Advertisement
The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App
Professionals >> Visit The Body PROThe Body en Espanol
  
  • Email Email
  • Printable Single-Page Print-Friendly
  • Glossary Glossary

Our Biology Is Social

A Talk With Richard Levins

January/February 2003

Um outro mundo é possível -- Another world is possible.

You're a professor of population sciences; so, what's up with us humans?

We can describe the present plight of our species as an eco-social distress syndrome. It pervades everything: The relations to the microbial world, to the physics of the atmosphere, to breathing in the chemosphere, to nutrition and food production -- even our own biologies have been transformed.

Human biology is a socialized biology. For instance, one of the constants of human physiology has been the belief that blood pressure increases with age. Well, it does in our society; it does not among hunter/gatherers and pastoralists. Our posture is very much determined by class position and gender relations: whether you're willing to be noticed or trying to avoid being noticed, and under what conditions. Even breathing -- the question of whether you breathe deeply or shallowly, depends on stress patterns. Our eating habits have certainly changed body size. The fact that we have electric light in this country means that people sleep less; serotonin and melatonin cycles are undoubtedly altered. We know that there are class differences in cortisol behavior. So our biology is social. Our human biology has been transformed. We are living in an environment that we've created, and a lot of that environment is social and emotional. And the emotional factors are as real as chemical ones.

Advertisement
A lot of these changes have been made possible by science. Science does good things too. How could it work differently?

Science has a dual nature. On the one hand it's part of a long historic increase in our understanding of the surrounding world. On the other hand it's the product of a knowledge industry. And that knowledge industry recruits, takes its agenda, and decides what's a problem and what's a good solution, on the basis of the needs of the owners of that industry. In an earlier time the owners of science were the princes, who kept scientists around as decoration. Now they are the trans-national corporations, so that ownership determines the patterns of knowledge and ignorance.

In the areas that are closest to my own knowledge, we know a lot about controlling pests with pesticides because they are commodities. That's a way in which knowledge can be turned into a marketable commodity. We know so much less about controlling pests by simply having the right mixture of crops or by creating good conditions for spiders, because you can only publish that knowledge as a column of advice in Farm and Garden.

So you have a pattern of knowledge and ignorance and the first thing a scientist has to ask is, "Is the agenda of my science really where it should be? Do I want to join in the cutting edge of that science or do we need a very different kind of cutting edge coming from a different source?"

To really be able to do this, you have to have one foot outside of the academy. Science is very good at picking up idiosyncratic mistakes, like having dirty glassware or dividing by zero or having confounding factors, but it's no good at all at identifying the shared biases of the whole community. That's simply described as "mainstream" or "common sense" or "cutting edge." People who evaluate research are the ones who've created the way it is now, so they tend to be very good at guaranteeing that the worst kinds of errors aren't made but not at really advancing science where it's needed.

There are different actors in the development of knowledge and they each have their areas of blindness as well as insight. So, for instance, in the international work I do with agriculture, it's very often the case that people living in the country feel a desperate urgency to guarantee that there will be beans available in three months. And this creates a great demand for pragmatism, which sometimes is unwilling to take the detours necessary to understand what's really going on. On the other hand, people coming from the outside very often have the luxury of looking at a longer time range, but are also less sensitive to the needs of the population. And the scientists from the country they are visiting are caught in between a concern for their own people but also with looking for validation from the international scientific community.

There's a tremendous urgency to get grants from the outside, to publish in foreign journals, to be invited to international meetings, to have a degree from one of the big places, and the problem is you then get a kind of intellectual colonialism. It's interesting that the great schools of tropical public medicine are not in the tropics. It's Walter Reed Hospital, the Pasteur Institute, the London School of Hygiene, and each of them is related to colonial expansion. So they focused on the diseases that interfered either with the safety of the troops, or the health of the colonial administrators, or with the extractive industries.

Yet this doesn't mean one takes an anti-science attitude, but rather a critical view: that science is a social product, and has to be understood in its time and place. And, therefore, with this critical view we can look for the kinds of biases that occur within the content of the science as well. Critics of science began by worrying about the application of science. In the sixties we had the research strike at MIT, which was an anti-war gesture; they were concerned with the misuse of science for war. Then they saw that science was also being misused for profit. Then it was recognized that not everybody had access to science, that there were questions about who was allowed into the club. So gradually the critique spread out until it began raising questions also about the content of science.

For a variety of reasons, science, coming from a long history of growing up as kind of a little brother of capitalism, shares the euphoria, the arrogance, the pragmatism, and the fragmented-ness of capitalism. So you have a preference towards a reductionist science -- they recommend subdividing a problem into the smallest pieces and so on -- because the dominant view is a fragmented, atomistic view of the world. The dialectical critique of science looks at that science both in its strengths and in its weaknesses. Answers to the classical problems, "What is this? What is it made of?" are descriptive and science has been very successful at getting those answers. The tools for answering those questions have become more and more sophisticated -- but the questions haven't.

Increasingly we see that the great successes of science have been in answering the classical questions. But the great failures have been in applying a fragmented science to a fragmented, complex reality. So pesticides create more pest problems, antibiotics give us new germs, hospitals are the focus of infection, the Corps of Engineers produces flooding -- and you start asking the question, "Well, why?" The people who made these mistakes were just as smart as we are, so why is it that what they did seemed so reasonable at the time? And, again, it's the combination of the economic constraints on science -- what gets supported, what gets published, what gets reviewed -- with the prevailing philosophy.

So the critique of science is needed, but you have to go outside of the scientific community to look at that critique. Very often, farmers, patients of all sorts -- the victims of science -- have a much deeper understanding than the professionals do. For instance, Black Lung disease was recognized in England fifty years before it was adopted in the United States. And the only reason for that is not that English doctors are smarter, but that the English working class had their own political party. Love Canal was discovered by the people who were living there, while the scientists were saying, "It's a random blip in the data, it's a cluster, it's not proven, it's anecdotal."

In AIDS activism the slogan was, "We are the real experts."

And it's interesting in retrospect, in which ways you were and which ways you weren't. If the element of desperation is missing among the scientists, it means that they'll demand a higher degree of evidence before allowing meaning. They'll also lack the subtlety of the experience. That means that when you design intervention programs, you miss a lot about what people really do.

For instance, there's now an insecticide-impregnated bed net program in Africa. I was just talking to a Cuban friend, who works in Cameroon, and she was telling me that, in Cameroon at least, it's too hot to sleep under a net at night; people would rather sleep on the floor. The bed net costs six dollars in a place where the average income is about $250 a year; then you have to impregnate it for eleven dollars, and redo this several times; so in the end it's not economical, and it makes you miserable, so people will use it occasionally, but not consistently.

So one of the things we're studying now is consistency. We find that when a health problem presents itself people get all excited and committed to doing something about it, but as soon as you start getting success, the threat is no longer as visible. As long as everybody knew somebody who died of AIDS, education worked. When the education works well enough and a new cohort comes along which doesn't have friends who've died of AIDS, then the education becomes abstract. And then the social gap between providers and patients becomes more visible, more palpable, and more likely to create skepticism.

The bed net is the condom of malaria, a disease that, by the way, is a tremendous, overlapping problem with HIV in Africa. How goes that struggle?

Most of the time, malaria is being discussed now in terms of drug resistance. It is being treated as a biochemical and genetic adaptation problem. The broader issues involve what affects the abundance of mosquitoes. For instance, irrigation is one of the things that have allowed mosquitoes to become endemic in places where they were only sporadic. The Aswan Dam is one of the big offenders there. Another issue is the destruction of the ecology of wetlands such as the eutrophication of lakes through nutrient pollution. Lake Victoria has its margin now covered with heavy growths of water hyacinth. So fish can't get in there to eat mosquitoes. There are big algal blooms from the runoff from human waste and from agricultural fertilizers. The algae die and sink to the bottom and absorb oxygen. So this means that the dragonfly larvae and the midges and other things that live at the bottom and threaten mosquitoes, are not there. In other words, the exposure to mosquitoes is not just a natural phenomenon. Every change in land use, when forests are cleared and so on, also causes changes in the mosquitoes that are around, and therefore in the exposure to malaria.

When you deal with diseases like encephalitis or West Nile, you're dealing with the relation of birds to their habitats. And one of the big things happening now is that birds that don't normally meet are meeting, because there are so few habitats available for them. The migrating birds will all gather in the few places that are still around. And there they can trade viruses. Then some of these birds move out into human areas, and then the mosquitoes transmit the virus from birds to humans. Part of the West Nile issue is that the cycle that had been maintained in bird populations is spilling out into horses and other animals and into the human population.

So, backyard bird feeders are avian bathhouses?

Each one of these diseases has its own special history. The rodent-borne diseases in Latin America, like Venezuelan hemorrhagic fever and Bolivian and Argentine hemorrhagic fever, are all involving changes in the agricultural pattern. In Venezuela, what happened was that the plains were plowed up to plant grain, and two things came from this. First of all, grain is mouse food, and secondly, farmers don't like to have snakes and jaguars around, so the mice got more food and fewer enemies. The mice were the reservoir for the virus, and so it increased its contact with people. In Panama, I think it's the changing agricultural season, relating to the adoption of different crops. In Argentina it was the cultivation of the Pampas. And there what happened was when they started growing corn there were weeds, so they brought in herbicides. The herbicides were aimed at the weeds that grow in the very beginning of the season when the corn is short. Once the corn gets up high, it doesn't matter what's growing there. And so the herbicides shifted the balance among weed plants to the ones that come along a little bit later and grow underneath the corn. And they happened to be the ones that were liked by a different kind of mouse. And it just happens that this different kind of mouse carried the virus of Argentinean hemorrhagic fever.

In the African forests, Ebola is, I think, related to the fact that big mammals were being exterminated, so small mammals increased and those were the ones that came into contact with people going into the bush for bush meat. So the lesson of all of this is that every time we change land use in any way, we're also changing the epidemiology. And therefore there has to be a health impact statement as well as an environmental impact statement, asking, what will any development scheme do to mosquitoes, to ticks, to snails, to mice, at least.

Anytime there are new overlaps there will be new blooms of viruses or whatever. And they are always surprises. We do our best, but then, for instance, it turns out that corn pollen is very good for the Anopheles mosquito that transmits malaria. And people have been growing corn a lot lately. In every backyard, every vegetable plot has some corn. So if there's standing water within about 60 to 100 meters of your corn, then there'll be Anopheles mosquitoes developing rapidly, coming out robustly and looking for a blood meal. So those are the things you couldn't have guessed. Except to know that bugs eat, and when you affect their array of plants, you're affecting their feeding. So there's always a kind of guessing you have to do.

One simple rule is that it's important to maintain biodiversity. When you reduce diversity, you lose a lot of species, but the ones that remain are not kept in check and you can have explosions of these nasties. So it's good to maintain biodiversity rather than get caught up in the economic rationale that only tells you to go for the most profitable land use.

How do activists and advocates affect the balance of political, social and economic interests?

One of the general perspectives we have is that in a very complicated world, every situation is different. And sometimes this is used to say that you can't really understand what's going on. But another approach is to say, first of all, that our knowledge has to be to understand patterns of difference, say in the form of behaviors. And secondly, because each place is different, and because there'll never be enough scientists to characterize each place, you have to link the knowledge of professionals and non-professionals. It takes a much bigger mobilization of collective intelligence to solve these problems -- and this will only work when the two can meet as equals. So there's been a lot of non-professional invasion of scientific turf, for example, the women's cancer movement, particularly the Women's Community Cancer Project, which has been insisting on the environmental causes of cancer; the River Watch network; the environmental justice movement; the Black Panther Party, which initiated a study of sickle cell; and the AIDS activist community. The intellectual resources exist; we have a well-educated country, and there is the possibility of tapping this knowledge and then demanding that science be directed toward answering the questions of the community, rather than responding to the grants of the pharmaceutical industry. A women's cancer group in Long Island organized a scientific conference where they brought the scientists together, but the women were the ones who asked the questions. It worked very well.

Which scientists are studying understanding patterns of difference?

The ecologists. The work of protein research can be pretty much done the same way in any lab in any place -- if you have the equipment. And so the differences are, who has the equipment and skill? But when you're dealing with epidemics, the social context of disease is an important ingredient. So in the health movements and the ecology movements, you get people who are able to link the particular to the global. And that's where the exciting knowledge is going to be emerging in these fields. Also, the intellectual independence that people develop in order to crack these problems, will, I hope, lead to political independence, creating an independent political structure, so they can play an independent role rather than simply lobbying the ones that are already in power.

What do you make of the recent Bush Administration proposal to treat people with HIV in Africa and the Caribbean?

I haven't studied the proposal, but I have studied the proposer. So it's clearly not out of concern for the health of people, but it's a political move to show his compassion and the compassionate side of conservatism. I'm sure there's a lot of fine print about what kind of help will be provided. For example, I doubt whether there'll be any of it going to reduce poverty. Now, the impact of HIV in Africa is not only on the patient with AIDS, but on the caretaker and on the other members of the family. What's happening in a lot of places is that as the disease progresses, less and less time can be put into the farm. Eventually you can fall below the threshold where the farm is no longer sustainable and you either sell off your cattle or rent out the land, and depending on the rules of landholding and land use, the poorer farmers who are infected can lose their land and lose their livestock; if both parents die and teenagers inherit the farm, they may not be able to hold onto it; it may revert to more distant kin. So we have to look at AIDS and the epidemic as a crisis of survival, which in some people will be the AIDS symptoms themselves, in other people it will be hunger, through the failure of the farm, or it will be neglect of children through lack of parental care. You have to see it as a social as well as biological epidemic.

Now, it operates differently in each society because of the rules of landholding and the kinds of mutual aid that are available, and I'm sure that the Bush program is not going to deal with that. I think that a lot of it will be pharmaceutical, and that his drug company buddies will be able to cash in on it. So, I'm skeptical because it seems to be part of his war for hearts and minds.

Some U.S. government officials acknowledge the potential for social destabilization in Africa arising from AIDS but they tend to frame it as a national security problem for the U.S.

You'll find that in all those reports, social unrest is regarded as a problem. Well, some of us would see it as a great advantage. There are places that should not be tranquil. The message of Porto Alegre* is that another world is possible if you do things differently; we can break out of the constraints imposed by the rulers.

Richard Levins is a professor in the Department of Population and International Health at the Harvard School of Public Health. He is an ex-tropical farmer turned ecologist, biomathematician and philosopher of science whose central intellectual concern has been the understanding and influencing of processes in complex systems, both abstractly and as applied to evolutionary ecology, economic development, agriculture and health.

* The theme of the 2003 World Social Forum, held in Porto Alegre, Brazil was: Another World Is Possible.



  
  • Email Email
  • Printable Single-Page Print-Friendly
  • Glossary Glossary

This article was provided by Gay Men's Health Crisis. It is a part of the publication GMHC Treatment Issues. Visit GMHC's website to find out more about their activities, publications and services.
 
See Also
More U.S. HIV Prevention Policy Analysis
Advertisement:
Find out how a Walgreens specially trained pharmacist can help you

Tools
 

Advertisement