Why global disease eradication programs are politically awkward to initiate, incredibly difficult to prosecute, and nearly impossible to conclude

Government-organised vaccination campaigns are political projects that presume to shape the immunity of whole populations. Like other pervasive expressions of state power – taxing, policing, conscripting – mass vaccination arouses anxiety in some people but sentiments of civic duty and shared solidarity in others. As a rule, controversy clings to immunisation programmes, and different social formations – classes, urban elites, ethnic and confessional majorities and minorities, specialised workforces, refugees, provincial antagonists of capital cities – have at different times and places disputed, evaded or actively opposed state-led vaccination. Nonetheless, in most communities vaccines have come to be accepted as the most effective means for halting the spread of communicable diseases. People now tend to demand public health immunisation, and the development of new vaccines, for example against HIV, malaria and Ebola, are eagerly awaited. But compliance is always an issue. A key premise of this collection is that a state's ability to produce, or at least distribute, large quantities of vaccine, as well as its ability to manage the necessarily awkward intrusion into healthy bodies, have at different times and places strengthened or weakened social cohesion. As will be seen, mass immunisation should not be considered a neutral practice; it requires assessment in its relation to state power, national identity and the individual's sense of obligation to self and others