Rachel Kahn Best's "Common Enemies"

Rachel Best is Assistant Professor of Sociology at the University of Michigan. She studies political responses to social problems, focusing on how advocacy and culture shape whose concerns are addressed and whose are ignored.

Best applied the “Page 99 Test” to her new book, Common Enemies: Disease Campaigns in America, and reported the following:

Does the National Institutes of Health spend the right amount of money to research various diseases? Or are some diseases over-funded, and others neglected? The trouble with answering this question is that there’s no obvious way to decide which diseases are most deserving of public research funding. Should we count up deaths? Ask which diseases inflict the most suffering? Account for healthcare expenditures? Page 99 jumps into the middle of these debates, discussing two other measures people sometimes use to prioritize diseases for research funding.

First, some scientists and health officials argue that we should prioritize research based on scientific opportunity, funding the areas with the greatest potential for new treatments and cures. This is a reasonable suggestion, but one that could reinforce inequalities in funding. “Since research funding attracts students and researchers to specialize in fields, develop expertise, begin projects, and make discoveries,… using potential to set priorities would widen the gaps between well-funded and neglected diseases.”

Second, scientists and officials also sometimes argue that we should base research funding on “the degree to which a disease is neglected by private industry.” This is another reasonable suggestion, but given that public research findings are often licensed to private companies, it raises concerns about providing a subsidy to the already lucrative pharmaceutical industry.

Page 99 gives a snapshot into the politics of ranking diseases. The rest of the book reveals the long history of disease campaigns, from the early twentieth century crusade against tuberculosis to contemporary fights against diseases like breast cancer. Other chapters explain why so much of American philanthropy and public policy focuses on campaigns against single diseases, and how this disease focus shapes how we distribute resources and the types of health policies we pursue.

Learn more about Common Enemies at the Oxford University Press website.

--Marshal Zeringue