Description

Early in the study of public health, most students come across the

famous quote from the nineteenth-century German pathologist and social

reformer Ruddolf Virchow: 'Medicine is a social science and politics is

nothing else but medicine on a large scale' (Aston, 2006). The phrase has

been used and abused many times since but is usually invoked to draw

a link between medicine and public health on the one hand and politics

on the other hand. The coronavirus 2019 (COVID-19) pandemic that ravaged the world and the efforts to address it have made the link between

public health and politics very visible to all. Specifically, the pandemic

has demonstrated that the choices that governments make to address

infectious disease threats are necessarily and inherently informed by both

scientific evidence and a host of other economic, social, and ethical

considerations. Reconciling these sometimes-conflicting imperatives is the

stuff of politics.

But Virchow's understanding of politics was very particular, as revealed

in the second and less well-known part of his statement. After characterizing

politics as medicine on a larger scale, Virchow went on to write,

'Medicine as a social science, as the science of human beings, has the obligation

to point out problems and to attempt their theoretical solution;

the politician, the practical anthropologist, must find the means for their

actual solution' (Aston, 2006). For Virchow, indeed for many in public

health, politics is a practical matter, something that is done by politicians,

and something that can and should be informed by the insights

of medicine and, by extension, public health sciences such as epidemiology.

Unfortunately, translating scientific evidence into public policy is

a messy business indeed. Moreover, medicine and public health have few

effective tools for systematically understanding the choices governments

make, much less the broader complexities of politics.