While Snowden’s history is centred on the western world, more recent decades do concentrate on Africa and Asia, and the international community’s waning commitment to controlling disease. Snowden’s analysis of the HIV/AIDS pandemic that emerged in the 1980s shows how only decades of painstaking efforts in treatment, education and prevention – against dangerous cultural conservatism – have been able to bring its annual death toll below a million.
Snowden, an emeritus professor of history at Yale, believes that epidemic disease has shaped nations and civilisations every bit as starkly as economics or politics or war. One of the more depressing realisations in reading this necessary and persuasive book is that almost every line of it would apparently come as news to Donald J Trump: the terrible decades and centuries in the shadow of the bubonic plague, the desperate blight of smallpox and cholera and typhus and polio, and the enormous advances in public health brought about by sanitation and vaccination and antibiotics. All of that cumulative hard-won wisdom – the triumphs of Edward Jenner and Joseph Lister and Alexander Fleming and Florence Nightingale and Jonas Salk in persuading governments of the possibilities of their science – was erased from history by a president who believes injections of disinfectant might represent a novel cure.