The coronavirus pandemic has forced us to rethink the politics of health in the broadest sense. In particular, we have had to confront again that vexed relationship between the state, the dominant social relations and public health. Concepts that may have seemed obscure and or to have fallen out of one academic fashion, such as biopolitics or “naked life”, have leapt from the page and become suddenly irrepressibly pertinent to our everyday experiences. The same could be said about ‘the state of exception’, whose recent popularity recalls the onset of the War on Terror, and now refers to the extreme, authoritarian measures taken to confront the pandemic. At the same time they pose the challenge of how to think about the politics of health from the perspective of the subaltern classes. In view of this challenge I believe that these concepts need to be both problematized and re-elaborated.

A recent intervention from the philosopher Giorgio Agamben offers, in my opinion, an example of a failure to answer this challenge so grave, that it may lead many to reject the problem and concept of biopolitics itself - specifically because the mentioned concepts are so closely associated with Agamben’s work. In an article written at the very first stages of the Covid-19 epidemic in Italy, Agamben characterized the measures implemented in response to the Covid-19 pandemic as an exercise in the biopolitics of the ‘state of exception’. This text has sparked an important debate on how to think of biopolitics in relation to events such as pandemics and the measures associated with them. In it, Agamben, suggested that the measures taken were imposing an ‘authentic state of exception’ and that the ‘invention of an epidemic offered the ideal pretext’ for further limitations to basic freedoms. The article provoked a series of responses. Jean-Luc Nancy insisted that the danger from the epidemic is indeed real and that the very notion of the exception is becoming the rule as a result of the increased ‘technical interconnections’ of all kinds in contemporary life. Roberto Esposito in his response to both Agamben and Nancy defended the relevance of biopolitics as a way to think important contemporary developments but also suggested that the situation in Italy ‘has more the character of a breakdown of public authorities than that of a dramatic totalitarian grip’. Others stressed the reality of the danger of the pandemic, the need to avoid easy dismissals of warnings by experts and the need to rethink the very notion of responsibility we have toward others. I think that this debate offers a way to rethink the very notion of biopolitics, and I would like to offer some preliminary thoughts on the possibility of an alternative thinking of biopolitics.

The notion of biopolitics, as it was formulated by Michel Foucault, has been a very important contribution to our understanding of the changes associated with the passage to capitalist modernity, especially in regards to the ways that power and coercion are exercised. From power as a right of life and death that the sovereign holds, we pass to power as an attempt to guarantee the health (and productivity) of populations. This led to an expansion without precedent of all forms of state intervention and coercion. From compulsory vaccinations to bans on smoking in public spaces, the notion of biopolitics has been used in many instances as the key to understanding the political and ideological dimensions of health policies.

At the same time, it has allowed us to analyse various phenomena that are often repressed in the public sphere, from the ways that racism attempted to find a ‘scientific’ grounding to the dangers of trends such as eugenics. And indeed Agamben has used it in a constructive way, in his attempt to theorise the modern forms of a ‘state of exception’, namely spaces where extreme forms of coercion are put in practice, with the concentration camp the main example.



The questions regarding the handling of the Covid-19 pandemic obviously raise issues associated with biopolitics. Many commentators have suggested that China made steps towards containing or slowing the pandemic because it could implement an authoritarian version of biopolitics, which included the use of extended quarantines and bans on social activities, which was helped by the vast arsenal of coercion, surveillance and monitoring measures and technologies that the Chinese state has at its disposal.

Some commentators even claimed that because liberal democracies lack the same capacity for coercion or invest more on voluntary individual behaviour change, they cannot take the same measures and this could inhibit the attempt to deal with the pandemic.

However, I think that it would be a simplification to pose the dilemma as one between authoritarian biopolitics and a liberal reliance on persons making rational individual choices.

Moreover, it is obvious that simply treating measures of public health, such as quarantines or ‘social distancing’, as biopolitics somehow misses their potential usefulness. In the absence of a vaccine or successful anti-viral treatments, these measures, coming from the repertoire of 19th century public health manuals, can reduce the burden, especially for vulnerable groups.

This is especially urgent if we recognize that even in advanced capitalist economies public health infrastructure has deteriorated and cannot actually stand the peak of the pandemic, unless measures to reduce the rate of its expansion are taken.

One might say that contra Agamben, the concept of ‘naked life’ can better describe the pensioner on a waiting list for a respirator or an ICU bed, because of a collapsed public health system, than the attempt to adjust to the practical exigencies of social distancing or quarantine measures. In light of the above I would like to suggest a different return to Foucault. I think that sometimes we forget that Foucault had a highly relational conception of power practices. In this sense, it is legitimate to ask whether a democratic or even communist biopolitics is possible.

To put this question in a different way: Is it possible to have collective practices that actually help the health of populations, including large-scale behaviour modifications, without a parallel expansion of forms of coercion and surveillance?

Foucault himself, in his late work, points towards such a direction, around the notions of truth, parrhesia and care of the self. In this highly original dialogue with ancient philosophy, in particular Hellenistic and Roman, he suggested an alternative politics of bios that combines individual and collective care, based on a certain obligation and courage to tell the truth, in non-coercive ways.

In such a perspective, the decisions for the reduction of movement and for social distancing in times of epidemics, or for not smoking in closed public spaces, or for avoiding individual and collective practices that harm the environment, would be the result of democratically discussed collective decisions based on the knowledge available and as part of a collective effort to care for others and ourselves. This means that from simple discipline we move to responsibility, in regards to others and then ourselves, and from suspending sociality to consciously transforming it. In such a condition, instead of a permanent individualized fear, which can break down any sense of social cohesion, we move towards the idea of collective effort, coordination and solidarity within a common struggle, elements that in such health emergencies can be equally important to medical interventions.

This offers the possibility of a democratic biopolitics. This can also be based on the democratization of knowledge. The increased access to knowledge, along with the need for popularization campaigns makes possible collective decision processes that are based on knowledge and understanding and not just the authority of experts.



Biopolitics from below

The battle against HIV, the fight of stigma, the attempt to make people understand that it is not the disease of ‘high risk groups’, the demand for education on safe sex practices, the funding of the development of therapeutic measures and the access to public health services, would not have been possible without the struggle of movements such as ACT UP. One might say that this was indeed an example of a biopolitics from below.

And in the current conjuncture, social movements have a lot of room to act. They can ask of immediate measures to help public health systems withstand the extra burden caused by the pandemic. They can point to the need for solidarity and collective self-organization during such a crisis, in contrast to individualized “survivalist” panics. They can insist on state power (and coercion) being used to channel resources from the private sector to socially necessary directions. They can organize struggles for paid sick leave and for an end to measures such as eviction. They can put their collective ingenuity in practice to create forms of support for the elderly and those without any assistance. They can project, in all possible ways, the fact that today the struggle against the pandemic is a struggle waged by labour, not capital, by doctors and nurses in understaffed public health systems, by precarious workers in the vital supply chains, by those that keep basics infrastructure running during the lock-down. And they can demand social change as a life-saving exigency.



(This text is a revised and referenced version of text that first appeared here)

