ABSTRACT
According to David Byrne (2004:4), the European Union Commissioner for Health and Consumer Protection, from the standpoint of the spread of infectious disease, the world may be “on the eve of a 21st-century calamity.” While health forecasts are fraught with uncertainty, one gauge of the seriousness of the potential human impact of global warming on health can be seen through a consideration of the worldwide influenza pandemics of the 20th century. Influenza is a zoonotic disease, with birds and pigs being the primary animal hosts. There were three influenza pandemics during the century, each causing widespread illness, mortality, social disruption, and significant economic loss. These occurred in 1918, 1957, and 1968. In each case, mortality rates were determined primarily by five factors: the number of people who became infected, the virulence of the virus causing the pandemic, the speed of global spread, the underlying features and vulnerabilities of the most affected populations, and the effectiveness and timeliness of the prevention and treatment measures that were implemented (World Health Organization 2004). These factors unite a range of biosocial causal forces, including production, communication, and transportation technologies; the medical and public health infrastructures; the specific pathogens involved and the nature of their current and past interactions with human hosts; and the pre-existing health status of affected individuals and populations. All of these, in turn, are shaped, to greater or somewhat lesser degree, by overarching political economic structures globally and locally. The emergence, course, and impact of epidemics, in short, are sculpted by the configuration of human social relationships including prevailing patterns of social inequality (Baer, Singer, and Susser 2003, Singer and Baer 2008).
