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University of California Press

About the Book

Recent years have witnessed an upsurge in global health emergencies—from SARS to pandemic influenza to Ebola to Zika. Each of these occurrences has sparked calls for improved health preparedness. In Unprepared, Andrew Lakoff follows the history of health preparedness from its beginnings in 1950s Cold War civil defense to the early twenty-first century, when international health authorities carved out a global space for governing potential outbreaks. Alert systems and trigger devices now link health authorities, government officials, and vaccine manufacturers, all of whom are concerned with the possibility of a global pandemic. Funds have been devoted to cutting-edge research on pathogenic organisms, and a system of post hoc diagnosis analyzes sites of failed preparedness to find new targets for improvement. Yet, despite all these developments, the project of global health security continues to be unsettled by the prospect of surprise.

About the Author

Andrew Lakoff is Professor of Sociology and Communication at the University of Southern California. He is the author of Pharmaceutical Reason: Knowledge and Value in Global Psychiatry and coeditor of Biosecurity Interventions: Global Health and Security in Question

Table of Contents

Introduction

1. A Continuous State of Readiness
2. The Generic Biological Threat
3. Two Regimes of Global Health
4. Real Time Biopolitics
5. A Fragile Assemblage
6. Diagnosing Failure
Epilogue

Acknowledgments
Notes
Bibliography
Index

Reviews

"Andrew Lakoff offers an engaging analysis of the evolving state of emergency response to global health crises... Unprepared is an impressive account of outcomes based on their counterfactuals."
Social Forces
"Significantly, the book focuses not only on the changing mode of governing—the emergence of preparedness—but also on the diverse governmental technologies applied within this approach. If the problem has shifted from knowledge-dependent possibilities (accidents, risks), manageable by means of risk technology, to potential threats, what types of intervention technologies become possible? . . . The book seeks neither to provide a manifesto for the importance of preparedness nor to criticize its failures. Instead, drawing on the perspective of historical ontology, it tracks the emergence of an unstable consolidation of global health security, posing the question: "How did the norm of preparedness come to structure expert thought and action concerning the future of infectious disease?”
Bulletin of the History of Medicine
" As a basic, yet detailed overview, this book would do well to serve practitioners engaged in public policy issues, particularly regarding public health, and scholars who engage in similar research. Further, the author helps generate possible conversations regarding our current national issues in public health, such as the opioid crisis or tobacco use. Arguably one of this book’s primary contributions is the way it promotes contemplation and discussion on global health catastrophes whether the reader is intimately involved in the field or even using historical analysis in their own research to apply methods for addressing future challenges."
Anthropology & Education Quarterly
"As studies in historical ontology, Lakoff’s works have taught us how to see today’s world of epidemic anticipation and control beyond that cornerstone of hygienic modernity: prevention. Unprepared fulfills the promise of his invitation to the dizzying depths of global health security by laying bare how enactments of readiness are intricately and at the same time anxiously linked to an unstable constitution of threat."
Somatosphere
"From the Justinian plague to the Victorian cholera, epidemics have challenged both scientific knowledge and political action. Revisiting a series of recent outbreaks labeled 'global health emergencies,' Unprepared shows how, despite considerable epidemiological and biological advances, international agencies and national governments each time face similar issues, dilemmas, controversies, criticisms, and failures. It is an important contribution to the anthropology of contemporary anxieties and uncertainties."—Didier Fassin, author of When Bodies Remember: Experiences and Politics of AIDS in South Africa

"An original, penetrating, and highly readable account of the rationalities and tensions involved in governing global health emergencies in the twenty-first century. Essential reading for all those interested in global health, health security, and emergency preparedness. Prepare to discover how we became unprepared!"—Stefan Elbe, Professor of International Relations and Director of the Centre for Global Health Policy, University of Sussex

"Lakoff lucidly dissects efforts to anticipate, recognize, and respond to global emergencies, exposing an expanding anxiety over preparedness beneath both crisis and failure. In an era where appeals to health increasingly measure both hopes and fears, this is a vital book."—Peter Redfield, author of Life in Crisis: The Ethical Journey of Doctors without Borders