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Identity of a Disease
The intersections of class, region and other social dimensions that go into the discovery and identification of some diseases as epidemics while relegating other pervasive and lethal illnesses as “ordinary” are examined. In this regard, the lopsided relationship between epistemology and epidemiology is explored in detail. It is argued that the combination of Covid-19 with other diseases (also referred to as co-morbidity), as well as undeclared silent epidemics of several other diseases, require recognition.
As the spectre of Covid-19 haunts India and harsh extraordinary state measures unleash thei impact on the most vulnerable sections of society, it is increasingly imperative to locate the current paranoia within the wider context of diseases and the process by which the scientific community engages with them. Bombarded by the perceived or real threat of Covid-19, the majority of our country’s poor are now paradoxically more aware and fearful of the disease than tuberculosis (TB) and other lethal diseases that already plague them or have much greater propensity to reach them. In this context, it is necessary to explore the skewed relationship between epistemology (ways of knowing) and epidemiology (study of incidence, distribution, and control of diseases).
A popular perception is that there is an incremental progress of science that is based on the relentless labour of scientists, who accumulate scientific knowledge through continuous collection of facts and revisiting of scientific parameters where necessary. It is assumed that such accumulation of data and evidence is an objective, unbiased process. In the case of medical science, for example, the assumption is that anomalies, that is, contradictions between the medical evidence and the classificatory schemes being utilised, elicit interest in particular quarters of the scientific community. Through further research some scientists stumble upon the aetiology of a disease, and hence the need emerges for new classificatory schemes and categories.1 From there begins a rigorous peer review process that can translate either into the dismissal of findings or, on the contrary, the corroboration of the research, which then leads to further advancement in scientific knowledge. Such fetishising of science leaves unquestioned the very process of scientific knowledge production. Nothing, of course, unfolds in a bubble.
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