Staples James
Department of Social and Political Sciences, Brunel University of London, London, UK.
Med Anthropol Q. 2024 Dec 17. doi: 10.1111/maq.12905.
Achieving a target of zero-zero disease, zero disability, and zero discrimination-has become the dominant focus of campaigns to control or eliminate diseases, from HIV/AIDS to malaria to leprosy. Given the historical failure of most eradication programs over the last century, such teleological imaginings of disease-free futures might seem overly utopian. But even if it were possible to eradicate such diseases in their entirety, would this be universally welcomed, even by those most affected by them? In this article, I compare the narratives of national and international bodies concerned with eliminating leprosy, in particular, with the more ambivalent narratives of those affected by the disease in India, the country where the disease is most prevalent. For the latter, the promise of elimination not only seems unrealistic, but represents a potential loss of identity. Imagining disease trajectories in less linear terms, I argue, might also nuance understanding of them.
实现“零疾病、零残疾、零歧视”的目标,已成为从艾滋病毒/艾滋病到疟疾再到麻风病等疾病控制或消除运动的主要关注点。鉴于上个世纪大多数根除计划在历史上的失败,这种对无病未来的目的论想象可能显得过于乌托邦。但即使有可能完全根除这些疾病,这会受到普遍欢迎吗,即使是那些受其影响最大的人?在本文中,我比较了关注消除麻风病的国家和国际机构的叙述,特别是与印度受该疾病影响者更为矛盾的叙述,印度是该疾病最流行的国家。对于后者来说,消除的承诺不仅似乎不切实际,而且代表着身份认同的潜在丧失。我认为,以不那么线性的方式想象疾病轨迹,也可能使对它们的理解更加细致入微。