ABSTRACT
Public health is a domain of positive knowledge par excellence in the sense that it is based on the recognition of natural phenomena inscribed in the body (disease, for instance) and the necessity to establish facts through empirical methods (most notably epidemiology). For the common sense as well as for experts, the existence of the Ebola virus in haemorrhagic fevers and of Plasmodium falciparum in malaria, the social distribution of tuberculosis and cancer in the population, the health risk caused by expanding obesity or environmental hazards, the importance of preventing cardiovascular disease and parasitic infections, the benefits related to medical education of diabetic patients and harm reduction policies for drug users are all taken for granted– even if heterodox theories occasionally emerge, as was the case with AIDS for which dissident scientists and politicians contested the role of HIV (Fassin 2007), and controversies regularly arise over certain risk factors, the most infamous example having been the denial of the effect of tobacco smoking on the occurrence of various deadly pathologies (Oreskes and Conway 2010). Furthermore, the need for action and the sense of urgency generally associated with the recognition of health problems reinforce their undisputable obviousness and unquestionable reality, circumscribing the realm of legitimate interrogations to issues of efficacy or perhaps more accurately effectiveness, if one accepts the distinction between the former measured in ideal conditions and the latter assessed in real-world conditions (Flay 1986), along with efficiency since, in times of fiscal constraints, it has become increasingly necessary to prove that better outcomes can be obtained at the lowest cost (Hollingsworth 2008). The combined self-evidence of facts viewed as naturally embedded and empirically demonstrated and responses regarded as technical and imperative, which thus characterizes public health, translates into normative attitudes and normalizing programmes promoting what is good for the individuals and the population.
