This is particularly true in the context of Global Health. The 1AC’s approach to health management is underwritten by the three axes of economic, racial, and scientific inequality that coalesce to produce a Vital Abandonment of subaltern subjects unable to reap the benefits of biomedical advancements. The plans defense of patent ownership recirculates capital back into the Global North creating a genocidal terrain of anti-black exclusion at the molecular level.

The most prominent of these global axes of inequality is undoubtedly economic in nature and manifests in the highly unequal international access to biomedical interventions during global health emergencies. “[T]he single greatest global challenge in public health,” a report by the Third World Network (TWN) notes, “is to address the huge disparities between wealthy and poorer countries in their citizens’ access to vaccines, therapeutics, and diagnostics” (Hammond 2021, 3). The global demand for new biomedical interventions spikes dramatically during pandemics and certainly runs much higher than the initial international production capacity for novel therapeutic products. With global pharmaceutical production largely concentrated in profit-orientated commercial and corporate enterprises, and in a context where demand outstrips global supply under market conditions, the factor most likely to determine who will secure access to those scarce treatments during a pandemic is price. Low- and middle-income countries (LMICs), therefore, routinely struggle to compete with their wealthier counterparts in securing access to such life-saving biomedical interventions. Recent experiences with COVID-19 underscore those longer standing concerns. In the early stages of the COVID-19 pandemic, many high-income countries pledged support for the new COVAX facility—an ambitious international procurement mechanism designed to equitably supply newly developed COVID-19 vaccines to the entire world. However, many high-income countries subsequently entered into extensive bilateral agreements with commercial vaccine manufacturers to supply their populations, and so the COVID-19 pandemic was once again marked by a resurgence of vaccine nationalism, with many high-income countries purchasing far more vaccine doses than needed for the size of their population (Hammond 2020, 2; Wouters et al. 2021). Over a year into the pandemic, many low-income countries were still struggling to vaccinate even 10 percent of their populations, while many high-income countries were already accumulating spare doses and contemplating additional “booster” shots (Usher 2021). As with many prior outbreaks, a major gap thus rapidly emerged between high- and low-income countries around access to vaccines during COVID-19 (Eccleston-Turner and Upton 2021; Mathieu et al. 2021). Yet, those international tensions over affordability are only the most immediately apparent economic inequalities that are relevant here. A subtler form of economic inequality additionally relates to how the global geographic distribution of pharmaceutical infrastructures has evolved historically. That is because countries home to substantial pharmaceutical infrastructures also possess a second option for securing access to scarce biomedical interventions; they can invoke the exceptional circumstances of a pandemic to nationalize pharmaceutical products manufactured within their territories. During pandemic flu (H5N1, H1N1), for example, the limited global manufacturing capacity for pandemic influenza vaccines was geographically concentrated in high-income countries (Australia, Europe, Japan, and North America), giving those countries and regions a distinct advantage in terms of securing priority access to medicines for their populations (WHO 2005, 47; Elbe 2018). Yet, this alternative option of nationalizing supplies, which has resurfaced in the form of widespread vaccine nationalism during COVID-19 (BBC 2021), is only available to those countries possessing such pharmaceutical infrastructures, again excluding the vast majority of the world’s LMICs. Thus, the geographically uneven global distribution of pharmaceutical infrastructures compounds their subaltern economic position during global health emergencies. Many LMICs are also at a third economic disadvantage here. Scholars of international political economy have described how biocapital, that is, the growing commercial exploitation of biological materials, has become a highly profitable component of the global economy (Rajan 2006; Birch and Tyfield 2013; Elbe and Long 2020). Global health emergencies can generate lucrative opportunities to produce such commercial biovalue and financial profit by triggering immense international demand for new diagnostics, medicines, and vaccines; virus samples are critical to those commercial production processes. While pathogen samples are initially shared for noncommercial public health purposes (such as characterization and monitoring of genetic variations), some of these samples are subsequently also used by the pharmaceutical industry for commercial and profit-orientated practices to develop propitiatory commercial biomedical interventions (Hammond 2020, 1). With biomedical expertise and production capabilities concentrated in highincome countries, however, such commercial revenues again flow mostly to their corporations and stakeholders. To the Indonesian health minister, the entire system of international virus sharing, therefore, appeared to perpetuate a protracted cycle of international economic inequality in which “the developed countries become richer and richer while the poor countries become poorer and poorer” (Supari 2008, 6). Emphasizing the powerful global health rationale for international virus sharing obscures, then, how those practices can also buttress the hegemony of already dominant economic actors in international relations and how LMICs frequently occupy a subaltern position during global health emergencies. Unlike their wealthier counterparts, LMICs cannot usually access the life-saving biomedical interventions that are subsequently developed with those critical samples. They also do not have the option of nationalizing such products to secure access for their populations nor can they reap the considerable commercial benefits generated from such biomedical technologies. Viewed from this perspective, the entire process of international virus sharing can appear intensely unjust, resembling an elaborate international circuit of dispossession “in which property is generated under conditions that require its divestment and alienation from those who appear, only retrospectively, as its original owners” (Nichols 2018, 5). Echoing the geopolitics of knowledge articulated by Walter Mignolo (2002) to ask “who and when, why and where is knowledge generated” (Mignolo 2009, 160), there is also a highly stratified geopolitics of biomedicine that only selectively protects some populations against emergent viral harms.

The Whiteness of Global Health Security

This international axis of economic inequality is entangled with a second axis of racial inequality. That is because the uneven geographic distribution of biomedicine is historically closely bound up with the legacies of racialized colonial expansion, extraction, and capitalism (see Bhattacharyya 2018; see also Jones 2008). Throughout those histories, biological resources central to the advancement of scientific knowledge, medicine, and commerce were taken from indigenous and colonized peoples and then brought back home to metropoles of European empires, frequently without explicit consent (Schiebinger 2007, 6). Many of these practices were carried out on the basis of the constructed racial inferiority of the people from which those resources were taken (Quijano 2000; 2007b). Land appropriation from indigenous communities in the so-called New World, for example, was catalyzed by their perceived racial and cultural “otherness,” which meant that they were not recognized as having “true” possession of these lands (Harris 1993, 1721–22; see also Grovogui 1996). Those experiences of colonialism still resonate within the contemporary context of global health emergencies (King 2002; Packard 2016; Richardson 2020).

The ongoing practices of international virus sharing continue to exhibit a dominant “whiteness”—understood here not as a simplified marker of “ethnicity” or skin color but as “a “standpoint” rooted in structural power” (Sabaratnam 2020, 5). The philosopher George Yancy argues that whiteness can be conceived of as a particular power–knowledge nexus “inextricably linked to a (white) regime of truth and modalities of power” (Yancy 2004a, 108), which places whites in positions of power vis-à-vis non-whites by virtue of their whiteness (Yancy 2004b, 6; see also Abímbo. ´lá and Pai 2020). Such white normativity manifests during global health emergencies when, for instance, outbreak countries are not perceived as having equally legitimate ownership rights over biological materials located inside their territories, and it therefore appears acceptable to remove such samples from their countries. “Each time I looked into the past,” the Indonesian health minister observed during the H5N1outbreak, “I saw the shadow of imperialism that had taken the most resources of my country because we had no technology to take the benefits from our resources” (Supari 2008, 10). During the Ebola outbreak in West Africa, several of the outbreak countries became similarly concerned that thousands of biological samples were being transferred out of their countries amidst the chaos of the initial response (Yozwiak, Schaffner, and Sabeti 2015). With public concern growing that international researchers were effectively “stealing African populations’ biological property,” several governments enhanced export restrictions around such biological samples (Abramowitz et al. 2018, 105). As one observer puts it: “Everyone knows it’s a holy mess. At the moment, it means all sharing [of samples] is on hold” (quoted in Freudenthal 2019).

The whiteness of global health emergency management is further reflected in discussions about the security considerations surrounding those lethal virus specimens. Here, too, outbreak countries are frequently cast in an inferior position when foreign experts remind them that they lack the capacity to handle such dangerous pathogens safely, and it would therefore be better to transfer them to countries owning such facilities. Very few countries in the world possess the high-security biosafety level 4 (BSL-4) laboratories needed to securely handle dangerous pathogens. Yet, this comparative “underdevelopment” of many outbreak countries is no mere accident of history. A more diachronic perspective would suggest that this is often also grounded in the longer histories of colonialism that sanctioned—politically, economically, and socially—the underdevelopment of other parts of the world through practices of extraction and colonialism (Rodney 2018). This historical legacy leaves many outbreak countries confronting a difficult dilemma: should they oblige to foreign requests to hand over their samples, destroy them, or retain the samples with all of the attendant biosecurity risks that entails (Rizk et al. 2020, 30)? They must make these deliberations, moreover, against the backdrop of long-standing suspicions that powerful foreign countries may covertly steal such pathogen samples from them anyway in the name of national security (Rizk et al. 2020, 30).

Finally, the whiteness of global health emergency management is also evident when interactions with outbreak countries do not afford their official representatives a level of recognition befitting countries of equal standing. One report of the Yellow Fever outbreak in Angola notes how the European Centre for Disease Prevention and Control (ECDC) “came under considerable fire by Angolan public health officials, for having sent young, inexperienced personnel who were simply using the epidemic as an opportunity for experience” (Abramowitz et al. 2018, 59). During the MERS outbreak, the government of Saudi Arabia felt similarly aggrieved by the practice of foreign researchers “parachuting” into their country without properly engaging or collaborating with government officials and without seeing the need to engage the local authorities (Katz and Phelan 2018b, 5). Entangled with the more prominent global axis of economic inequality is, therefore, also a second axis of racial inequality reflected in the ways that outbreak countries and populations of color are frequently construed as inferior in relation to established white norms and power structures—because their ownership claims over such samples are not recognized as being equally legitimate, because they are construed as being incapable of handling such pathogen samples safely, and because they are assigned a subaltern position in the research practices surrounding such novel pathogens.

Epistemological Extractions and Erasures Science does not stand outside of this entanglement of economics and race and forms yet a third global axis of epistemological inequality traversing virus-sharing practices. Throughout history, the epistemic practices of the natural sciences have frequently been put into the economic service of the powerful and have contributed to the international projects of imperialism and colonialism (see Harding 2011; Adas 2016). The entanglements of science and race are likewise attracting greater attention from historians of science, especially in relation to overt acts of scientific racism unfolding during scientific research as well as its contribution to the biologicization of race (Robinson 1983, 76; Saini 2019). Comparatively less attention, however, has been paid to what Michelle Murphy calls “the inverse subject of racialized disadvantage—the work of racialized privilege” and “to the work of racialization in scientific practices not explicitly about race, in practices we would call normal science” (Murphy 2006, 112). Although many of the scientific practices mobilized during global health emergencies are not thematically concerned with race, they nevertheless resonate with such epistemic privilege. The setting of research priorities during outbreaks, for example, often favor the scientific interests of powerful countries. During the Ebola outbreak in Africa local researchers felt that research priorities were mostly driven by the interests of foreign researchers rather than by local needs. Priority was given to research on biological specimens instead of focusing on questions about local transmission patterns, natural reservoirs, ecosystems, and diagnostics (Abramowitz et al. 2018, 89). These were the key questions for outbreak countries, but “[n]ot much has been done in this way, unfortunately. Only the samples were transported outside ….” (quoted in Abramowitz et al. 2018, 89). More recent revelations by investigative journalists underscore the significance of this problem. They detail how thousands of blood samples from West Africa were subsequently exported abroad and that scientists from Sierra Leone, Guinea, and Liberia are now frustrated because they cannot access these samples for research benefitting their countries, even though some of those scientists put their lives at risk to obtain the samples (Freudenthal 2019). Epistemic privilege is further reflected in the way that researchers from outbreak countries are often marginalized in, and excluded from, processes of scientific knowledge production. Researchers working in LMICs can confront powerful obstacles to satisfying their own research aspirations because they lack access to sophisticated laboratory facilities, cannot find sufficient time amidst their existing employment to conduct research projects, or do not have access to the funds required (Crane 2013, 131, 132). Again, such comparative scientific “underdevelopment” cannot just be construed as a natural state of affairs but is again also linked to longer histories of colonialism and racism (Rodney 2018, 14); it can leave scientists in outbreak countries with little choice but to cooperate with foreigners if they want to undertake research. As one African researcher put it: “When you have a really powerful team and a weak [one]… you can’t speak of sharing. This is an abuse of language. Either we share nothing, or give and others exploit, or keep back and nothing is done. But sharing, that means that each person has a capacity to do something … It is difficult for me to hear this word ‘sharing.’ It isn’t sharing when it’s a question of ‘I give’ or ‘I keep’” (quoted in Abramowitz et al. 2018, 25). The very language of “sharing” itself already masks the deeper inequalities often at play in this field. Scientists from high-income countries finally also occupy a privileged epistemic position regarding the allocation of rewards, prestige, and other career benefits resulting from research on novel pathogens. The international standing of scientists, and the funding they can attract for their research teams, is closely tied to publications and citations. Scientists’ careers can benefit substantially from publishing research about dangerous new pathogens at the forefront of international attention. Yet, LMIC scientists report experiences in which scientific analyses derived from samples they have shared in the past (because they lacked the powerful molecular research capacity of laboratories in high-income countries) were subsequently presented at international meetings and conferences without proper advance notification or without including those who had shared the samples in the authorship arrangements (Sedyaningsih et al. 2008; see also Elbe and BucklandMerrett 2017). Lisa Tilley highlights the problematic nature of such “piratic” research more generally, understood “as methodologies which do not value knowledge until processes of extraction, commodification and value addition have been applied through academic refinement, generally in the Global North” (Tilley 2017, 27–28; see also Chivalán Carrillo and Posocco 2020). An extensive array of academic value production surrounds the epistemological study of lethal viruses, culminating in a global health science “that paradoxically embodies and even benefits from the very inequalities it aspires to redress” (Crane 2013, 7; see also Kim 2021). In the end, international virus-sharing practices are also traversed by a third axis of global epistemological inequality whereby the roles, research priorities, and contributions of researchers from LMICs can become marginalized and even erased at times.

Vital Abandonment: A Global Matrix of Lethal Subjugation During global health emergencies, all three of these economic, racial, and scientific axes of inequality coalesce to produce an interlocking and lethal matrix of global subjugation: vital abandonment. Vital abandonment here refers to the very specific ways in which the above inequalities (and others) intersect during global health emergencies to generate an increased burden of death and disease for the world’s majority population—by depriving them of equitable access to medicines, vaccines, diagnostics and other life-saving medical equipment. Their resulting and interlocking subjugation is vital in the very literal sense that the sociologist Göran Therborn defines vital inequality as the “socially constructed unequal life-chances of human organisms” (Therborn 2013, 49). Yet, this biomedical marginalization is also frequently so severe that referring to it merely as another form of inequality would not do full analytical justice to the gravity of this phenomenon. The biomedical marginalization engendered at the intersection of all those international inequalities ultimately leaves most LMIC populations in a state of near-total disposability during global health emergencies (see Odysseos 2015), as their bare life effectively becomes exposed to the unfettered circulation of lethal viruses without any meaningful protection from any biomedical interventions (see also Hentschel and Krasmann 2020). In terms of this underlying severity, the biomedical marginalization experienced during global health emergencies also resonates with the notion of social abandonment advanced by the anthropologist João Biehl. Biehl observed how protracted zones of social abandonment have emerged in several Brazilian cities; he describes in moving detail how many sick people living in one of those zones—Vita—simply died without access to medicines, until someone eventually opened a small pharmacy relying mostly on donations (Biehl 2005, 103). During global health emergencies, a very similar plight is faced by hundreds of millions of people around the world, who also remain unable to access potentially life-saving medicines or vaccines. Thus, the notion of vital abandonment advanced here builds upon both Therborn’s idea of vital inequality and Biehl’s concept of social abandonment, to capture the very severe and widespread biomedical marginalization faced by the world’s majority population during global health emergencies (see also Selmeczi 2009). Precisely because this phenomenon of vital abandonment unfolds across such a vast geographic scale, moreover, it also remains analytically distinct from the much more localized zones described by Biehl as an anthropologist. Vital abandonment does not just manifest in particular urban areas of a country such as Brazil; it rapidly extends into a far more expansive international space during global health emergencies, geographically spreading across a whole array of formerly colonized peoples living across multiple continents and affecting the world’s majority population (see also Lowe 2015).