon the consciousness and the will Â… the plague seems to manifest its presence in and have a preference for the very organs of the body, the particular physical sites, where human will, consciousness, and thought are imminent and apt to occur’ (Artaud, 1958: 21).
The zombie-epidemic genre contains a number of noteworthy elements that concern the political and social aspects of epidemics. For instance, there is an ambivalent relation between magic and medicine. Western medicine and science often are forced to confront the supernatural body, either to explain the supernatural as merely superstition, or to fail to account for forces beyond the reaches of reason and science. An example is Lucio Fulci’s film Zombie, which re-locates a Dr. Moreau-like, colonial doctor in a tropical island undergoing a zombie epidemic, itself a byproduct of the doctor’s experiments. The doctor is ultimately unable to account for the results of his own experiments, eventually succumbing to the zombie epidemic himself. The zombies in such films always appear in the plural, as populations of zombies; they ten to be represented in large masses or as a mob, but in slow-motion, often representative of a “silent majority,” or a population whose voices have, for political, social, and economic reasons, been silenced. In George Romero’s Day of the Dead, for instance, zombie masses are the avenging force of immigrants, who take their revenge upon a border-controlling military. In the Hammer Studios film Plague of Zombies, the zombies in small town are turned into a slave work force by the local land-owning capitalist. While not all zombie films incorporate medicine and science, a great deal of them directly or indirectly configure the mass of zombies as a disease, an infestation of death into life, a disease in which the very distinction between life and death is effaced. This perversion of biological life, of life outside the language of nature, a pathology of life, is further seen in films such as Aldo Lado’s The Short Night of Glass Dolls, in which the wealthy old extract life from the young, who are then condemned to an inert but waking consciousness in the morgue.
However, it is Romero’s classic film trilogy which provides what is perhaps the most sustained meditation on the metaphor of the zombie. Horror films featuring zombies had previously been made in the U.S. – in the late 1920s, Bela Lugosi starred in White Zombie, followed by Jacques Tournier’s I Walked with a Zombie, both of which emphasized the colonial context of Haiti. Romero gave the zombie a decidedly American turn, however, by featuring more explicit references to science, technology, and modernity, and by recasting the horror genre in terms of political satire. In Night of the Living Dead (1968), Dawn of the Dead (1978), and Day of the Dead (1985), Romero returned to the common motifs of the zombie-epidemic genre: a process of both real and symbolic infection (in which various social ills are materialized in the living corpse of the zombie), a process of transmission (in which blood, brains, or flesh serve as the vector for turning the living into the living dead), and processes of consumption (in which the line dividing infection and cannibalism is often effaced altogether).
Many of the key themes of zombie films, and their meanings in American culture, can be understood through an (albeit ad-hoc) analysis of Romero’s living dead trilogy:
|Night of the Living Dead (1968)||Dawn of the Dead (1978)||Day of the Dead (1985)|
|Location||House (domestic)||Mall (consumer)||Bunker (military)|
Romero’s films always contain three types of characters: a power elite (police, military), a small group of survivors (the anti-heros), and of course the population of the living dead (that is, everyone else). However, from the first to the third film, there are a number of shifts in the character of the zombies. One is that the zombies go from mob rule to being characterized as the silent majority. In Night of the Living Dead the zombies are the social ill, depicted as if they were a lynch mob, and by and large we as viewers do not sympathize with them. By Day of the Dead, however, the zombies are the disenfranchised, symbolized by the figures of the immigrant, the homeless, and the war veteran. They are those literally shut out from society, and, seen in contrast with the military force and mad scientists occupying the bunker, we as viewers do sympathize with them. In Day of the Dead, the zombies are not the social ill, but only its effects; the real social ill is inside the bunker.
Another shift in Romero’s zombies is from massification to individuation: in Night of the Living Dead and Dawn of the Dead, the zombies are always a single group and never individuated, a homogenous biomass. In Day of the Dead, however, the zombies become individuated; they are become characters we as viewers sympathize with (e.g. the zombie ‘Bub’ in Day of the Dead who becomes, in a sense, a strange sort of hero in the film). What is interesting to note is that, in Day of the Dead, when zombies are individuated, they are no longer emblematic of the immigrant population, but rather of another type of silent majority: the disabled, the veteran, the uneducated.
Finally, the zombies in Romero’s trilogy effect a third shift, from defense to cure. In the first two films, the uninfected survivors spend most of their time warding off the zombies with the usual tactics: fire, dismemberment, and bullets in the head; only in special circumstances will the uninfected actively seek out a confrontation with the zombies. By the third film, the survivors are not only working towards a ‘cure,’ but they actively confront, strategize, and negotiate with the zombies. The Foucauldian ‘curing machines’ (machines à guérir) have been put into place, such that the act of healing (guérir) is always defined in a state of war (guerre). There is an ambiguity here regarding the dual functions of curing and combating.
The dissolution of the body politic
From the perspective of political philosophy, the body politic is always a matter of constitution. Even in more recent critiques of the nature of sovereign power implied in the body politic, what is at stake is still the constitution, the formation of the body politic, even if this constitution is bifurcated along the lines of ‘constituent’ and ‘constituted’ powers. And indeed, if the modern notion of sovereignty gains its legitimizing force from its moment of constitution (whether via a Hobbesian covenant or Rousseauian social contract), then it does seem that it is the very production of a ‘zone of indistinction’ or state of exception that is at stake. As Agamben notes, ‘what is at issue in the sovereign exception is not so much the control or neutralization of an excess as the creation and definition of the very space in which the juridico-political order can have validity’ (1998: 19).
As we’ve seen, this moment is often formed through a corporealizing process, in which some relation is set up between the body natural and the body politic. That relation may take the form of an analogy between the macrocosm and the microcosm, as it does in Plato, or it may take the form of an analogy between the ‘economics’ of the family unit and the politics of the state, as it does in Aristotle. The body politic may be informed — however indirectly — by the correspondences of humoral medicine (as it still is in Aquinas, via Averröes), by mechanistic physiology (as it is in Hobbes), or by an organicism emphasizing the relation of parts to the whole (as it is in Hegel and Rousseau). Whatever the case may be, it is worth reiterating the principle that unites this corporeality of the body politic: a foundationalism surrounding ‘life itself.’ While rarely described in specific terms, it is nevertheless this decidedly corporeal notion of ‘life itself’ that is at the core of the constitution of the body politic. ‘Life itself’ is not only the foundation upon which the body politic is constituted, but it is, more importantly, the core around which the ongoing decisions regarding the sovereign exception are made.
But, in these same texts in which the body politic is constituted on the foundation of ‘life itself,’ there is also a counter-movement in which the body politic is depicted as a body undergoing illness, decay, and death. As we have seen, Plato sets up direct analogies between the ‘imperfect societies’ of democracy, oligarchy, and tyranny, and the illness of the body. There is a largely unexamined tradition here, in which the body politic is vaguely medicalized in relation to disease: John of Salisbury’s twelfth-century Policraticus describes tyranny as a disease in the body politic, Aquinas’s political writings discuss the ‘mystical body of the Church’ (corpus Ecclesiae mysticum) through an explication of its physiology (itself influenced by St. Paul’s corporeal metaphors), in chapter XIX of Locke’s Second Treatise of Government, the breakup of the legislative branch is described as dissolution and death, and Rousseau notes that ‘the body politic, like the human body, begins to die from the very moment of its birth, and carries within itself the causes of its destruction’ (1988: 194).
What is particularly noteworthy in this regard is a technique used by several authors putting forth a decisively secular vision of the body politic, to create what amounts to tables of comparison between diseases in the body natural, and threats to the body politic. For instance, Thomas Starkey’s Dialogue Between Cardinal Pole and Thomas Lupset (written in 1535-36), carries out a more systematic analysis of the body politic and the particular diseases that afflict it (England’s decline in population as akin to ‘consumption,’ the unemployed poor are compared to ‘dropsy,’ and the dissent of commoners against the monarch is a ‘pestilence’) (1948: 79-83). Hobbes, as we have noted, spends an entire chapter documenting the correlation between diseases and various political actions and ideologies that threaten the unity of the sovereign power. In a sense, each political treatise which spends time explicating the constitution of the body politic is often obliged to spend time acknowledging the dissolution of the body politic. And the aim of such analogies is to reinforce the naturalness of the body politic (and in particular, the sovereign), as well as to deter or dissuade any possibility of popular dissent or civil strife — to prevent revolting bodies.
In fact, we can suggest something further about this hidden history of the body politic: that, in the body politic, disease is always the medicalized lens through which dissent is interpreted. Although the passages in these political treatises that deal with the disease analogy are short in comparison to the entire chapters dedicated to the origin of the body politic, in a sense they are more important, for they function as furtive, uncertain acknowledgments of the possible end of the very concept of body politic. Hobbes, as well as Spinoza — arguably on opposite sides of the fence politically — both agree that the greatest danger to the body politic comes from within. Even for Spinoza, the newfound theorist of democracy for many contemporary thinkers, ‘the fickle disposition of the multitude almost reduces those who have experience of it to despair, for it is governed solely by emotions, not by reason’ (1951: 216). The same things that constitute the body politic are therefore also the things that dissolve it (the ‘multitudes,’ civil strife, dissent, factionalism). Put another way, the body politic is defined by a set of topological fissures that are immanent to it, for it contains its own capacity for disease, dysfunction, and in some cases death. While such political treatises spend a great deal of time working out the constitution of the body politic, there is another position we can adopt in understanding their relevance for our current era of the war on terror, bioterrorism, and emerging infectious disease.
This is a shift from the biology of the body politic to a necrology of the body politic. Instead of focusing on the narrative of constitution of the body politic, a necrology would focus on the furtive, fragmentary, admissions of the dissolution of the body politic. A necrological analysis of the concept of the body politic in 16th and 17th century political thought — whose basic concepts (sovereignty, right, consensus) are still with us today — would reveal to us several things. For one, it would suggest that in any political order, there is always a greater threat from within the body politic than from without. It would also suggest that, keeping with the medical analogy, the dissolution of the body politic is an endemic problem, perhaps even an autoimmune problem. Finally, a necrological view would suggest that the body politic is always defined by and even constituted by its capacity for dissolution. This last point is in many ways the most important, for it suggests that part of the function of sovereign power — especially today in the age of global ’empire’ — is to carry out the ongoing management of a political order by constituting points of dissolution or threats. In other words, sovereignty today derives its legitimacy from its ability to continually identify potential and actual ‘diseases’ in the nation and threats to the population.
From biology to necrology
No situation is more exceptional than disease — except, of course, war. Indeed, one the hallmarks of contemporary biodefense initiatives in the U.S. is the implosion of biology and war in the dual biopolitics of epidemic and terror. A case in point is the U.S. Biosurveillance Program, put into place in early 2004 under the auspices of the Departments of Homeland Security (DHS) and Health and Human Services (HHS). With a budget of $274 million, the Biosurveillance Program aims to develop an information-based infrastructure for the real-time, nation-wide detection of potential outbreaks of disease (U.S. DHS, 2004). It builds upon Project BioWatch, an experimental early-warning system tested in several U.S. cities in 2003 (Hoffman et al., 2003; U.S. CDC, 1995; 2000). The CDC has, since the 1990s, had several such ‘disease surveillance’ or ‘syndromic surveillance’ systems in development within the U.S., including the National Electronic Disease Surveillance System (NEDSS), and a similar system was used during the 2002 Olympic Games (Gesteland et al., 2003; U.S. NEDSS, 2000). While the technical specifics of such systems vary, what many of them have in common is the use of information networks to gather and analyze data from hospitals, clinics, pharmacies, and possibly insurance companies, an idea that has met with significant resistance, especially regarding issues of privacy. The U.S. CDC and HHS have recently proposed clarifications to the 1996 Health Insurance Portability and Accountability Act (HIPAA) that offers greater individual control over ‘protected health information,’ though, according to another report, it is still unclear whether health professionals will be mandated by law to report patient-specific health data as part of the Biosurveillance Program (Roush et al., 2001).
Nevertheless, the ongoing development (and funding) of various surveillance initiatives illustrates the degree to which the broad concept of biodefense has come to include both bioterrorism and epidemics in a unique zone of indistinction. This implosion has been made explicit in the way that the U.S. government speaks of biodefense. Consider President Bush’s remarks in his 2001 State of the Union address: ‘Disease has long been the deadliest enemy of mankind Â… . We have fought the causes and consequences of disease throughout history and must continue to do so with every available means. All civilized nations reject as intolerable the use of disease and biological weapons as instruments of war and terror’ (U.S. White House, 2002). At a press conference announcing the Biosurveillance Project, HHS Secretary Tommy Thompson noted that ‘these new investments will not only better prepare our nation for, and protect us from, a bioterrorism attack, they will also better prepare us for any public health emergency. In fact, we’ve already seen our investments pay off last year in CDC’s leadership in fighting the SARS outbreak, and a coordinated public health response to the West Nile Virus’ (U.S. DHS, 2004).
No one will deny the real threats posed by emerging infectious disease, and the limited but demonstrated effectiveness of bioterrorism; that is, obviously, not what is at issue here. What is at stake is the manner in which U.S. biodefense policy has created an atmosphere in which it is impossible to distinguish national security from public health, war from medicine, terror from biological ‘life.’ The inordinate amount of funding and emphasis given to biodefense nearly suggests that public health can only be improved through the condition of permanent exception that is war, that the health of the population can only be improved by continually targeting the population as biologically vulnerable. In the case of U.S. biodefense policy, the perspective of necrology shows us that the current biopolitical state of emergency is maintained by constantly producing the virtual dissolution of the body politic. Here, security, defense, and medicine fold in to a single problem: how to identify any and all threats to the ‘life’ of the population, such that prevention and preemption will coincide perfectly. The threat to the body politic is also the threat to the collective body natural, and thus the threat to ‘life itself’ is also ‘life itself’; the threat to the medico-political conception of the state is, at some basic level, biology. The very concept of biological warfare implies this — biology is the weapon, the means, and the target all at once. U.S. biodefense policy is actually a philosophical, even existential statement: that, be it an intentional bioterrorist attack or an unintentional epidemic, the common threat to the population is ‘life itself.’ By definition, this undeclared ‘war on biology’ is without end, precisely because ‘life itself’ is constantly threatened with its own end.
In a sense, however, this biopolitical situation is to be found wherever a governmentality of public health confronts a medical emergency that is also a perceived political emergency (war, famine, epidemic, natural disaster). Indeed, the historical examples Foucault gives of biopolitics all suggest that public health always develops in a state of exception. The situation of U.S. biodefense today is, in this sense, no different. What is unique about the situation today is that the way in which that state of exception is governed. Today, over and above the networks of infection and transportation that make epidemics and bioterrorism possible, we are witnessing a network of communication and information that is deployed as a countermeasure. The CDC’s NEDSS combats West Nile virus, the WHO’s network combats SARS. Networks fighting networks. Today, it is information or code that mediates between war and biology. Computer databases at hospitals, information networks transmitting real-time health data, protocols surrounding the handling of medical data in relation to insurance companies, FDA approval of new vaccines for anthrax and other bioweapons, investment in pharmaceutical R&D, and the use of high-tech diagnostics technologies (pharmacogenomics, DNA microarrays), will all be used in this biopolitics.
We can move, then, from biology to necrology. In doing so, we point to the complicated layers of analogy, metaphor, and artifact in the U.S. biodefense ontology. Disease accounts for social ills, but in the form of epidemics it is a social ill. War provides the interpretive lens through which to metaphorize medicine, as well as to literalize the technology of biological weapons and bioterrorism. War and disease impact each other, and infect each other, in ways that are at once metaphorical, material, and artifactual. In this regard, a necrological perspective is worth thinking about as the boundary between bioterror and epidemic is blurred, for it raises the key issue of how a notion of ‘life itself’ is mobilized to guarantee sovereignty in the age of biopolitics.
Recall Aesop’s ‘fable of the belly,’ here given a decidedly militaristic interpretation by translator L. W. Daly:
The belly and the feet were arguing about their importance, and when the feet kept saying that they were so much stronger that they even carried the stomach around, the stomach replied, ‘But, my good friends, if I didn’t take in food you wouldn’t be able to carry anything.’ So it is with armies too. Great numbers would mean nothing if the generals did not exercise good judgment. (Aesop, 1961: 148)
A necrology is thus one attempt to think beyond the genealogy of the ‘fable of the belly.’
1 The translation is by Bloom. Other contemporary English translations offer some variants. The Lee translation stresses the connection between disease and dissension, whereas the Bloom translation emphasizes the role of balance in body and polis. The Lee translation is the point of reference for other references within the text, primarily because it is the clearer, more straightforward translation for the purposes of this essay.
2 The U.S. Food and Drug Administration (FDA) has links to the Bioterrorism Act, online at http://www.fda.gov/oc/bioterrorism/bioact.html.
3 For instance, the U.S. NIAID has a program dedicated to genomics and proteomics applications for biodefense (including a NIAID Microbial Sequencing Center), online at http://www.niaid.nih.gov/dmid/genomes/pfgrc/default.htm.
Aesop Without Morals (1961) Trans. L.W. Daly. New York: T. Yoseloff.
Agamben, G. (1998) Homo Sacer: Sovereign Power and Bare Life. Trans. D. Heller-Roazen. Stanford: Stanford University Press.
Aquinas, T. (1997) ‘On Kingship’ (De Regimine Principum), in D. Bigongiari (ed.), The Political Ideas of St. Thomas Aquinas. New York: The Free Press.
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