Alexandre White

via Zoom

The Speculative Pandemic:  Epidemic risk, Necrofinance and the World Bank

What are the historic and contemporary roles of capital markets and complex financial products in global health management? In 2017, in response to the widely seen failure of the global community to respond fast enough to the West African Ebola Virus epidemic (2013-2016), the World Bank developed a novel financial product aimed at providing swift financing to prevent the rapid spread of epidemic crises. The World Bank has aimed to utilize global bond markets to finance aid delivery to epidemic stricken regions through the creation of a pandemic bond instrument- the Pandemic Emergency Financing Facility (PEF). This is the first time that capital markets have been used to effect the rate of epidemic spread. In the Pandemic Emergency Financing Facility we see a transformation in how epidemic threat is quantified, how those suffering are constituted and realized in the responses to epidemic. The glaring weaknesses in the West African Ebola response exposed the limits of the World Health Organization, existing global health responses and the reliance on global charity. Rather than devoting significant funds to health systems development or holistic strategies of epidemic prevention, the World Bank sought to find a solution in the domain of finance and capital markets speculation. In doing so it  produced a novel form of global finance, one for which the lives of populations can be abstracted to financial value and risk. This raises the question of what are the potential roles of capital markets in infectious disease management? How is epidemic risk assessed when focused through the manifold lenses of finance? This paper explores the history of catastrophe financing products and the contemporary history of international epidemic response to discern the roots of the PEF. Examining both the previous West African Ebola Virus Epidemic (2013-2016) as well other recent epidemics I demonstrate which assumptions of epidemic threat undergird the World Bank’s PEF structure and how it breaks from previous frameworks of pandemic threat appraisal such as the World Health Organization’s Public Health Emergency of International Concern designation. Drawing upon the theories of Achille Mbembe, Jean Baudrillard and others this paper examines the roots of pandemic speculation and locates its role within the larger ecosystem of global infectious disease control.


Alexandre White is an Assistant Professor of Sociology and the History of Medicine at Johns Hopkins University and School of Medicine. He is also the Associate Director of the Center For Medical Humanities and Social Medicine. White’s  research foci, at the intersections of the sociology of race and ethnicity, history of medicine, and global historical sociology, critically investigates global racial formations and how racial forms of governance, rooted primarily in imperial projects, have produced contemporary social phenomena. White has published extensively in social science journals on the topics of racism, slavery and medicine including in the journals, Sociology of Race and Ethnicity, Theory and Society and Social Science History. He is the editor of the volume Global Historical Sociology of Race and Racism and has published in medical journals such as the British Medical Journal, the New England Journal of Medicine and the Lancet. White’s first book Epidemic Orientalism has been accepted and is forthcoming at Stanford University Press. This book explores how epidemic threats become the focus of international management, regulation and control, as well as the political, economic and racial ideologies that have shaped international coordination to stop pandemic spread. 

Since the emergence of COVID-19 he has produced a further line of research to address the challenges of this continuing pandemic. Supported by grants from the National Institute of Child Health and Human Development through the Hopkins Population Center (HPC) he has worked to develop a COVID-19 social science “data hub”. This data hub collects and manages county-level data on sociodemographic and health factors that influence the spread of COVID-19. In addition, he has helped to draft recommendations for safe, informed, effective, and collaborative vaccine delivery to minority populations in the United States. This report was published by the Johns Hopkins Center for Health Security and in the Journal of Health Security, and was profiled in the Washington Post, New York Times, and others. White has briefed Congress on COVID-19 responses and has written for or been interviewed for roughly 30 print, online, and television news reports by outlets including CNN, the Washington Post, the Wall St. Journal, New York Times, National Public Radio, Der Spiegel and others.