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Book Review: Plagues and the Paradox of Progress


A "paradox" is a philosophical notion which claims that something can exist in contradiction to itself. Paradoxes can transpire in all avenues of life and scientific disciplines. In Thomas J. Bollyky’s medical novel, “Plagues and the Paradox of Progress: Why the World Is Getting Healthier in Worrisome Ways” the global health program director states that as civilization advances, deeper predicaments are produced, consequently the paradox of progress is created. Bollyky delivers a holistic outlook on how the world of public health has dramatically shifted, specifically, infectious diseases by analyzing how subcategories — mobility, topical diseases, socio-economic factors — within the last century have shifted.

Analysis of The Cover Page

The cover page of Bollyky’s best-seller depicts a snapshot of a cerulean blue backdrop with a rainbow symmographic of the regions of the globe. The law professor subtly employs this representation to paint the thematic elements of his novel: collaboration and hope. Bollyky heralds those sentiments through the use of the color blue, which is associated with credibility and trust — characteristics that are prized in the medical community. Bollyky’s scientific publication, issued in 2018, was composed at a pivotal period in which public health agencies and private entities were — and ongoing efforts are continuing — to stop epidemics by way of ongoing computerization through allocating state-of-the-art industrialization. Bollyky’s novel speaks to audiences with non-specialistic backgrounds and those equipped with expertise in public health.


At the onset of the novel, Bollyky exercises a jet-engine point-of-view by adamantly pronouncing that a “slow decline in the death and disability from infectious diseases began 250 years ago” (Bollyky 22). Moreover, the public health scholar organizes three constructs that lead the novel: infectious diseases are declining, efforts to stop infectious diseases are vital on a global level, and third, the trend in which the diseases are declining is distinct from the past, thus the abrupt transformation is worrisome. Throughout the novel, Bollyky employs a holistic viewpoint when examining health outbreaks, given “increased global trade, …climate change…and urbanization” (23). Bollyky sheds light on how “[t]he notion that infectious diseases are in decline may be hard to believe” as he attributes this thought as the “paradox of progress against infectious diseases” (333). In the latter portion of the novel, Bollyky probes into this opposing notion.

Authors Depictions

The lens Bollyky established in the novel was significant to understanding the paradox the scholar ornamented. For instance, the introduction commences with the Enlightenment and Industrial Revolution being mark points for the decline of infectious diseases. The author notes health crises, throughout history — from the Enlightenment era to 450 BCE, 1918 Spanish Flu, and the HIV/AIDS pandemic — not in chronological order. The points that were mentioned were crucial, as Bollyky asserted, “[c]limate change allowed malaria to expand out of Africa” and novel risks such as “synthetic, man-made viruses may yet emerge,” however remaining vigilant in global contribution and collaboration to develop drug-resistance medicines and logistical measures to tackles complex situations is needed, suggests Bollyky (27). The portrayal of the influence of plagues on humankind is meticulously explained.

Example of a Paradox

In chapter six, “The Exoneration of William H. Stewart,” the chapter underscores how the sentiment of exhibiting a dismal outlook in inelastic public health and economic circumstances can be natural while models of crisis and a paradox are inserted in the latter portion. Bollyky sounds the alarm, by affirming that the exponential growth of poor cities is worrisome, amidst rising population numbers. In turn, these global difficulties pose various warnings for infectious diseases to circulate. Bollyky details, a lack of economic opportunities in developing nations “breed[s] instability and spurring desperate attempts at migration” (332). Economic disparities in low-income countries sow the seeds for health outbreaks called Bollyky. Furthermore, additional factors such as climate change and international trade, give leverage for consequential results from a public health standpoint. Bollyky's work in conversation to Stewarts' insights on how infectious diseases have been on a decline, “grappling with the consequences of the partial progress against infectious diseases in poorer nations” ultimately defines the paradox of progress against infectious diseases (332-333). Bollyky’s holistic approach to analyzing plagues and outbreaks is methodological and ushers steps to be taken for a promising future.

Forecasts From the COVID-19 Pandemic

As the ongoing COVID-19 crisis wavers over our everyday lives, the pandemic has highlighted the firm rifts among wealthy and poorer nations. In the summer of 2021, cases in the U.S. were at an all-time low, with seven-day averages standing at 22,341 (Adeel NY Times). By mid-July, as the Delta variant became predominant in the U.S., states in the south and midwest saw exponential cases. The vicious variant of concern, originally identified in India in December 2020 was overwhelming communities around Africa, Europe, and Asia. While the virus was on the other side of the world, and the U.S. acquired millions of life-saving vaccines, many supplies were not allocated to India. In turn, poorer nations become variant factories, due to the lack of life-saving supplies.

Recently, the W.H.O. named the Omicron variant — first identified in South Africa — as a variant of concern. As of Tuesday, Dec. 7th, 2021 the country of South Africa has administered 26.3 million COVID-19 vaccines, with 25.2% fully vaccinated (Ritchie Our World In Data). I anticipate more variants of interest will emerge if well-off nations do not donate vaccines to poorer nations.

Prediction For Human Societies

In terms of how human societies will change, I believe behavior patterns will shift. The COVID-19 pandemic has put a spotlight on world leaders — Presidents, Prime Ministers, Governors, and even industry executives — as many have shown their true colors from their poor leadership throughout the health crisis. In epidemiology and public health, there is a term used to describe the true toll/number of deaths from various causes during a particular epidemic/ or pandemic, called excess mortality. For the last year, I have been tracking the spread of COVID-19 on a global scale. One trend that I have observed that leads to spikes in cases is policy responses, which are related to excess mortality. Around the world, some regions have suffered largely from the crisis e.g. U.S., India, and Brazil. One factor that has contributed to significant casualties is government policy responses. I have witnessed first-hand government officials politicize health procedures, such as mask use or social-distancing policies. On a matter such as public health, having a leader who has well-rounded knowledge, or an appointed official to advise the leader regarding health outbreaks can mean the difference between losing hundreds of lives or protecting an entire community. The word “integrity” is tossed loosely when praising leadership during the COVD-19 pandemic. From former Gov. Andrew Cuomo of New York to Prime Minister of India, Narendra Modi. Integrity is a vital characteristic to have to effectively lead. Bollyky’s novel sheds light on the importance of public health education and the various factors that influence how viruses spread throughout history.

Works Cited

Adeel Hassan, et al. “Coronavirus in the U.S.: Latest Map and Case Count.” The New York Times, 7 Dec. 2021,

Bollyky, Thomas J. Plagues and the Paradox of Progress: Why The World Is Getting Healthier in Worrisome Ways. The MIT Press, 2018.

Ritchie, Hannah, et al. “Coronavirus Pandemic (COVID-19) - Statistics and Research.” Our World in Data, 5 Mar. 2020,


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