A critical perspective on pandemics and epidemics: building a bridge between public health and science education.

This academic position paper focuses on building a bridge between public health and science education in order to recognize the relationships between science and society-politics, economics, and ideology-in a pandemic context. To do this, we first present the contemporary dispute between the ways of understanding and explaining public health problems in light of a historical-territorial critical perspective; then, we show the configuration process of the formal and hegemonic concept of pandemic that has taken place over the period of the pandemics of the 1918 flu and the 2019 coronavirus disease; later, we give way to a historical-territorial understanding of the genesis of the 2002 and 2012 epidemics in relation to the coronavirus in the twenty-first century; and lastly, we indicate the key points from the historical-territorial critical perspective of public health that science education can use in order to contribute to a critical and reflective understanding of epidemics and pandemics. In this framework, "configuration process" is a category we propose and use in order to explain that specific events such as epidemics and pandemics are interwoven in a social, historical-territorial, trajectory of world power relations.

Este documento de posición académica, titulado «Una perspectiva crítica de las pandemias y las epidemias: construyendo un puente entre la salud pública y la educación científica¼, se enfoca en la construcción de un puente entre la salud pública y la educación científica que tiene por objeto reconocer las relaciones que existen entre la ciencia y la sociedad ­esto es, entre la ciencia y la política, la ciencia y la economía, y la ciencia y la ideología­ en un contexto de pandemia. Para ello, después de ofrecer una necesaria introducción, se presenta en la primera parte, y a la luz de una perspectiva crítica histórico-territorial, la disputa contemporánea entre las formas de entender y explicar los problemas de salud pública. Esta disputa se presenta en dos subtítulos, uno denominado «De la teoría del germen a la biomedicina¼, y otro denominado «De la perspectiva sociohistórica a la perspectiva histórico-territorial¼. En la segunda parte se expone el proceso de configuración del concepto de «pandemia¼ que, formal y hegemónico, ha tenido lugar entre la pandemia de gripe de 1918, declarada por el Ministerio de Salud de Inglaterra y Gales en 1920, y la pandemia de la enfermedad por coronavirus de 2019, declarada por la Organización Mundial de la Salud en 2020 el mismo año. En la tercera parte, la denominada «Crónica de una pandemia anunciada en tiempos del capitalismo neoliberal¼, se presenta una comprensión, de perspectiva histórico-territorial, sobre la génesis de las epidemias que estuvieron relacionadas con coronavirus en los años 2002 y 2012. Con el ánimo de mostrar la similitud encontrada entre las génesis de las epidemias de 2002 y 2012, el apartado dedicado a la epidemia de 2002 se subtitula «Un mercado de animales salvajes en la génesis de la epidemia del Síndrome Respiratorio Agudo Severo (SARS)¼, y el dedicado a la epidemia de 2012, «Un mercado de animales domesticados en la génesis de la epidemia del Síndrome Respiratorio de Oriente Medio (MERS)¼. Finalmente, en la última parte, se señalan asuntos clave de la perspectiva crítica histórico-territorial de la salud pública que la educación científica puede utilizar para contribuir a una comprensión crítica y reflexiva de las epidemias y pandemias. En este marco, «proceso de configuración¼ es una categoría que se propone y utiliza para explicar que acontecimientos concretos, como las epidemias y las pandemias, están entretejidos en una trayectoria social de relaciones mundiales de poder, que es histórico-territorial.

Flu pandemic, world power, and contemporary capitalism: building a historical-critical perspective.

OBJECTIVES: To present a historical-critical analysis of the configuration process of the 2009-2010 flu pandemic in order to show the relationships between this process and the organization of world power, and to promote social and political mobilization. METHODS: Primary and secondary sources on the dynamics of the 2009-2010 flu pandemic were studied. The sources were validated by plausibility assessment and historiographical analysis. From a historical-territorial and critical approach, the relations between the world configuration of the pandemic and the economic, political, and ideological power relations of contemporary capitalism were identified. RESULTS: It is revealed that the expanding monopoly of the pig industry provided favorable conditions for the evolutionary explosion of the influenza A(H1N1) virus. The World Health Organization (WHO) made decisions that were inclined toward the economic interests of the pig and pharmaceutical industries within the framework of financial-cognitive capitalism. CONCLUSIONS: The modes of conduct of these institutions and companies materialized the world relations of economic, political, and ideological power of our time, which determined the configuration process of the pandemic. The worldwide spreading of the virus is barely a trail of the process.

Universal health coverage and capital accumulation: a relationship unveiled by the critical political economy approach.

OBJECTIVES: To analyze the fundamentals of the global health agenda from 1944 to 2018, especially regarding Universal Health Coverage, in order to unveil its relations with capital accumulation in health services and to contribute to world social mobilization to change this tendency. METHODS: A historical study was carried out based on a purposeful selection of primary sources on the global health agenda from multilateral organizations and secondary sources about the changes of capitalism from the study period. RESULTS: The global health agenda changed from the state responsibility for health to an insurance healthcare system based on markets. The medical-industrial complex pressured national economies, broke postwar pacts, and urged economic globalization. The neoliberal, neoclassical, and neo-institutional discourse that promoted a new state-market relationship eased the new capital accumulation in healthcare into financial and cognitive capitalism. CONCLUSIONS: Understanding these relationships allows us to provide elements for social mobilization geared to transform the healthcare sector toward a new vision of health with a nature-society relationship that contributes to socially constructing human and environmental health, rather than gaining profits based on illness and chronic suffering.

El concepto de pandemia: debate e implicaciones a propósito de la pandemia de influenza de 2009 / O conceito de pandemia: debate e implicações sobre a pandemia de influenza de 2009 / The concept of pandemic: debate and implications on the influenza pandemic of 2009

El ensayo organiza y presenta el debate suscitado entre dos corrientes de pensamiento, a raíz de la pandemia de influenza de 2009. Las posiciones involucradas en el debate están representadas, de un lado, por la Organización Mundial de la Salud (OMS) y, de otro, por las perspectivas críticas, principalmente la asumida por la corriente latinoamericana de medicina social. El debate se ha centrado en el concepto de pandemia, la causalidad que se le ha atribuido a las pandemias y la respuesta que en coherencia se ha propuesto y emitido. En el desarrollo del ensayo se presentan críticamente las dos posiciones y se exponen al final del texto algunas conclusiones que, por definición propia, pero también porque la inmersión en el debate así lo amerita, están inscritas en el marco de las perspectivas críticas.

This essay organizes and presents the debate rose between two theoretical trends related to the influenza pandemic of 2009. The positions involved in the debate are represented, on the one hand, by the World Health Organization (WHO) and, on the other hand, by critical perspectives mainly coming from Latin-American Social Medicine. The debate has been focused on the concept pandemic, its attributed causality and the responses proposed and emitted. This essay presents the two positions in a critical way and exposes some conclusions that - by own definition and because of the level of immersion in the debate requires it- are subscripted in the frame of the critical perspectives.

Este ensaio organiza e apresenta o debate realizado entre duas correntes de pensamento, que foi ocasionado pela pandemia de influenza de 2009. As posições envolvidas no debate são representadas de um lado pela Organização Mundial da Saúde (OMS) e, de outro lado, pelas perspectivas críticas, principalmente aquela assumida pela corrente latino-americana da medicina social. O debate tem se concentrado no conceito de pandemia, a causalidade que tem sido atribuída às pandemias e a resposta que em consequência tem sido proposta e emitida. No desenvolvimento do ensaio apresentam-se criticamente as duas posições e no final do texto são expostas algumas conclusões que, por definição própria, mas porque a imersão no debate justifica, estão inscritas no entorno das perspectivas criticas.