The Coming Plague: Newly Emerging Diseases in a World Out of Balance

The socio-historical context of The Coming Plague is centered on the state of public health in the mid-1990s. With academic training in the biological sciences and a professional career as a public health reporter, Garrett has a deep background in the cultural and scientific issues involved in public health debates at the time. In the 1990s, the issue of emerging diseases was at the forefront of cultural awareness in a way that was not true either of the decades immediately before or immediately after. The rising tide of the AIDS epidemic had produced an intense focus on public health issues in the 1990s, jarring the Western world from a comfortable sense of assurance that medical progress was making continual strides in disease management. Geopolitical events in the 1990s constituted a lull that enabled greater public engagement on issues like disease control, whereas the news cycle in the 1970s and 1980s had been dominated by geopolitical storylines like the Vietnam War and the Cold War. After the 1990s, geopolitical news would come to dominate again after the experience of 9/11 ushered in wars in Afghanistan and Iraq. It would not be until a quarter-century after The Coming Plague’s publication that issues of disease management would again dominate global public awareness.

Other social factors in the mid-1990s contributed to The Coming Plague’s perspectives, including reappraisals of how to deal with an exploding crisis in drug use after the incomplete results of the Reagan administration’s “war on drugs.” People were also becoming ever more aware of the social issues that arose from living in a global community, with ever-greater connections to every part of the world, which allowed Garrett’s focus on local outbreaks in Africa, for example, to carry significant public interest.

It is also important to note The Coming Plague’s place in the context of medical developments. The mid-1990s were a period in which many of the challenges were becoming ever more evident, but before new waves of treatment options began to become available. For instance, it was only after The Coming Plague that a “cocktail” mix of various medications was found to have a significant treatment impact on AIDS and that progress was made on new classes of antibiotic compounds and new vaccine technologies. Even with those advances of the 2000s and 2010s, however, much of Garrett’s analysis still proved prescient when the world found itself unprepared to deal with the outbreak of Covid-19 in 2019 and its worldwide spread in the subsequent years.