Abstract

This essay deploys the concept of pandemic as a set of discursive relations rather than a neutral description of a natural phenomenon, arguing that pandemic discourse is a product of layered histories of power that in turn reproduces myriad forms of imperial and racial power in the new millennium. The essay aims to denaturalize the idea of infectious disease by reframing it as an assemblage of multiple histories of American geopower and biopower from the Cold War to the War on Terror. In particular, Asia and Asian bodies have been targeted by US discourses of infection and biosecurity as frontiers of bioterrorism and the diseased other. A contemporary example of this bio-orientalism can be seen around the 2003 SARS epidemic, in which global discourses projected the source of contagion onto Asia and Asians. Pandemic as method can thus serve as a theoretical pathway for examining cultural concatenations of orientalism and biopower.

Deimperializing Pandemics

In Asia as Method, Kuan-Hsing Chen outlines a paramount task for contemporary intellectuals: to deimperialize, decolonize, and “de-cold war” current conditions of knowledge.1 Like others before him, Chen grapples with an observed impasse in postcolonial cultural studies, where critical responses to the legacies of empire remain locked in an ongoing critique of the West and hence paradoxically reinstate Western structures of knowledge as de facto frames of reference. The challenge, according to Chen, is “multiplying the objects of identification and constructing alternative frames of reference”2—constructing a new practice of thought whereby Asia and the third world can constitute primary conceptual frameworks for their own and each other's identifications and comparisons. For Chen, Asia is perhaps uniquely suited to this method, for its various post–World War II movements of deimperialism, he argues, were interrupted by the Cold War and the rise of US neoimperialism. Asia as site can thus be turned into a matrix of thwarted political histories and uncompleted epistemologies with the potential to catalyze alternative orders of knowledge, serving at once as geopolitical archive and its own internal heterotopias.

In this essay, I propose that pandemic as an object of knowledge bears a similar critical potential as Chen's Asia. Rather than the neutral description of a natural phenomenon, pandemic is treated here as a set of discursive relations, a product of layered histories of power that in turn reproduces myriad forms of biopower in the new millennium. Pandemic discourse traverses multiple spheres of contemporary life, permeating not just national and international public health governance of disease outbreaks but also cultural imaginations of infection and bodies, contact and borders, globalization and otherness.3 Politically, the framework of pandemic emergency helps grant legitimacy to sovereign and authoritarian applications of power under the sign of biosecurity.4 Socially and culturally, the fear-inducing trope of planetary contagion works to consolidate and intensify historical forms of racial othering5—exemplified, for instance, in a resurgence of biological orientalism toward China and Chinese bodies in the wake of the 2003 SARS epidemic.

This essay proposes two heuristics for pandemic as method. Following Chen, the first deploys the pandemic concept for an archaeology of imperialist knowledge. Rather than simply an archaeology of pandemic discourse, pandemic as archaeology tactically uncovers those moments in this discourse's historical development when biomedicine and biosecurity mutually institutionalized each other. As my analysis accentuates, this has been a bilateral process: even as security regimes have incorporated the logic of infectious disease emergence toward geopolitical ends, so the life sciences have articulated and constituted their microbial objects of knowledge within geopolitical contexts and terms of thought. Since this analysis focuses on a Western and primarily US-driven discourse, it is not an execution of Chen's Asia as method.6 Instead, it is a critical geopolitics, one that leverages pandemic discourse to denaturalize the idea of infectious disease and reframe it as an assemblage of multiple histories of American geopower and biopower, from the Cold War to the War on Terror. This section, then, may be considered a US-based response to Chen's call for “critical intellectuals in countries that were or are imperialist to undertake a deimperialization movement by reexamining their own imperialist histories and the harmful impacts those histories have had on the world.”7 Insofar as the geopolitical narrative I trace has Asia both near and far as its frequent target—Asia as the site of the communist axis, assorted rogue states, and terrorist insurgency—Asia may be considered the unrecognized geography that has shaped and sustained the territorial imagination of infectious disease knowledge.

The second heuristic deploys pandemic discourse to highlight the theoretical nexus between orientalism and biopolitics. If the geopolitical underpinnings of biomedicine belong to an obscured history, contemporary imaginations of pandemics often explicitly project the site of infectious disease origins onto Asia and Asian bodies. Pandemic can thus serve as one theoretical pathway for examining cultural concatenations of orientalism and biopower. Along this method, Asian sites and bodies can be analyzed as having historically and persistently provided the racialized material for processes theorized as biopolitics—but rarely for these processes' theorizing. This second heuristic I call pandemic as bio-orientalism.

Pandemic Discourse and the Fear Effect

For an exemplary illustration of contemporary pandemic discourse, we can look to the World Health Organization (WHO) and its numerous reports over the past two decades. According to WHO, infectious disease epidemics are “contemporary health catastrophes”: not only are they “common occurrences in the world of the 21st century,” but “every country on earth has experienced at least one epidemic since the year 2000.”8 Globalization is the “real driving force” behind this crisis, as increased air travel renders the cross-border spread of infectious agents ever more likely and swift.9 While we cannot undo globalization, we can atone for our past neglect. As the 2000 WHO Report on Global Surveillance of Epidemic-Prone Infectious Diseases asserts:

In the 1970s many experts thought that the fight against infectious diseases was over. In fact, in 1970, the Surgeon-General of the United States of America indicated that it was “time to close the book on infectious diseases, declare the war against pestilence won, and shift national resources to such chronic problems as cancer and heart disease.”

Indeed, complacency about the threat of communicable diseases in the 1970s led to less priority for communicable disease surveillance systems. Partly as a result, these systems were not maintained in large parts of the developing world, and this retarded recognition of the magnitude of problems posed by new and re-emerging communicable diseases, and therefore effective action to control them.10

On this account, we are currently living out the disastrous health consequences of an earlier generation's biomedical hubris and moral lapse. Not only had experts and laypeople alike been overly smug about the human conquest over microbes, but this misguided belief cost us precious time and “retarded” our biological defense systems, allowing known and unknown microbial dangers to evolve and proliferate in the intervening decades. As the report highlights, “over 20 new pathogens have been discovered since the mid-1970s,” HIV prime among them, while numerous other infectious diseases previously thought to be under control, such as malaria, cholera, and tuberculosis, have undergone a troubling resurgence.11 To optimize surveillance of these disease threats and make up for lost time, we must collect them all under one rubric—as emerging and reemerging infectious diseases, or EID, which encompasses not just new infections but also newly virulent old ones. Thus arises the contemporary category of EID as an object of scientific study and global disease governance.

This is the standard narrative of contemporary infectious disease as told in epidemiology textbooks and popular science writings. Tellingly, many of these texts also open with the notorious pronouncement, supposedly made by then-US Surgeon General William H. Stewart, about it being “time to close the book on infectious diseases.” The putative year and occasion of his utterance may differ from source to source—from 1970 to 1969 or 1967, from a congressional testimony to a White House visit or a groundbreaking ceremony—but the line is so resonant that it has been cited in countless textbooks, journal and magazine articles, public health documents, and scholarly monographs, by CDC physicians as much as New Yorker journalists.12 Even Stewart's 2008 obituary in the Lancet ends with a reference to it.13 Irrespective of their genre, audience, and level of scientific expertise, these sources are strikingly similar in their interpretation: that Stewart epitomized the medical overconfidence of an earlier era, that his sentiment “captured the hubris of the period,”14 and that he was profoundly wrong about our coming relationship with infectious diseases. What Stewart proclaimed so “confidently”15 and “enthusiastically”16 has turned out, in hindsight, to be “almost laughable naiveté,”17 and it is the “misfortune of us all,” laments one microbiology textbook, that “those wise men [like Stewart] underestimated the adaptability of the multitudinous life forms that share the Earth with us, both infectious agents and predators.”18 In all these instances, Stewart's words are conjured as a point of departure, an easy rhetorical pivot to more sobering warnings about the many microbial threats facing today's interconnected world, weaving a seeming consensus around what might be called a complacency thesis.

This official narrative about the origins of infectious disease underpins contemporary pandemic discourse. Encapsulated by Stewart's eminently quotable line, pandemic discourse puts into circulation a host of themes with subtle yet far-reaching implications regarding the fragility of the globalized world, the precarity of the status quo, the rapid reproduction of invisible enemies, the foolishness of inaction, and the moral properness of fear. With our species life constantly perched on the brink of pandemic calamity, fear is no longer an isolated or temporary emotional state but a baseline of contemporary planetary existence. In recognizing the former surgeon general's benightedness, we are prompted to feel both better and worse, at once more enlightened and more perturbed, more satisfied with our heightened awareness yet more frightened because of it. Enlightenment shifts from an experience of empowered knowledge to a paradoxical one of dread and anticipation. Epiphany makes us afraid—and rightly so, as authorities high and low admonish us. Fear is the proper posture of globalized human life.19

Most crucially, pandemic discourse generates this fear effect in order to secure our consent to a range of technologies whose ostensible rationale is to safeguard the survival of our species but that work to consolidate global forms of biopower. According to the dominant narrative, we have ended up in this present state of precarious life not because of anything we did but precisely because we did nothing. This past of collective inaction, with the 1960s to 1980s as a period of planetary surveillance lapse and lost time, makes all the more urgent the present need for biodefense preparations. One supposed lesson of this history is that we cannot trust our own sentiments and judgments, especially our individual and communal feelings of stability and safety, because those feelings have turned out to be perilously deceptive. Instead, for real security in a post-complacency age, we must place our trust in and cede our political agency to strong authority structures that rule for our own good. This discourse casts unguardedness and optimism as near-fatal blunders, contrasted with the embrace of tough countermeasures as responsible and smart action. Brian Massumi would call this regime of affective governance the politics of everyday fear, its operative logic of preemption ontopower.20 In both political and public health arenas, this model of power strategically blurs the distinction between preemptive and actual states of disease emergency so that we are saturated with fear and inculcated into habits of paralysis and compliance.21 Increasingly normalized, this power now operates under the sign of biosecurity.

Pandemic as Archaeology

The history of this paradigm of pandemic emergency and biosecurity can be retold from the perspective of a critical geopolitics, however. Charting alternative origin stories for this discourse yields three key moments in US geopolitical history: the post-9/11 War on Terror, the late 1980s–90s post–Cold War period, and the 1950s early Cold War era. As Andrew Lakoff and Stephen Collier stress, contemporary biosecurity does not occur solely or even primarily on the terrains of national policy and military defense; it spans multiple domains, constellating government actors and policy experts with health officials and life scientists as well as humanitarian activists in new assemblages of authority and knowledge.22 By understanding how perceived biological threats such as infectious disease have come to be “problematized,” or configured as targets in need of surveillance and intervention, we can better move toward “critical, reflexive knowledge” and an alternative ethics of “living with risks.”23

The most proximate scene of biosecurity's solidification is the post-9/11 US security state's War on Terror. The extent to which the American government came to coopt the language of disease emergence was illustrated by Donald Rumsfeld's oft-cited speech from a 2002 Department of Defense news briefing in which he observed: “There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don't know. But there are also unknown unknowns. These are things we don't know we don't know.”24 As Bruce Braun points out, Rumsfeld's logic mimed the contemporary perception of the “virtuality of molecular life”: just as biology increasingly gets articulated in terms of virtual networks of unknown and dangerous viruses that “circulate and recombine in novel ways, threatening our bodies and identities,” so national security came to be couched in terms of hidden networks of sleeper cells and emerging threats.25 Melinda Cooper calls this the “biological turn” in US foreign policy after 9/11, but more than a simple rhetorical resonance, she argues that this turn reflected a fundamental philosophical reconceptualization of warfare by the Bush administration. Moving away from the previous geopolitical doctrine of mutual deterrence, the US government strategically “conflate[d] public health, biomedicine, and war” so as to make operative a security agenda of “full-spectrum dominance, counterproliferation, and preemption.”26 The epidemiological tenets of microbial emergence, resistance and counterresistance, and humans' permanent warfare against germs were transferred over and made central to defense policy. Within this new security framework, war became integral to the very conceptualization of life, or as Cooper puts it, “as if permanent war were simply a fact of life.”27

In the reverse direction, national security now propels biological research—including the creation of new infectious diseases. In anticipation of potential bioterrorist attacks, the US government's agency for developing cutting-edge military technology, the Defense Advanced Research Projects Agency (DARPA), has been actively inventing antibiotics and vaccines for not only known pathogens but also ones that do not yet exist. In the name of biodefense, “DARPA finds itself in the paradoxical situation of having first to create novel infectious agents or more virulent forms of existing pathogens in order to then engineer a cure,” thus “blurring the difference between defensive and offensive research.”28 For Cooper, this ideological convergence between biomedicine and biosecurity represents the culmination of neoliberalism's politics of life, which entrenches ideas of speculative preemption and catastrophe risk so as to disable a counterpolitics. What we can further emphasize is the real geography that underlies the post-9/11 biosecurity imagination. Despite rather postmodern descriptions of Al-Qaeda as a fluid organization of dispersed and fluctuating networks, the actual targets of US antiterrorism measures remain fixed in Asia and Africa. As in the case of the 2003 Iraq War, Rumsfeld's invocation of “unknown unknowns” served to justify American military invasion of Iraq in the absence of evidence that it was stockpiling weapons of mass destruction. Concurrently, the formulation of a prototerritory of infectious disease emergence took place against the backdrop of this geopolitical theater of war.

Yet the consolidation of the biosecurity position predates 9/11 and can be traced back to the late 1980s and 1990s, as part of the US response to post–Cold War geopolitics after the dissolution of the USSR. As Susan Wright details, up until the 1980s, the American government mostly regarded terrorism as a “second- or third-tier security problem—a problem that happened elsewhere,” so that proponents of biological defense remained marginal in national security discussions.29 With the end of the Cold War, however, the former template of the Soviet threat was replaced by the discourse of hostile third-world “rogue states,” and the prospect of nuclear warfare was superseded by the menace of biological and chemical weapons of mass destruction. Before 9/11 gave a concrete context to this logic, the 1995 Aum Shinrikyo attack on the Tokyo subway provided biosecurity advocates within the US government with an early platform. This attack, they warned, represented the “index case” for contemporary acts of bioterrorism: a vital “threshold” had been crossed, a taboo lifted, and henceforth, terrorists of all stripes would follow suit by employing bioweapons on civilians.30 Bioterrorism, they argued, was “no longer the stuff of science fiction or adventure movies” but “a reality which has already come to pass, and one which, if we do not take appropriate measures, will increasingly threaten us in the future.”31 As Wright recounts, this “alarmist” stance overtook Washington during the 1990s, and the congressional budget for counterterrorism defense soared.

Biological research benefitted directly from this political paradigm shift, as the study of infectious diseases now became a security priority. Significantly, a small cohort of prominent scientists was instrumental in linking infectious disease to biowarfare as coterminous national security threats. These scientists served as key advisers in Washington, organizing research forums and participating on government panels as well as supplying successive White House administrations with numerous reports on bioterrorist scenarios. They presented their views as impartial and nonpartisan extensions of scientific expertise, and their voices carried tremendous weight in determining government policy and budget allocations as well as the direction of scientific research. Two figures in particular stood out. Donald Henderson, the elder statesman of American epidemiology credited with eradicating smallpox in the 1960s and 1970s, was crucial in lending his support to the biosecurity position. At a 1998 CDC-sponsored conference on emerging infectious diseases, for instance, he categorically dismissed the objections of bioterrorism skeptics, and in a report later that year by the Institute of Medicine and the National Research Council, he warned that it would be a “grave mistake” for the government to delay biodefense preparations.32 In that same year, he was named the founding director of the Johns Hopkins Center for Civilian Biodefense Studies, with an earmarked $1 million in congressional funding.33 Even more influential than Henderson was Joshua Lederberg, Nobel Prize–winning molecular biologist and scientific adviser since the 1950s for nine consecutive White House administrations. He organized and supervised many of the research panels at the National Academy of Sciences and the Institute of Medicine, and in his reports to the government, he repeatedly forecast the calamitous impact of biowarfare, even handpicking experts specifically to dramatize for politicians apocalyptic scenarios of bioterrorist attacks on American cities. He was the one who identified the 1995 Tokyo subway attack as a “threshold event,” claiming that “Aum Shinrikyo has done us a favor by . . . making it obvious that there is a very serious threat; that terrorists would use any means imaginable at their disposal.”34 Again, Asia enters into this history as a strategic site, this time as a “threshold” of biothreat to be held at bay, in a coordinated narrative of bioterrorism. As Wright notes, Lederberg too reaped financial benefit from his political advocacy, as he later became a board member of EluSys Therapeutics, a biotechnology company with a biodefense research focus.35 The intertwined interests of neoliberal and neoconservative forces with public health became entrenched in this era, even if only a handful of high-profile scientists were directly implicated in this development.

In fact, the basis for the conjunction between biomedicine and biosecurity was set already in the historic 1989 NIAID/NIH Conference on Emerging Viruses held in Washington, DC. This conference was attended by over two hundred American scientists and public health experts, including both Henderson and Lederberg, and it was the forum where the term emerging viruses was first coined by the conference's principal organizer, epidemiologist Stephen Morse.36 In his follow-up landmark edited volume, Emerging Viruses, Morse captured the core message of the meeting:

The problem of emerging viruses is not likely to disappear. If anything, it will increase; episodes of disease emergence are likely to become more frequent. . . . Constructive action has been paralyzed in the past by a combination of apathy and uncertainty. The AIDS epidemic is a powerful reminder of the price of apathy. It is also a demonstration that infectious diseases can still be a major threat to human life. Although we cannot yet predict specific disease outbreaks, and may never be able to, we now understand many of the factors leading to emergence. . . . Part of the question therefore becomes whether people will continue unwittingly to precipitate emerging diseases and suffer the consequences, as has happened throughout history, or will begin to take responsibility for these human actions.37

According to Morse, since recent human history has witnessed waves of epidemics culminating in the AIDS crisis, we need to understand outbreaks not as “acts of God” but within a framework of “disease emergence.” He therefore coined the phrase emerging viruses to designate not just new pathogens but also known ones that are “rapidly expanding their range.”38 As Andrew Lakoff points out, this classification is powerfully “generative,” for it unifies under one name an array of illnesses not previously linked. The term converts a “disparate set of disease threats” into a single “imperative” of biodefense preparation.39 So even if the category of EID seems “self-evident” by our time, it is a “relatively recent invention,” by a relatively elite and invested group of microbiologists and epidemiologists.40

The 1989 conference laid the conceptual cornerstone for later biosecurity techniques. Nicholas King pinpoints this conference as the catalyzing moment for what he calls an “emerging diseases worldview.” Not just a set of scientific explanations or policy proposals, this worldview, he argues, is deeply ideological: it “comes equipped with a moral economy and historical narrative, explaining how and why we find ourselves in the situation that we do now, identifying villains and heroes, ascribing blame for failures and credit for triumph,” as well as providing “a consistent, self-contained ontology of epidemic disease” that allows for strategic intervention and management.41 As King shows, in the decade after the conference, leading scientists and health officials in the United States increasingly conjured pandemic scenarios and tied them directly to national security, helping to formalize and cement the emerging diseases worldview across multiple spheres of knowledge. Endorsing a system of global epidemic surveillance and medical commoditization, this worldview represents a model of capitalist biopower that seeks not only to be omnipresent and omniscient but to profit from sickness everywhere.42 Indeed, in his edited volume, Morse already strongly promoted global disease surveillance as an “essential first step” for securing national and human health.43 He cited Henderson's proposal for creating a fleet of international disease surveillance centers modeled on the CDC, as well as global surveillance systems for early detection and rapid tracking of outbreaks, electronic databases for instantaneous accessing of medical information, and the marketization of health commodities such as drugs and vaccines.44 In fact, given the advent of internet technology and the global pharmaceutical industry, Henderson's blueprint has been not only realized but surpassed. Current systems of syndromic surveillance, which gather real-time data from numerous sources and monitor for patterns of symptoms distributed across populations, now work to “identify potential outbreaks while they are still invisible to healthcare professionals,” effectively relocating disease knowledge from physicians and patients to the information systems overseen by national security authorities.45 In turn, this disease governance template has been exported to the WHO by American CDC officials, and from there it has disseminated into the public health institutions of countries such as China, becoming ever more established on a global scale.46

Echoing King's analysis, we can also see a penchant for moral parables in the champions of infectious disease and biosecurity discourse. On their account, in a narrative that has become canonized as scientific lore, Morse and Henderson consistently portray themselves as the longtime underdogs in American public health, the unjustly ignored wise men who were never complacent, the small but marginalized contingent of microbiologists and epidemiologists who valiantly disputed the earlier era's status quo and ultimately came to be vindicated by the microbes' vengeful return. In short, they were the heroes to William Stewart's villain. Ironically, it turns out that Stewart's infamous line about “closing the book on infectious diseases” is itself the stuff of urban legends—one that, as far as the records indicate, originated in this very 1989 conference on emerging viruses, in a personal correspondence between none other than Henderson and Morse.47 Henderson had apparently heard the remark secondhand, from unnamed people who were in turn recalling a speech from memory years later, and he went on to repeat this anecdote both at the conference and in his essay for Morse's volume.48 Morse, for his part, footnoted the quotation and attributed it to Henderson in a medical textbook a few years later.49 Two journalists who attended the conference reported this line in the media, and one of them, Laurie Garrett, further popularized it in her 1994 bestselling book The Coming Plague.50 But Stewart himself never made the alleged statement, and on the contrary, he expressed the opposite view on multiple occasions that “warning flags are still flying in the communicable disease field” and that “we cannot turn our backs on microbiology.”51 That the notion of emerging viruses was bestowed official birth at exactly the same moment as the mythic invention of the Stewart quotation, and by the same group of ascendant scientists, intimates just how essential the fable of a benighted villain is to the founding legitimacy of the infectious disease paradigm, as if the latter must create its own dark prehistory to claim an epochal birthright.

Finally, if we trace the NIAID/NIH 1989 conference and its ideological roots further back, we arrive at the Cold War as another vital scene of pandemic discourse's emergence. Before Morse coined the term emerging viruses, microbiologist René Dubos was the first to use emergence in the 1950s to describe the behavior of microbes. According to Dubos, microbial evolution was far from stable or linear but radically unpredictable and disruptive, and since humans are locked in an unremitting coevolving ecology with microbes, there can be no final overcoming of them. Cooper sees in Dubos's germ theory “an alternative vision of warfare and a counterphilosophy of disease” that would ultimately culminate in the post-9/11 biosecurity credo of permanent, preemptive, speculative warfare.52 Along with his protégés, Dubos developed models of disease ecology in these early years of the Cold War.53 As Lakoff contends, this was the period of the decisive rise of an “ideology of preparedness” in US politics and public health. Toward the end of World War II, some US military strategists argued against demobilization, maintaining that the country needed to remain prepared to respond to new enemy threats such as a nuclear attack. They campaigned for “military and civilian readiness, in peacetime, for an anticipated future war,” in effect projecting a state of “permanent mobilization for total war.”54 This preparedness model was transferred over to natural disaster management beginning in the mid-1950s, when defense officials started to treat environmental disasters and modern warfare as bearing “a close affinity.”55 It also led to the founding in 1951 of the CDC's Epidemic Intelligence Service (EIS) by Alexander Langmuir, the father of infectious disease epidemiology and Henderson's mentor. Langmuir advocated an approach of “hypervigilance” against epidemics, of “continued watchfulness” on a global scale, and he proposed a global network of centers that would provide around-the-clock surveillance and early rapid detection for both natural and unnatural outbreaks.56 Henderson's later template of global disease surveillance was consciously modeled on Langmuir's. As he noted in his essay for Morse's volume, the contemporary issue of infectious disease surveillance is not unprecedented but had been raised “at least once before”—in 1950, at the start of the Korean War, when fears of a biological attack on civilian populations prompted the creation of the EIS.57 In this essay, Henderson vividly resurrected the Cold War language of permanent total war, writing that “the world is increasingly interdependent, and . . . human health and survival will be challenged, ad infinitum, by new and mutant microbes, with unpredictable pathophysiological manifestations.”58

The 1989 conference, then, had a direct lineage in Cold War epidemiological frameworks, with its presiding scientists pushing for not just a revival but permanent normalization of Cold War biosecurity techniques. Again, this history is anchored in a US geopolitics in which Asia figures repeatedly and strategically as the site of multiple forms of potential biothreat, requiring exceptional modes of power to be mobilized at home. Infectious disease discourse therefore epitomizes the insufficient deimperialization of contemporary conditions of knowledge. So far, I have used pandemic as a prism for a geopolitical archaeology. Now I turn to pandemic as a method for diagnosing contemporary bio-orientalism and tracing it to one particular historical formation.

Pandemic as Bio-orientalism

As a theory of the ways politics captures biological life into its domain—as “power's hold over life,” in Michel Foucault's original formulation, “the acquisition of power over man insofar as man is a living being”59—biopolitics seems ideally suited as a framework for analyzing the operations of disease governance. Indeed, disease plays a paradigmatic, one might say narratively indispensable, role in Foucault's history of power. Most famously, the plague inaugurated for him projects of disciplinary power, exemplified by mechanisms of panoptic surveillance and control, but this plague template was also preceded by leprosy's “rituals of exclusion.” As Foucault underscored, different diseases gave rise to different “ways of exercising power over men” and different “political dream[s]”: “The leper was caught up in a practice of rejection, of exile-enclosure . . . those sick of the plague were caught up in a meticulous tactical partitioning . . . the great confinement on the one hand; the correct training on the other. The leper and his separation; the plague and its segmentations.”60 Yet, as epidemics were superseded by endemics, “illnesses that were difficult to eradicate . . . affecting a population” as “something permanent,” so too did sovereign and disciplinary power structures give way to a contemporary “‘biopolitics’ of the human race,” represented by a modern “medicine whose main function will now be public hygiene, with institutions to coordinate medical care, centralize information, and normalize knowledge.”61 Later, Foucault would call this last type of power security: where sovereignty excludes as in the case of leprosy and discipline quarantines as in the case of plague, security inoculates as with smallpox.62 Each biopolitical moment has its corresponding disease. Philipp Sarasin calls this recurrent motif a minor “trace of infection” in Foucault's writing,63 but we can flip the order of priority here and postulate that the history of Western disease governance has been that which underlay the inception of contemporary biopolitical theory.

To be sure, for later theorists, the most telling scenes of biopower will change. For Giorgio Agamben's models of sovereign power and bare life, the intractable historical prototype would be the Nazi death camps; for Achille Mbembe's necropower, slavery and colonialism; and for Brian Massumi's ontopower, the post-9/11 War on Terror. What these subsequent articulations make ever more visible is that biopolitics becomes conceptually relevant not merely when there exists a politicization of any life but when the life to be excluded, surveilled, disciplined, detained, stripped bare, subjugated, slain, or preempted entails some form of otherness, whether racial, colonial, or geopolitical. Yet biopolitical theories often take recourse in an abstracted language of space, however real and acknowledged the historical referents, whether it is Foucault's panopticon or “spaces of security”;64 Agamben's “state of exception,” “zone of indistinction,” or “camp as nomos”;65 or Massumi's “prototerritory.”66 Mbembe is perhaps most explicit and steadfast in reversing this intellectual movement from history to theory when he moves instead from imagined geographies back to historically politicized ones. For him, the colony is “the location par excellence” for not just particular variants of biopolitics but also the accumulated operations of it: the colony, as with the plantation system and the apartheid regime, has been a consummate site for the “concatenation of biopower, the state of exception, and the state of siege.” And “crucial to this concatenation,” he emphasizes, is “race.”67

Following Mbembe, I would suggest that Asia, akin to the colony, has been the rationale for the concatenation of multiple manifestations of Western biopower; as such, it has occupied a key place in the geopolitical history, if not the conscious theorizing, of biopolitics. As we saw, over the course of the past century, Asia has been variously and strategically cited within US discourses of infectious disease and biosecurity as the threshold of bioterrorism as well as the biological other that justifies preemptive biodefense. A more recent example of the nexus between Asia and global biopolitics centers on the 2003 SARS epidemic. As the new millennium's first pandemic, with its origins in southern China, SARS incited deep anxieties and fears about the contemporary world and its breakdown of the boundary between first-world health and third-world contagion.68 The Chinese communist government's initial cover-up of the outbreak at home further fueled age-old orientalist tropes of China as the site of exotic and unhygienic culinary traditions as well as authoritarian secrecy, a lethal combination for global health security.69 It was partly in the context of these orientalist perceptions that the WHO began to act routinely beyond its jurisdiction in response to SARS, bypassing and sometimes overriding state authorities to issue travel advisories, collecting disease data from nonstate sources, and disseminating this information to other countries without the consent of affected governments. Most controversial among these measures was WHO's unprecedented global travel advisory for Hong Kong and Guangdong, a move calculated not just to safeguard global health but also to pressure the Chinese government into compliance. In 2005, the World Health Assembly would go on to revise the International Health Regulations to formalize these powers for WHO and to grant it additional authority, from everyday surveillance and intelligence gathering to crisis management. David Fidler argues that SARS radically transformed global health governance into a “post-Westphalian” paradigm, which centralizes medical authority and regulatory power on a global scale more than ever before.70 If for Mbembe colonialism and slavery are the historical forms of life that enact theories of biopolitics, we might say that bio-orientalism similarly haunts global biopolitical history.

Contemporary pandemic discourse further sustains this biopolitical history. In popular culture as much as public health arenas, Asia is frequently depicted as the birthplace of one wave of infectious disease after another. A 2004 issue of Time magazine typifies this bio-orientalist pandemic imagination: the cover image shows a giant egg about to be hatched, with a bird's beak poking through a crack in the shell, while the headline poses the ominous question, “Bird Flu: Is Asia hatching the next human pandemic?” As the article goes on to assert, the avian flu was the “latest scourge to emerge from Asia.” Barely a year after the containment of SARS, the bird flu was already “spreading with alarming speed through Asia's poultry farms,” with outbreaks in South Korea, Japan, Vietnam, and Thailand. Though the virus was not yet virulent among humans, “the great fear of health officials around the world is that the virus could, like SARS, jump the species barrier, mutate into a deadly and highly contagious form and set off a worldwide pandemic.” This “next deadly global epidemic” would be what epidemiologists call “a slate wiper,” but what endangers the world is not just the virus itself but “dissembling and stalling by local governments [that] have already allowed the pathogen to spread in Asia—not only in birds but also among the men and women who raise them for a living and the kids who gather eggs or simply kick up infected dust in their villages.”71 Given the combination of Asia's dishonest and corrupt governments, the poor hygiene and general level of medical ignorance of its rural residents, as well as the rapidity of international travel enabled by globalization, Asia stands to jeopardize public health the world over. The expertise of health officials and epidemiologists is summoned, and even the experts, the article declares, are afraid. As Priscilla Wald has demonstrated, cultural narratives of disease outbreaks follow formulaic conventions, one of which is a “geography of disease” where “timeless, brooding Africa or Asia” is imagined as “the birthplace of humanity, civilization, and deadly microbes.” Infectious diseases are constructed as third-world problems “leaking” into the global North, in a one-way traffic of emergence.72 The underlying message of the pandemic orientalist narrative seems to be that, while we may lament the loss of Asian lives to deadly microbes, we should not slacken our vigilance toward Asian bodies precisely because they may host those microbes—if not every single body in actuality, then the collective Asian body in potential.

Pandemic bio-orientalism alone, however, does not account for the range of biopolitical theories and practices vis-à-vis Asia. That is to say, an imagined geography of pandemic Asia does not thereby transform actual Asian territories and bodies into spaces of a “terror formation,” exceptional violence, or camp life à la Mbembe's colony.73 For a historical analogue that illuminates alternative orders of biopower over Asian bodies and sites, we can spotlight one particular formation of Asia within the US national polity: Chinatown. As Kay Anderson notes, historically, “Chinatown” has not been a “neutral term” but “one that relied on a range of cultural assumptions held by Europeans about the Chinese as a type . . . it was an evaluative term, ascribed by Europeans no matter how residents of that territory might have defined themselves.”74 Chinatown can thus be productively analyzed along Edward Said's lines as an internal Orient within the United States, and not fortuitously, it has served as the operative site for a wide range of public health biopolitics. We can focus here on one revealing instance: infectious disease governance in San Francisco's Chinatown.

As scholars have long recognized, nineteenth-century American constructions of Chinese racial difference often relied on motifs of Chinese cultural excess, of “disease, contagion, and pollution.”75 San Francisco's Chinatown, as the country's main port of entry for Chinese immigrants and its largest Chinese enclave up until the Chinese Exclusion Act of 1882, was considered by health officials and politicians as “a ‘plague spot,’ a ‘cesspool,’ and the source of epidemic disease and ailments,”76 associated successively with tuberculosis, smallpox, syphilis, leprosy, and plague. For example, as both Susan Craddock and Nayan Shah document, smallpox was progressively attributed to Asians and especially the Chinese over the course of the nineteenth century's closing decades, as four smallpox epidemics broke out in San Francisco. Despite the ambiguous origins and pathways of these epidemics, city health officials increasingly targeted Chinese immigrants as infectious agents and Chinatown as a “cancer spot” and a “laboratory of infection.”77 Ships from Asia with one infected Chinese passenger were quarantined, but while white passengers were simply kept on board, some of them even allowed to go ashore during the quarantine period, Chinese passengers were segregated onto another empty ship at the harbor, “left to suffer their disease imprisoned in the hull of a ship with no medical assistance.”78 Chinatown itself was subjected to a compulsory public health campaign of sanitary cleanup, with teams systematically inspecting and fumigating every household. Some health officials also advocated the building of bigger prisons to incarcerate Chinese residents who failed to comply with health ordinances, while others desired a wholesale ejection of the Chinese population and the decisive expunging of Chinatown.79 According to one health officer, the 1876 epidemic was so severe because of the “unscrupulous, lying, and treacherous Chinamen,” who had a “willful and diabolical disregard of our sanitary laws”; they were, in short, “enemies of our race and people.”80 Within this framework, the Chinese were responsible for smallpox not just as originary biological hosts with unhealthy cultural habits but also as a morally depraved and malicious enemy race intent on destroying America. In the same period, syphilis was another infectious disease often attached to the Chinese race, especially Chinese women, most of whom were regarded as prostitutes. It was considered a “female counterpart to smallpox,” with Chinatown as the immoral locale of “stench, decay, and ‘oozing slime’” where Chinese sex workers plied their sinister trade.81 These infectious disease discourses helped fuel anti-Chinese social sentiments and contributed significantly to the passing of a series of federal Chinese exclusion laws by the century's end. Conversely, they also inspired the rise of missionary reform programs by middle-class white women, who with their house-to-house Chinatown visits aimed to “rescue” fallen prostitutes as well as heathen housewives by instructing them in the ways of Christian civilization and cleanliness.82

Clearly, the medical and epidemiological racialization of Chinatown and the Chinese in late nineteenth-century San Francisco entailed a host of biopolitical techniques—not merely quarantine but segregation, not merely surveillance but incarceration, not merely expulsion but exclusion, and not merely discipline but conversion. These techniques carried a residue of racial difference, separating out not just all diseased bodies but installing additional divisions between racialized diseased bodies, in a production and reproduction of Chinese otherness. The one-to-one correspondence between diseases and power structures as envisioned by Foucault was saliently confounded in the governance of Chinese bodies, in relation to which even one infectious disease could activate an entire history of Foucauldian biopower. As Shah discerns, “At the turn of the century, ‘health’ and ‘cleanliness’ were embraced as integral aspects of American identity; and those who were perceived to be ‘unhealthy’ such as Chinese men and women, were considered dangerous and inadmissible to the American nation.”83 Aside from consolidations of national domesticity, this period also coincided with the inaugural moment of America as an empire with overseas territories in Asia and the Pacific. In these overlapping contexts, San Francisco's Chinatown may be understood as at once a municipal, national, and imperial terrain, a territorial assemblage at the crossroads of race, nation, and empire. Its discursive construction and biopolitical governance constellated local racial prejudices, nationalist ideologies, and geopolitical ambitions—the very concatenation that constitutes the prehistory of contemporary pandemic bio-orientalism.

Nonetheless, we should not conflate Chinatown's biopolitical order with more extreme historical incarnations of bare life and the medical camp during the same period, such as Hawaii's leper colony on the island of Molokai. In this other colonial annexed space, in the ambiguous geopolitical zone of the US Pacific, the introduction of leprosy was also imputed to Chinese immigrant laborers. Here the disease was called mai pake, or “Chinese sickness,” since the biomedical establishment at the time identified leprosy as an “essentially Chinese disease,” “inherent” to the Chinese race and transmitted by either heredity or sexual contact. In San Francisco, it was treated with procedures of segregated quarantine similar to smallpox cases, though dozens of “Chinese lepers” were eventually deported to Hong Kong, in an early implementation of medical deportation.84 In Hawaii, however, the majority of those infected were native Hawaiians, leading to an alternative racial discourse of disease susceptibility, with Hawaiians constructed as a hypervulnerable racial population. In addition to biopolitical measures such as those enacted over Chinese bodies in San Francisco, here, leprosy patients became medical subjects along the full spectrum of biopower, in what Neel Ahuja calls a paradigm of “racial engulfment.”85 Within a newly emergent imperialist discourse of “the Hawaiian leper,” patients were not simply isolated and quarantined, with their rights suspended in a classic configuration of detention and surveillance. More disturbingly, with the rise of liberal humanist medicine, patients were hailed as self-determining subjects who could volunteer for scientific experimentation in an exercise of their “medical citizenship.”86 The most well-known example involved microbiologist Eduard Arning and a native Hawaiian named Keanu, a convicted murderer and death row inmate. Arning offered Keanu a choice: he could follow through on his sentence of execution by hanging, or he could volunteer for leprosy research. Keanu opted for the latter, and Arning injected him with the bacterium from an infected patient. Keanu eventually developed leprosy in jail and died on Molokai several years later.87 As Nicholas Turse shows, this episode was not a singular occurrence but part of a wider practice of leprosy research via human experimentation on the island, including instances of other scientists inoculating healthy native Hawaiians with leprosy without the latter's knowledge.88

So, as Ahuja rightly concludes, the biopolitical milieu on Molokai cannot be reduced to purely that of either Agamben's sovereign power and camp life or Foucault's disciplinary surveillance or liberal governmentality. Rather, this specific biopolitical matrix strategically confuses sovereignty, discipline, and governmentality, in complex “layerings” of US imperial and racial governance. The semblance of agency and citizenship, in the proffering of a right to be medicalized and experimented on in the name of public health and human security, ultimately reproduced colonial dependency and racial stratification89—and, Mbembe might add here, death. At this historical Asia-Pacific site, we can mark the early frontiers of a bio-orientalist necropower.

Notes

2

Ibid., 1–2.

3

For cultural and literary analyses of the epidemic imagination, see Mayer, “Virus Discourse”; Wald, Contagious; Schweitzer, Going Viral.

4

For analyses of the connections between national security and infectious disease governance, see Fidler and Gostin, Biosecurity; Lakoff and Collier, Biosecurity Interventions.

5

For analyses of historical linkages between public health, infectious disease, and the governance of racialized, immigrant, or colonial populations, see Kraut, Silent Travelers and “Immigration, Ethnicity”; Craddock, City of Plagues; Molina, Fit to Be Citizens?; Ahuja, Bioinsecurities. For historical analyses of US public health governance of Chinese immigrants more specifically, see Craddock, “Embodying Place”; Shah, Contagious Divides.

6

This essay is part of a larger book project on global pandemic discourses on SARS. There I discuss not just US and WHO responses to the outbreak but also the PRC government's; in addition, I spotlight an alternative archive of non-crisis-driven cultural responses to and representations of SARS produced at the epidemic's epicenters, especially China and Hong Kong.

11

Ibid., 1–2.

12

For an example of CDC physicians using Stewart's line to discount its complacency, see Berkelman and Hughes, “Conquest,” 426; for an example of a science journalist doing so, see Specter, “Doomsday Strain” and “Risks of Viral Research.” A quick Google Books search for the phrase “close the book on infectious diseases” yields over seventeen hundred results, among them medical texts such as Essentials of Infectious Disease Epidemiology, The Encyclopedia of Infectious Diseases, and Infectious Diseases. The line has also made its way into a host of anthologies in adjacent medical and public health fields, including Pandemic Influenza: Emergency Planning and Community Preparedness, Immigrant Medicine, Foundations for Osteopathic Medicine, and A Companion to Paleopathology.

19

See Margaret Hillenbrand's essay in this issue for an analogous argument about how “the transversal nature of precarity, rather than fostering a natural solidarity, may instead breed fear over fluid social status and the ever-present possibility of a sudden plummet downward,” and how this fear of collapsed social distinctions may shape Chinese artists' and viewers' “cruel or disdainful gaze” toward contemporary subalterns such as waste pickers.

23

Ibid., 11–12, 26–28.

25

Ibid., 18–19.

27

Ibid., 98.

28

Ibid., 91.

30

Joshua Lederberg, qtd. in ibid., 73.

31

Senate Minority Staff Statement, Senate Government Affairs Committee, Permanent Subcommittee on Investigations, “Hearings: Global Proliferation of Weapons of Mass Destruction,” March 27, 1996, qtd. in ibid. 78.

32

Ibid., 88, 93.

33

Ibid., 95.

34

Qtd. in ibid., 73.

35

Ibid., 90–91.

38

Ibid., 10.

40

Ibid., 5.

42

Ibid., 776–79.

46

For an analysis of the CDC epidemic model in China's health system, see Mason, Infectious Change.

51

Qtd. in ibid., 2, 4.

55

Arthur S. Flemming, Director of the Office of Defense Mobilization, qtd. in ibid., 27.

56

Ibid., 80–81.

58

Ibid., 283; emphasis added.

77

1880 report by Committee to Investigate Chinatown, qtd. in Craddock, City of Plagues, 80.

78

Ibid., 74–75.

80

Dr. John Meares, qtd. in Shah, Contagious Divides, 1, 60.

83

Ibid., 12.

84

Qtd. in ibid., 99.

86

Ibid., 67.

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