By Porter Anderson, Editor-in-Chief | @Porter_Anderson
‘Political Allegiances Are Defining Science’A scientist, pediatrician, and global health advocate, author Peter J. Hotez, MD, PhD, couldn’t have had a better demonstration of what his new book is about if he’d orchestrated it, himself.
As Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science was released today (March 2) by Johns Hopkins University Press, the Republican governor of Texas, Greg Abbott, abruptly announced that “It’s now time to open Texas 100 percent,” canceling that huge state’s masking requirement and allowing businesses to operate at full capacity.
As Julie Bosman and Lucy Tompkins report at The New York Times this evening, Abbott’s move comes one day after Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in a White House briefing, “We stand to completely lose the hard-earned ground we have gained” if citizens, let alone state governments, don’t maintain COVID-19 precautions.
In a release day interview with Publishing Perspectives, Hotez—who directs the Texas Children’s Hospital Center affiliated with Houston’s Baylor College of Medicine—goes right to the point of his book’s title: political dynamics have revved anti-scientific rhetoric and agitation to a fierce level of intensity in the face of the coronavirus COVID-19 pandemic.
“One of the things we’ve learned about COVID-19,” Hotez says, “is that it’s not only the virus. This is an era when political allegiances are defining science.”
A committed internationalist, Hotez puts Donald Trump into a gallery of world leaders in COVID-19 denial, including Brazil’s Jair Bolsonaro; Nicaragua’s Daniel Ortega; Mexico’s Andrés Manuel López Obrador; the Philippines’ Rodrigo Duterte.
“And there’s Putin,” Hotez adds, “lobbing hand grenades with his system of weaponized health communication.”
Hotez is monitoring his most immediate concern for the American market—the B.1.1.7 “UK” variant’s fast rise, with an epicenter in southeast Florida. He speaks from his offices as dean of the National School of Tropical Medicine and a professor in molecular virology at Baylor College of Medicine.
“We have to create a new global governance around combating anti-science,” he says.
“And at the same time, we have to build up vaccine development capacity. You know, the fact is that no new vaccines can be made on the African continent or in the Middle East. There’s barely anything in Latin America. And so we end up with this dependence on the multinationals, which are always going to prioritize North America and Europe.”
His understanding of what the pathogen is revealing on the international scale is based in his own work in “vaccine diplomacy,” which he describes as “simultaneous scientific and diplomatic opportunities between nations.”
Serving as Barack Obama’s US science envoy from 2014 to 2016, he honed his understanding for a balance of medical science and political energies in initiatives between Washington and capitals in the Middle East and North Africa. Between 2000 and 2017, he writes, the annual worldwide children’s death toll from measles fell from nearly 500,000 to fewer than 100,000, an evaluation revealed by the investigators linked to the Global Burden of Disease Study, supported by the Gates Foundation.
‘Unexpected and Fundamental Changes’
Despite data that could reveal such progress, “after Ebola and Zika”—which of course is how a virologist marks time—Hotez says he and his colleagues could see a global health security agenda forming.
“We met at Davos,” he says, “and put together the Coalition for Epidemic Preparedness Innovations (CEPI). So there was already a recognition that terrible things were coming and there were some measures taken to mitigate it. But it just didn’t match the scope of something like COVID-19.”
Nevertheless, the reason his first chapter in the new book is titled “A New Post-2015 Urgency” is because it was in that year that “We started to see unexpected and fundamental changes leading to a new order in which infectious and tropical diseases either emerged or returned.”
Six years later, Hotez, in his last chapter of the new book, “The Broken Obelisk,” lays out what he sees as the best hope of a path forward.
“Today,” he writes, “the G20 nations, comprising 19 countries and the European Union, represent almost 90 percent of the global economy, yet they also harbor most of the world’s poverty-neglected diseases, including the NTDs [neglected tropical diseases]. My finding that poverty-related neglected diseases are now widespread among the G20 nations has relevance …
“I would like to see vaccine diplomacy shaped as a priority for a future G20 summit, with a focus on some key areas.
“First would be a commitment from each of the G20 nations to confront neglected diseases. Based on my analysis of data released both by the WHO and the Global Burden of Disease Study, curing and preventing disease among the poor and vulnerable populations living amid wealth in the G20 has the potential to eliminate more than two-thirds of the world’s neglected diseases.
“Research and development is central to addressing global neglected diseases. Along those lines, every member country of the G20 should agree to establish national innovation funds to promote the development of neglected disease vaccines. The national innovation funds created by the Japanese and South Korean governments (in collaboration with their indigenous life sciences industries and the Gates Foundation) represent interesting templates, but we need greater participation and similar initiatives from all of the G20 nations, especially the large, middle-income BRICS countries (Brazil, Russia, India, China, and South Africa).”
‘Five or Six Years of Decline in Global Health’
While the impact of the contagion on the world publishing industry still is being assessed—with the International Publishers Association (IPA) taking the lead in its From Response to Recovery survey work—Hotez is ready to make it clear what his three top messages are in Preventing the Next Pandemic.
- “First of all,” he says in our interview, “COVID-19 is not something completely different from what we’ve been seeing. It’s the culmination of five or six years of decline in global health.
- “Second, the drivers of disease are not the things we biomedical scientists usually think about. They’re not microbiological factors. They’re things like war and political instability and climate change and urbanization, human migrations, shifting poverty, and this very important rise in anti-science. These are human-made forces, and right now we don’t really have effective international mechanisms for litigating these things.
- “And so the third point—as if it isn’t clear by now—is that pandemic disease and neglected diseases are as important as all the other things we put in belt and suspenders for in terms of infrastructure, like nuclear deterrence and combating global terrorism and climate change.
“We need to think of pandemic disease in the same context as other global security threats.”
And before it’s dark on the day of his new book’s launch—about the time when a lot of authors might be working on a drink in a masked or Zoomed launch party—Hotez is where most people now know him: on his office camera. He’s become one of the most familiar faces of the cohort of public health specialists who work MSNBC and CNN’s air at all hours of the day and night, parsing the daily shifts in news around the pandemic for viewers trying to keep up with epidemiological realities they’d never encountered until the coronavirus COVID-19 became unavoidable.
He’s talking to CNN’s The Lead anchor Jake Tapper as the news breaks that his own state’s governor, Abbott of Texas, is announcing an end to coronavirus mitigation efforts, including masking.
“I side with [CDC director] Dr. Walensky here,” Hotez says to Tapper, “because I share her concerns about this B.1.1.7 variant. We saw in the UK what happened. It appeared in September and by December, it had out-competed and dominated all of the other virus lineages. We saw a heightened level of transmissions, so this is a more transmissible virus. And the UK government has put up data that hasn’t been peer-reviewed but it looks pretty compelling, saying that this variant is more lethal, as well.”
In short, the anti-science factor that’s so deeply complicating this pandemic’s presence in our lives and deaths has appeared again. Once more, a conservative governor has dismissed what the scientific community is saying. He’s telling the 29 million residents of Texas that the state is now “100-percent open.”
Hotez leans into the camera in his lab coat: “With B.1.1.7 accelerating, this is the time that you don’t want to begin relaxing restrictions. I understand that we’re beginning to vaccinate, but we’re just starting. Only about 15 percent of the [US] population has received a single dose with very modest levels of protection.” Indeed, only 8 percent of the American population of 328 million is so far fully vaccinated with both doses of the mRNA vaccines from Pfizer-BioNTech and Moderna.
The new Johnson & Johnson one-dose vaccine has just gone into the first citizens’ arms today, president Joe Biden invoking the Defense Production Act to have that manufacturer’s rival, Merck, retool two facilities to produce the Johnson & Johnson vaccine amid the rising urgency of the moment.
“If we were to hang on a few weeks,” Hotez says, “we’d learn a lot more. We’d figure out what this variant is doing and we’d have a higher percentage of the US population vaccinated.”
But even as Abbott “opens” Texas, Mississippi’s governor, Tate Reeves, also Republican, is rolling back his state’s rules on businesses and lifting mask mandates.
It is, as Hotez’s title puts it, a time of anti-science.
The Politics of a Plague
For many publishers, there’s a parallel point developing.
For several years, many political books ruled the nonfiction charts in many of the world’s markets. Not only did Trump become the bookseller-in-chief in the United States as he made fruitless runs at publishers whose many Trump books he didn’t want to see published, but international sales also rose in writings on nationalist, populist, and often racist political dynamics that can seem as contagious as the virus.
As it turns out, Hotez’s book may be a harbinger of another key focal trend in nonfiction ahead, books readers reach for to try to make sense of what has happened, how it happened, and whether it might happen again. (The answer, woefully, is yes.)
A quick search reveals titles scheduled out to June 2022 when Daniela Lama’s The Unimaginable Storm: A Doctor’s Journey Through a Modern Pandemic is scheduled to be published by from Hachette’s Little, Brown Spark.
In October of this year, Sanjay Gupta, MD, releases World War C: Lessons From the Pandemic and How to Prepare for the Next One, just months after his still-new Keep Sharp: Build a Better Rain at Any Age (January 5). Both Gupta books are from Simon & Schuster.
In August, Cambridge University Press is to publish Barbara Kellerman’s The Enablers: How Team Trump Flunked the Pandemic and Failed America. The following month, it’s the other viewpoint in COVID: The Politics of Fear and the Power of Science from Turner Publishing and written by Marc Seigel, called by Trump, the publisher says, “one of his primary guides to the COVID-19 pandemic.”
It becomes immediately as apparent in publishers’ lists as in Peter Hotez’s writings: we’re still in the political category.
More from us on the coronavirus COVID-19 pandemic and its impact on international book publishing is here.