Foreign Bodies: Pandemics, Vaccines and the Health of Nations by Simon Schama review – scientists to the rescue | History books

‘In the end,” writes Simon Schama at the beginning of his extraordinary book on pandemics old and new, “all history is natural history.” Foreign Bodies is ostensibly an account of the bacteriologists and epidemiologists who studied the natural history of infectious diseases from the late 18th to the early 20th centuries, developing vaccines and saving millions from smallpox, cholera and the plague. But as its subtitle suggests, it is also a reflection on the political and scientific conflicts of the Covid pandemic, and the failure of contemporary leaders to coordinate a scientifically driven global response to the virus.

Over millennia, biological and environmental imperatives rather than states and empires have shaped human destiny. Now capitalism’s degradation of the planet threatens our future survival. Zoonosis – the transmission of infectious diseases from animals to humans – has always bedevilled humanity, but the risks are increasing as we encroach further into natural habitats. The Global Virome project estimates that there are more than half a million unknown viruses with zoonotic potential; since 1980 sub-equatorial regions have experienced viral outbreaks every eight months; the Sars epidemic of 2003–4 has now been traced back to dragon-tiger-phoenix soup, a combination of palm civet meat, chrysanthemum petals and snake served in restaurants in southern China. If these facts are sobering, the response of our politicians, described with measured fury by Schama, is terrifying: now as before, international cooperation founders as national tribalism belittles science and its “cosmopolitan” practitioners.

What can history tell us about how we got here, and how to respond in the future? The answer is conveyed through a meticulous retelling of a terrible yet scientifically innovative period, beginning with the cholera pandemics of the 1850s and taking in a three-decade epidemic of bubonic plague that by the 1920s had killed a staggering 12 million people, mostly in India. White, male, Christian European colonial authorities, obsessed with segregation and sanitation, doused homes with carbolic and limewash. When that didn’t work they were forced to turn to outsiders: migrants, exiles – the “foreign bodies” of the title – who challenged prevailing social and scientific assumptions. Schama’s varied cast includes Lady Mary Wortley Montagu, the first European to inoculate her children against the disease in 1721 after learning the “Turkey way” of variolation – an early form of vaccination. We meet Adrien Proust, Marcel’s father – known as the “geographer of epidemics” – who travelled to Istanbul and Tehran, trying unsuccessfully in his 1873 essay on international hygiene to establish protocols for global public health. Exiles and émigrés flit between the research institutes led by Robert Koch in Berlin and Louis Pasteur in Paris before dispersing across the globe to the frontlines of cholera and plague outbreaks in the “great game of competitive medical imperialism”. By the 1890s German, French, Swiss, Russian, Japanese and English bacteriologists, doctors and nurses were to be found at centres of contagion such as Hong Kong, Singapore and most notoriously Bombay. They went in order to research and deliver vaccinations, confronting terrible conditions as well as the ignorance and suspicion of colonial officials.

But, as Schama notes, it wasn’t just the officials who were suspicious. He deftly captures the paradox of medicine being seen as a “poisoned gift” of empire: while the bacteriologists saved millions of lives, they also rode roughshod over local mores – in India there was horror at the mixing of castes in hospitals and the intimate examination of women, while others worried about animal matter in the vaccines. Schama even argues that the sparks of Indian nationalism that eventually broke the Raj – unified social and religious outrage that coalesced into strikes and mass demonstrations – were struck during the plague of 1897.

The central outsider in Foreign Bodies is the “culturally hybrid prodigy” Waldemar Mordechai Wolff Haffkine. A Ukrainian Jew, Haffkine took up arms during the Odessa pogrom of 1881 before becoming a protege of Élie Mechnikov, the founder of immunology. Haffkine eventually developed a cholera vaccine, which he tested on himself in 1892. It worked, and by 1893 he was in India inoculating 42,000 villagers, slum dwellers and soldiers a year. In 1897 he developed a plague vaccine in Bombay, once again testing it on himself, and created the world’s first large-scale vaccine production line. By 1902 more than 2 million Indians had been protected.

In November that year, however, a contaminated bottle of vaccine killed 19 people in a Punjabi village. In what became known as the Little Dreyfus affair, the British authorities hung Haffkine out to dry – exhibiting barely disguised antisemitism – despite evidence that he was not responsible. He was defended by the Nobel prize-winning doctor Sir Ronald Ross against “the common enemy: ‘institutional barbarism’; the disrespect for science, the unconscionable inattentiveness to its illuminating knowledge, by those entrusted with public health”. Here as elsewhere echoes of the Covid era abound, leading Schama to a passionate defence of scientists like Dr Anthony Fauci. Something about the inoculators and epidemiologists, he writes, always gets “under the skin of public tribunes for whom nothing, certainly not epidemiology, is politics-free”.

But if societies are to fortify themselves for a zoonotic future they will need to rely on exiles and émigrés, cosmopolitan and liminal individuals, those benign “foreign bodies” Schama describes with such careful attention. There are, in fact, “no foreigners, only familiars, only a single precious chain of connection that we snap at our utmost peril,” he declares. In doing so, he makes an urgent case for building a better future on our toxic past.

Jerry Brotton is professor of Renaissance studies at Queen Mary, University of London, and the author of A History of the World in 12 Maps (Penguin). Foreign Bodies: Pandemics, Vaccines and the Health of Nations by Simon Schama is published by Simon & Schuster (£30). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply.

‘In the end,” writes Simon Schama at the beginning of his extraordinary book on pandemics old and new, “all history is natural history.” Foreign Bodies is ostensibly an account of the bacteriologists and epidemiologists who studied the natural history of infectious diseases from the late 18th to the early 20th centuries, developing vaccines and saving millions from smallpox, cholera and the plague. But as its subtitle suggests, it is also a reflection on the political and scientific conflicts of the Covid pandemic, and the failure of contemporary leaders to coordinate a scientifically driven global response to the virus.

Over millennia, biological and environmental imperatives rather than states and empires have shaped human destiny. Now capitalism’s degradation of the planet threatens our future survival. Zoonosis – the transmission of infectious diseases from animals to humans – has always bedevilled humanity, but the risks are increasing as we encroach further into natural habitats. The Global Virome project estimates that there are more than half a million unknown viruses with zoonotic potential; since 1980 sub-equatorial regions have experienced viral outbreaks every eight months; the Sars epidemic of 2003–4 has now been traced back to dragon-tiger-phoenix soup, a combination of palm civet meat, chrysanthemum petals and snake served in restaurants in southern China. If these facts are sobering, the response of our politicians, described with measured fury by Schama, is terrifying: now as before, international cooperation founders as national tribalism belittles science and its “cosmopolitan” practitioners.

What can history tell us about how we got here, and how to respond in the future? The answer is conveyed through a meticulous retelling of a terrible yet scientifically innovative period, beginning with the cholera pandemics of the 1850s and taking in a three-decade epidemic of bubonic plague that by the 1920s had killed a staggering 12 million people, mostly in India. White, male, Christian European colonial authorities, obsessed with segregation and sanitation, doused homes with carbolic and limewash. When that didn’t work they were forced to turn to outsiders: migrants, exiles – the “foreign bodies” of the title – who challenged prevailing social and scientific assumptions. Schama’s varied cast includes Lady Mary Wortley Montagu, the first European to inoculate her children against the disease in 1721 after learning the “Turkey way” of variolation – an early form of vaccination. We meet Adrien Proust, Marcel’s father – known as the “geographer of epidemics” – who travelled to Istanbul and Tehran, trying unsuccessfully in his 1873 essay on international hygiene to establish protocols for global public health. Exiles and émigrés flit between the research institutes led by Robert Koch in Berlin and Louis Pasteur in Paris before dispersing across the globe to the frontlines of cholera and plague outbreaks in the “great game of competitive medical imperialism”. By the 1890s German, French, Swiss, Russian, Japanese and English bacteriologists, doctors and nurses were to be found at centres of contagion such as Hong Kong, Singapore and most notoriously Bombay. They went in order to research and deliver vaccinations, confronting terrible conditions as well as the ignorance and suspicion of colonial officials.

But, as Schama notes, it wasn’t just the officials who were suspicious. He deftly captures the paradox of medicine being seen as a “poisoned gift” of empire: while the bacteriologists saved millions of lives, they also rode roughshod over local mores – in India there was horror at the mixing of castes in hospitals and the intimate examination of women, while others worried about animal matter in the vaccines. Schama even argues that the sparks of Indian nationalism that eventually broke the Raj – unified social and religious outrage that coalesced into strikes and mass demonstrations – were struck during the plague of 1897.

The central outsider in Foreign Bodies is the “culturally hybrid prodigy” Waldemar Mordechai Wolff Haffkine. A Ukrainian Jew, Haffkine took up arms during the Odessa pogrom of 1881 before becoming a protege of Élie Mechnikov, the founder of immunology. Haffkine eventually developed a cholera vaccine, which he tested on himself in 1892. It worked, and by 1893 he was in India inoculating 42,000 villagers, slum dwellers and soldiers a year. In 1897 he developed a plague vaccine in Bombay, once again testing it on himself, and created the world’s first large-scale vaccine production line. By 1902 more than 2 million Indians had been protected.

In November that year, however, a contaminated bottle of vaccine killed 19 people in a Punjabi village. In what became known as the Little Dreyfus affair, the British authorities hung Haffkine out to dry – exhibiting barely disguised antisemitism – despite evidence that he was not responsible. He was defended by the Nobel prize-winning doctor Sir Ronald Ross against “the common enemy: ‘institutional barbarism’; the disrespect for science, the unconscionable inattentiveness to its illuminating knowledge, by those entrusted with public health”. Here as elsewhere echoes of the Covid era abound, leading Schama to a passionate defence of scientists like Dr Anthony Fauci. Something about the inoculators and epidemiologists, he writes, always gets “under the skin of public tribunes for whom nothing, certainly not epidemiology, is politics-free”.

But if societies are to fortify themselves for a zoonotic future they will need to rely on exiles and émigrés, cosmopolitan and liminal individuals, those benign “foreign bodies” Schama describes with such careful attention. There are, in fact, “no foreigners, only familiars, only a single precious chain of connection that we snap at our utmost peril,” he declares. In doing so, he makes an urgent case for building a better future on our toxic past.

Jerry Brotton is professor of Renaissance studies at Queen Mary, University of London, and the author of A History of the World in 12 Maps (Penguin). Foreign Bodies: Pandemics, Vaccines and the Health of Nations by Simon Schama is published by Simon & Schuster (£30). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply.