The balance of the evidence suggests that epidemics and pandemics may exhibit emergent properties. Thus, emphasizing the connectivity between domains, the processes of violent conflict and inter-state warfare may interact with increasing speed of travel, increasing magnitude of trade, burgeoning population pools in mega-cities, and ecological degradation to facilitate the continuing emergence of zoonotic pathogens, and their endogenization within the human ecology. Therefore, we are likely to be confronted with many novel (and pathogenic) microbial agents in the centuries to come.7
Such complex and interactive processes of emergence contribute directly to the non-linear manifestations of pathogens as rapidly (often geometrically) expanding epidemics. While there is some preliminary evidence to suggest that certain domestic institutions of governance may respond to epidemic disease in non-linear fashion (i.e., rapid and punctuated change), such patterns of change are also observed at the international level.8 Therefore, this domain of inquiry requires greater study before any firm conclusions may be drawn.
In the final analysis, emergence and proliferation of infectious agents should logically increase as processes of globalization accelerate. However, disease events will act as biotic countermeasures (negative feedback loops9) to slow the processes of globalization through reductions in the movement of trade goods and migrants, the depletion of human capital, and the erosion of economic productivity. In a very real sense, then, infectious disease acts as a negative feedback mechanism (or a natural brake) on the processes of globalization.
On reflection, punctuated-equilibrium theory appears to offer some utility in explaining the political outcomes associated with visitations of contagion. At the level of the sovereign state, the broad spectrum of political history clearly indicates that outbreaks of epidemic disease often resulted in rapid debilitation of military forces, in destabilization of relations between society and the state, and often in fractured or paralyzed domestic institutions of governance. In the most extreme cases, such as plague in Europe or smallpox in the Americas, pathogens resulted in the rapid and non-linear destabilization of entire polities as the contagion exceeded adaptive capacity. In the modern era, one can certainly argue, certain agents of contagion have contributed to the sclerosis and fragility of domestic institutions. For example, the pandemic influenza of 1918 certainly affected the prosecution of the war, as it directly undermined the German offensives in the spring and summer of 1918, undercut the economic productivity of affected polities, stressed Austrian institutions of governance, and even limited the efficacy of the American Expeditionary Forces in the latter months of the war.
The fracturing of domestic institutions is also evident in the case of BSE, wherein the emergence of prions generated rapid and profound institutional changes throughout British, French, and ultimately European structures of governance. The SARS epidemic also resulted in significant non-linear change in domestic structures of governance in affected polities, particularly Canada and China. Conversely, punctuated-equilibrium dynamics are not as apparent in the case of the HIV/AIDS pandemic, although arguably viral-induced stresses have directly contributed to the collapse of the Zimbabwean economy, imperiled the structural cohesion of the apparatus of governance, limited the state's provision of public goods, and propelled the state into its draconian repression of an increasingly disaffected and rebellious population. Indeed, this enduring consonance between the appearance of contagion and the hierarchical abuses of power by the state against its population is evidence of punctuated-equilibrium dynamics in operation, as the balance of power between society and the state is altered.
At the international level, the punctuated-equilibrium model is equally salient. The case studies illustrate that the 1918 influenza affected the balance of capabilities between the various protagonists in World War I. Further, contagion combined with war to generate stresses that contributed to the rapid demise of empires (German, Austrian, and Ottoman) in the fall of 1918. Thus, pandemic influenza altered the structure and trajectory of international relations in Europe in the decades that followed. Moreover, SARS resulted in the rapid (if ephemeral) empowerment of the World Health Organization relative to its sovereign member states, and BSE resulted in the rapid and permanent reform of various institutions within the construct of the European Union. Finally, the HIV/AIDS pandemic has resulted in the formation of a new division within the UN superstructure (UNAIDS) and has fomented the creation of a multilateral institution (the Global Fund for HIV, Tuberculosis and Malaria).
Epidemic disease often precipitates evolutionary change in affected societies and in the architecture of governance within an affected polity. Conversely, changes in technology, social relations, and ingenuity (technical and social) may stimulate corresponding evolutionary pressures within the microbial realm, accelerating prospects for mutation and the colonization of novel ecological niches. The interaction between human societies and microbes may, then, be seen as co-evolutionary in its dynamics, each side responding to changes in the other over time. Human societies do not simply adapt to some static exogenous environment; they change that microbial environment, leading to the decline of certain pathogens and the rise of new challengers.10
In the twentieth century, advances in public health and anti-microbials shifted the balance of power toward human societies. However, there is a significant difference in the velocity of change in each variable, as pathogens possess the capability of rapid genetic mutation, enhanced by the processes of swapping DNA between pathogens via surface antigens and transposons (antigenic shift). As pathogens acquire increased resistance through exposure to our anti-microbial armamentarium, the balance of power begins to shift back toward the microbes. Evidence of this is increasingly apparent in surging mortality from such resistant pathogens as methycillin-resistant staphylococcus aureus (MRSA), van-comycin-resistant enterococci (VRE), multi-drug resistant tuberculosis, and resistant strains of HIV and malaria. Furthermore, humanity's penchant for ecological degradation only increases the mathematical probability of emergence of novel (and perhaps lethal) pathogens from their natural reservoirs. Such dynamic systems are likely to exhibit oscillations in dominance between microbes and humans over considerable periods of time. Although we humans have enjoyed a recent period of dominance, the lack of significant progress in developing new anti-microbials suggests that the balance may be shifting to favor our microbial adversaries.
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