About

What is health, who can have it, who should have it and what should be done to have it? Who is listened to when answering these questions and how does selective listening shape ways of living, getting sick and dying?

In the colonial myth of modernity, the individual and the superior Man define the answers. Western Man is the ultimate expression of biological and cultural evolution; his health comes first. The more distante from the elite, health is more a necessary resource to keep the workforce functioning and to meet commercial biosecurity requirements. A minimum level of health must be guaranteed for human and other-than-human workers to be profitable, and for animal and plant products not to be condemned on the market. Without individualism and anthropocentrism, the colonial myth of modernity withers and other ways of living and being healthy emerge.

Curiously, modern science itself is dismantling the notion of the biological individual. Multispecies collectives of bacteria co-participate in the embryological, physiological and immunological processes that make up multicellular organisms. There are more bacterial cells than human cells in the human body. The genetic material of humans co-evolves with that of the living beings who depend on them and on whom they depend. Biologically, what we call humans are always more-than-humans, multispecies collectives that are part of other multispecies collectives. More than individuals, there are bodies-territories or, in biological jargon, holobionts. You are a holobiont, just like the whales decimated by extractivism and the disturbance of marine ecosystems, or the cockroaches living in the sewers that can’t cope with the overcrowding of cities taken over by the real estate market.

Ideologically, the self-sufficient, independent and selfish individual is the character in the fiction known as the “state of nature”. In one version of this fiction, people in constant conflict and paranoia try to rob others and not allow themselves to be robbed and killed. One of the solutions put forward to overcome the state of nature is a social contract in which a selfish calculation convinces free, equal and independent men of the advantage of renouncing total freedom in order to submit to the authority of a ruler who guarantees the protection of private property and life. At the time this solution was formulated, it was understood that women were dependent on their husbands and therefore not free, equal and independent, which prevented them from participating in the contract. This was the birth of the modern nation-state, a structuring fiction for the interpretation and organisation of social reality, which, after having been a way out of monarchical regimes, became another apparatus of oppression. A fictional state of nature that has been overcome by a modern reality that is genocidal and belligerent like no other; the same one that provoked world wars and Nazism; nuclear weapons; the one that made a globe, drew the planet on it to divide it among white men and violently imposed its customs on the world (globalisation); the one that talks about the Anthropocene instead of the Capitalocene, while selling green solutions and making the earth more hostile to biocultural diversity. A minimum of realism invalidates this modern individual, because we are born, grow up and live in interdependence, mobilising various affections that go far beyond conflict and paranoia. If there are individuals, they are not “indivisible” creatures, but relational configurations whose materiality, agency and meaning emerge and take place in these relationships.

But who are we? In the colonial myth of modernity, there is a superior human whose existence depends on an inferior point of comparison. Animalisation was the solution that modernity found to support this idea of superiority. It creates the animal as a point of inferiority against which the superior human is set: white, male, heterosexual, of European origin. Colonial animalisation is an apparatus for the production of inferior Others, applied to other-than-human beings as well as to humans; from the non-whites exhibited in zoos until the beginning of the 20th century, to today’s non-whites who, along with other queer people, have fewer privileges, are insulted by being attributed animal characteristics or being “treated like animals”. It is in this degrading spectrum, from human to animal, that “us” and “others” become intelligible categories for modernity. Decolonially, to be treated like an animal is to be treated with respect, because this animality is not an inferior condition marked by the absence of the human essence. It’s something we share with a multitude of other animals. From the point of view of decolonial animality, ‘who we are’ is always a situated question, and the Other is not inferior, but circumstantially different, a living being to be cared for.

Collective care for ourselves and others – without individualism and anthropocentrism – is the basis of the multispecies health we conceive. Far from being a naïve abstraction of a world without suffering, this care is about taking the interests of others seriously, engaging in conflicts to try to solve them as fairly as possible and cultivating our empathy for other living beings. While species is a category of biological taxonomy, it also denotes and connotes a set of entities with something in common. There can be biological species, but also species of beings, knowledge, relationships and existences. Therefore, multispecies collectives are not limited to living beings, much less to animals. The composition of a given multispecies collective is always circumstantial and linked to a point of view. The health of multispecies collectives understood in this way is located on the colonial-capitalist peripheries of modernity. What this health seeks is not the inclusion of the peripheries into the colonial centre; on the contrary, it seeks to make them so peripheral that they are beyond the reach of the pathological marginalisation operated by that centre. It’s about public and collective health, based on good living (buen vivir), which doesn’t want to prematurely and anthropocentrically close off the composition of the public and the collective.

The MUHE Network (Multispecies Health Network) began by calling itself the OHP Network (One Health of Peripheries) in an attempt to decolonise what is called ‘One Health’ in the global North, to address the health of humans, animals and the environment. However, the term itself has a colonial connotation and we have come to the conclusion that it is better to avoid it. Biological species have different ecological and epidemiological functions. In many ways there are more similarities between humans and rats than between rats and eagles, or between humans and dogs than between mosquitoes and rhinos. However, One Health lumps and reduces the diversity of animals into the category of “animals” and removes humans from it to put them into an exceptional, separate category, that of humans and only humans; the other living beings are lumped into the category of “environment”, sometimes distinguishing the plants. In this categorisation, human and other-than-humans living beings are not environments (multispecies collectives, bodies-territories, holobionts).

One Health says that there is just One health. If that’s the case, then there’s no such thing as health and One Health, because there aren’t two, there’s just one: health. But from a conceptual point of view, health is understood in different ways, there is no just One definition. The World Health Organisation (WHO), which supports One Health, defines health as if it were the nirvana: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Taking the environment as a set of physical, biological and chemical conditions that surround living beings and things, according to the WHO definition, environmental health implies that the environment has a mind and an underlying neurological system, that it has a mind that does not depend on a neurological system or, simply, that environmental health is not about the environment itself, but refers to its influence on the health of its inhabitants. This problem of minds without a neurological basis extends to plants, microorganisms and various other living beings. It’s not clear how the WHO’s definition fits in with the idea of One Health, which is One and at the same time refers to several healths (human, animal, plant and environmental). Under other conceptual approaches that can be applied to multispecies collectives, health is understood as a phenomenon (state, process, attribute, function, capacity, experience), idea (cultural construction, symbolic production, way of understanding the world), practice (actions of care, promotion, prevention, recovery, rehabilitation), among others. When reviewing the epistemological literature, it is clear that there are theories about the complexity of health, but there is no One Unified theory that synthesises all the ways of understanding health. The logic of a One Health, as the only One, is conceptually unsustainable.

If, in an attempt to circumvent the above impasse, One Health is understood merely as a way of naming an approach to health, it is also clear that it is not the only One. There is public health, new public health, collective health, community health, environmental health, planetary health, global health, eco-health… As well as there being more than one way of defining One Health, this has become shorter in its own scope and, as well as One Health of Peripheries, there is Structural One Health, Just One Health, Relational One Health and More-than-One Health. All of these health approaches make it possible to consider the environment and the health of its other-than-human inhabitants, even if instrumentally, with human health as a priority. Each of these health approaches is Unique in its own way, without being the only approach, the One that includes and Unifies all the others. In terms of approach, there is no such thing as only One Health, but rather a multiplicity.

The Brazilian National Health System (Sistema Único de Saúde – SUS), which has the adjective “unique” in its Portuguese name, presents us with a challenge of a different kind. We support a robust public health system, and the current situation reminds us that this means defending a dynamic SUS capable of responding to the complexities of our times. Despite its name, the SUS is not unique. In the territory that for some time now has been called Brazil, there are indigenous peoples, especially those who have not been invaded by modern colonisation (“isolated”), who take care of their health by means other than the SUS. There are also those who use the SUS but at the same time make use of other non-Western health systems outside it. Unfortunately, there is also a private health system that undermines the SUS. On the other hand, the users of the SUS are human beings, and when the SUS takes care of other living beings, it does so anthropocentrically. And if these creatures continue to exist, it’s because they have the health to do so. Who takes care of them? Sometimes anthropogenic health systems for other-than-human beings, but it’s good to remember that living beings themselves are, too, health systems, and if they stop working, they die. A responsive SUS cannot close itself off to self-criticism and the possible conclusion that it was never unique, just misnamed.

In the Western myth, there is only One universe, the one discovered by the West, in which science is the Only source of truth and the path of modernity is the Only One that humanity should follow. This colonial monoculture is crumbling in the face of the crisis of civilisation we are experiencing, which is increasingly incompatible with life on Earth, as modern science itself testifies. We need to understand and live in a different way from the one that has led us into such a crisis. This doesn’t mean banning Western sciences and technologies, but simply redirecting them towards decolonial interests without making them hegemonic. Nor does it mean denying the idea of unity and totality. It is by unifying and totalising that we compose collectives, but these procedures (in the plural) are provisional, they have to be repeated in order to recompose collectives, correcting marginalisations that unfairly leave some out. Against narratives that claim to be the only ones, especially the monologue of modernity, we prefer to emphasise multiplicity.

Through universalisation and naturalisation, we may be convinced that modernity, that is, the colonial-capitalist order, is the only thing that exists and can exist, even though it is recent and provincial, as well as widely and violently imposed. Any alternative or questioning is systematically ridiculed and inferiorised in order to erase and prevent ways of being and living that do not conform to colonial-global interests. The masters of the big house, ‘socio-economically concerned’, opposed the end of slavery because of its strong economic and social impact. They even “cared for the health” of the slaves through strategies reflected in quantitative indicators of morbidity, mortality and reproduction. What kind of economy and society is it that is not brutally affected by slavery, but rather by its end? What kind of health is it that improves objective indicators measured in slaves and does not seek the end of slavery? What are the current forms of slavery and who are the current marginalised beings whose indicators are improved while the pathological marginalisation to which they are subjected is naturalised?

Today’s “socio-economically concerned” masters continue to defend the oppressions that maintain their privileges in order to avoid structural changes that would have a strong economic and social impact. That’s the point, because structural changes against injustice don’t leave things as they are, they aim to generate destructive impacts on the oppressive economy and society in order to build economies and societies of solidarity in favour of the most vulnerable multispecies collectives. The masters and their acolytes are always ready to defend agribusiness, while ignoring, condemning or ridiculing (three ideological strategies) agroecology and agrarian reform. “Do you care about animals, plants and nature when there are millions of starving children? What you need is to increase the GDP by producing tonnes of cheap meat!” Agro’s miracle solution assumes that there are no externalities to say that meat is cheap; it ignores the fact that nothing is cheap for those living in poverty; it doesn’t question who takes up most of the GDP; it doesn’t worry about food sovereignty and diversity. It’s one thing to end poverty and produce diverse and healthy food, but it’s another to enrich oligopolies by producing second-rate food for second-rate citizens. Today’s masters apply the same logic in every commercialised field; for them, no mission is impossible as long as it is in line with their interests, otherwise it is folly, naivety and a utopia doomed to failure.

The colonising health (or the colonisation of health) comes in various guises, is supposedly neutral because it is scientific, and seeks to improve quantitative indicators that narrowly and conveniently define the health of humans and other-than-humans. It manages to improve some health indicators for marginalised beings, but it never takes seriously the pathological effects of marginalisation, because without marginalisation, coloniality is undone. It is a health that talks about the ‘natural history’ of diseases and removes the pathological effects of marginalisation from these histories, reserving the causal role only for micro-organisms, molecules, organic failures and other targets of intervention that do not threaten the myth of modernity.

Decolonial health movements are not an abstract negation of hegemonic structures of oppression. When oppressions are structural, we somehow reproduce them even when we want to end them. But structures are not immutable and do not account for everything that exists. This is where (de/contra/anti)colonisation comes in, in a genuine effort to reproduce these pathological structures less and less, in alliance with other multispecies collectives that have resisted modernising genocides and ecocides. The decolonial promotion of multispecies health has no magic formula for the immediate and absolute realisation of a utopia. Consequently, it starts from the situated possibilities it encounters in everyday life, consciously inheriting and taking on the weight of both the historical and colonial present, as well as decolonial resistance, so that today’s utopias become tomorrow’s realities. When utopias don’t materialise, dystopias take over.

The planet is feverish, heated by climate change. We don’t want antipyretics to mask the growth of the colonial cancer disguised as benevolent globalisation; we want to eradicate it. It’s an invasive operation that’s never been done, with the likelihood of further metastases and a poor prognosis. But without surgery, the prognosis is grim. There is no easy way out of this entanglement.

Multispecies health involves decolonial life experiences, understandings and transformations; it is a praxis of actions informed by knowledge of the pathological effects of marginalisation, which builds knowledge from those actions; it is an invitation and a choice to be and live differently, interested in the multispecies good life (buen vivier), and therefore increasingly distant from the colonial-capitalist-modern centre that provides comfort to the few – mainly white people – at the expense of the oppression of the many. Multispecies health is another way of multiplying the ongoing decolonial flight.

And you, holobiont, are you going to play along with the myth of modernity or are you going to engage with multispecies health?