Securing circulation pharmaceutically: Antiviral stockpiling and pandemic preparedness in the European Union

Abstract

Governments in Europe and around the world amassed vast pharmaceutical stockpiles in anticipation of a potentially catastrophic influenza pandemic. Yet the comparatively 'mild' course of the 2009 H1N1 pandemic provoked considerable public controversy around those stockpiles, leading to questions about their cost-benefit profile and the commercial interests allegedly shaping their creation, as well as around their scientific evidence base. So, how did governments come to view pharmaceutical stockpiling as such an indispensable element of pandemic preparedness planning? What are the underlying security rationalities that rapidly rendered antivirals such a desirable option for government planners? Drawing upon an in-depth reading of Foucault's notion of a 'crisis of circulation', this article argues that the rise of pharmaceutical stockpiling across Europe is integral to a governmental rationality of political rule that continuously seeks to anticipate myriad circulatory threats to the welfare of populations -including to their overall levels of health. Novel antiviral medications such as Tamiflu are such an attractive policy option because they could enable governments to rapidly modulate dangerous levels of (viral) circulation during a pandemic, albeit without disrupting all the other circulatory systems crucial for maintaining population welfare. Antiviral stockpiles, in other words, promise nothing less than a pharmaceutical securing of circulation itself.

The past shall not begin: Frozen seeds, extended presents and the politics of reversibility

“…7 Michel Serres’ remark that stocks are places where ‘time is frozen’ (Serres, 2016: 179) can be taken literally in this case. The recalcitrant and unpredictable processes of life are ‘suspended’ (Hayden, 2003; Hoyer, 2017; Lemke, 2019) or ‘arrested’ (Chrulew, 2017) to transform the plants into a manageable stock that remains permanently available and can be relied upon in the future (see also Elbe et al, 2014; Folkers, 2019; Keck, 2017).…”

What COVID-19 revealed about health, human rights, and the WHO

“…Pandemics have been an area of less focus in global politics and human rights. Although theories of international relations have been used to explain certain outcomes-such as the lack of a united response to COVID-19 (Farrell and Newman 2019; Busby forthcoming), or how the securitization of health leads to domestic policies such as drug stockpiling (Elbe, Roemer-Mahler, and Long 2014), or the role of health in diplomacy (Fazal forthcoming)-threats to health are undertheorized in relation to public goods. Pandemics call into sharp relief how individual rights can and must be curbed for the sake of collective well-being (Colgrove and Bayer 2005;Bayer 2007), especially as the human right to health is both an individually held and a collectively shared right (Toebes 2015).…”

The somatic-security industrial complex: theorizing the political economy of informationalized biology

“…These cartographies of vulnerability operate at multiple scales from the molecular to the molar (Ahuja, 2016;Braun, 2007;Chen 2014). Underlying fears of biological exchange is the premise that living systems are all inherently and increasingly vulnerable to a biological event of significance (Elbe, Roemer-Mahler, & Long, 2014;Garrett, 1994;King, 2002;WHO, 1994).…”

“…Thus for many, the emphasis of Western GHSA has been on surveillance and containment in resource poor countries, rather than in building badly needed capacities to deal with very real threats (Fauci, 2014;Heymann et al, 2015;Kalra et al, 2014;Ooms et al, 2017). In contrast, the US and other Western states have devoted substantial resources toward protecting their own citizens and borders from pandemic threats, via global disease surveillance, stockpiles of medical countermeasures, and investments in medical and virological research (Bell & Figert, 2012;Elbe, 2011;Elbe et al, 2014). For Lee and McInnes, the problem of health security is broader still for global health, as it has skewed focus away from international public health and health systems (McInnes & Lee, 2006), despite some welcome gains in investment in select infectious disease such as HIV.…”