Early in the study of public health, most students come across the
famous quote from the nineteenth-century German pathologist and social
reformer Ruddolf Virchow: 'Medicine is a social science and politics is
nothing else but medicine on a large scale' (Aston, 2006). The phrase has
been used and abused many times since but is usually invoked to draw
a link between medicine and public health on the one hand and politics
on the other hand. The coronavirus 2019 (COVID-19) pandemic that ravaged the world and the efforts to address it have made the link between
public health and politics very visible to all. Specifically, the pandemic
has demonstrated that the choices that governments make to address
infectious disease threats are necessarily and inherently informed by both
scientific evidence and a host of other economic, social, and ethical
considerations. Reconciling these sometimes-conflicting imperatives is the
stuff of politics.
But Virchow's understanding of politics was very particular, as revealed
in the second and less well-known part of his statement. After characterizing
politics as medicine on a larger scale, Virchow went on to write,
'Medicine as a social science, as the science of human beings, has the obligation
to point out problems and to attempt their theoretical solution;
the politician, the practical anthropologist, must find the means for their
actual solution' (Aston, 2006). For Virchow, indeed for many in public
health, politics is a practical matter, something that is done by politicians,
and something that can and should be informed by the insights
of medicine and, by extension, public health sciences such as epidemiology.
Unfortunately, translating scientific evidence into public policy is
a messy business indeed. Moreover, medicine and public health have few
effective tools for systematically understanding the choices governments
make, much less the broader complexities of politics.
