Epidemiology is more than discourse: critical thoughts from Latin America

The essay by Avilés1 is a powerful and well stated piece of work. It will certainly become an important reference regarding the misuse of epidemiology in the context of international politics. There is wide evidence concerning the political uses of science and technology as a tool for colonialism and economic domination.2 Indeed, the health field has been one of the most affected by such processes, with its research agenda and priorities for action defined by central countries.3 In the past, yellow fever and malaria control, nowadays the so called emergent and re-emergent diseases, are good examples of this kind.4

The paper1 consists of an analysis of the ideological discourse that lies beneath the Epidemiological Profile of El Salvador, a single author document sponsored by the United States Agency for International Development (USAID). Its major goal is the denunciation of epidemiological transition theory as a offspring of modernisation ideology,5 a doctrine that supports the action of international agencies. Avilés' critique of epi-transition theory is put forward on five grounds: legitimisation tool; political dissimulation; reality homogenisation; defence against domination challenging; source of naturalisation of epidemiological processes. Although such criticism sounds reasonable …