After a difficult pandemic year in which millions have died, the start of vaccination around the world offers cause for hope. But once the immediate threat of sickness or death subsides, there are deeper questions we need to ask about the pandemic.

“Vaccines are great,” Dr. Eugene Richardson says. “But what does the analysis look like when we go further upstream?” The Harvard infectious disease physician and anthropologist analyzes the structural and historical causes of outbreaks—examining not just their medical, but also their social, drivers.

Richardson has written about the toxic history of disease in his latest book, Epidemic Illusions: On the Coloniality of Global Public Health. In our first Tiny Spark podcast of 2021, Richardson says public health officials must understand the legacy of colonialism and the need for reparations, just as much as vaccination programs.

Richardson recalls being in the Democratic Republic of Congo in 2018 during the most extensive Ebola outbreak in the country’s history. As a clinical volunteer in North Kivu, he saw how misinformation led to suspicion of the virus. He says we need to closely examine why.

“Someone in the Congo saying that the US built Ebola as a bioweapon, when you really talk about it with them, it ends up being not a nugget of ignorance,” Richardson explains, “but a strong critique of being conditioned by decades, centuries of depredation.”

Our podcast digs into that depredation and explains why moving towards reparations could address some of the legacies of colonialism, while also looking at the wider role of Western aid in perpetuating colonial practices in humanitarian disguise.

“They can feel good about contributing once in a while to fleeting events,” Richardson says of donors. But when it comes to the long-term work on redistributive justice, redistributing resources and wealth, which could push towards global health equity? “That’s something that’s not acceptable to those elites in power.”

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Cover Image: Excerpt from the cover of Epidemic Illusions. Published by MIT Press.

Body Image: Dr. Richardson standing by an Ebola CUBE at the Alima treatment center in DR Congo. Photo by Marta Lado. Portrait courtesy of Stanford Hospital.