How do societies tackle epidemic disease? Long before scientific medicine, human societies coordinated and innovated in response to biological shocks—sometimes well, sometimes badly. This lecture uses historical epidemics to analyse how human societies deal with “externalities”—situations where my action creates costs or benefits for others beyond those that I myself incur. Social institutions—markets, states, communities, religions, guilds, and families—help us manage the negative externalities of contagion and the positive externalities of social distancing, sanitation, and immunization.
Each institution enables us to coordinate, innovate and inspire each other to limit contagion. But each institution also has weaknesses that can make things worse. Markets shut down voluntarily during every epidemic in history—but they also brought people together, spreading contagion. States mandated quarantines, sanitation, and immunization—but they also waged war and censored information, exacerbating epidemics. Religions admonished us to avoid infecting our neighbours—but they also preached against science and medical innovations. Communities deployed peer pressure to foster neighbourly responsibility—but they also ignored problems outside the village boundaries and organized resistance to public health measures.
What decided epidemic outcomes, history suggests, was neither market voluntarism, state despotism, religious moralism, nor communal social capital. Rather, effective controls to balance the epidemiological and economic costs of pandemics required coordination across a framework of interdependent institutions – a temperate state, an adaptable market, and a strong civil society in which a diversity of institutions played to their own strengths and checked each other’s flaws.
Conference: How did we lift the burden?
This keynote lecture is part of the international conference How did we lift the burden?, which will be held from 28 until 29 August at Radboud University. This conference includes a workshop and farewell reception of professor Angélique Janssens. You can register for both the workshop and the keynote lecture through the conference website:
Register for the keynote and/or workshop
Image credits: Grimburgwal House – 1890 Courtesy of ‘Stadsarchief Amsterdam’
