Pathogenesis

Starred review from January 23, 2023
Revisiting the theme of William H. McNeill’s Plagues and Peoples (1976), sociologist and public health scholar Kennedy debuts with a virtuoso analysis of the fallout from encounters between deadly viral and bacterial pathogens and human populations that lacked immunity. Looking back to prehistory, he argues that Homo sapiens supplanted Eurasian Neanderthals 40,000 years ago by virtue of pathogens they brought from Africa, not superior intelligence. Elsewhere, he contends that epidemics depopulated the Roman Empire and led to the rise of Christianity and Islam, while the Black Death initiated Britain’s transition from feudalism to capitalism. A smallpox epidemic allowed Hernan Cortés to conquer the immunologically naive Aztec Empire in 1520, but Africa’s endemic malaria killed Europeans so quickly that they were unable to colonize the continent until quinine became available in the 19th century. And while modern sanitation and medicine have triumphed over cholera and other pathogens, Covid-19 highlighted the “stark inequalities” that still result in millions of poor and marginalized people dying each year from preventable infections. Though there’s a one-size-fits-all aspect to Kennedy’s thesis that disease-bearing microbes are responsible for the modern world, he marshals a wealth of surprising scholarship in lucid and succinct prose. The result is a fascinating look at history from the perspective of its tiniest protagonists. Agent: Simon Lipskar, Writers House.