Is Public Health a fascist movement?

 

When describing and evaluating my new definition of Fascism, I tended to go back and forth over the question whether the Public Health-movement qualifies as fascist. In order to keep my article on fascism focused on the important movements, I have decided to write a separate essay to delve into this question deeper. My previous answers to this evaluation are not yet satisfying to me. I have dismissed the classification the first time around (May 2019) and corrected myself when re-evaluating it in December 2019. And I found my arguments unconvincing when I last read them back. So I'll try again.

I have two ways in which I'm going to evaluate this question: a comparison to my own definition, and a comparison to Umberto Eco's 14 characteristics of Ur-Fascism.

My own definition is: Fascism is collaboration between nihilism and moral supremacism, aimed at the violent implementation of a morally superior society. I have specified how the traits of nihilism, moral supremacism, their synergy and the ironing out of inconsistencies are expected to manifest themselves.

I will compare the characteristics of the modern Public Health movement with my definition and the additional specifications. But let me first give a brief overview of what I mean by the Public Health movement.

Public Health

For the description of the Public Health movement, I lean heavily on the work of Christopher Snowdon and Carl V. Phillips, who have spent many years documenting the development of an essentially benign movement into an authoritarian-leaning cult striving for very narrowly defined lifestyles, controlled by government. As Chris Snowdon has extensively documented in his excellent book "Velvet Glove, Iron Fist, a history of anti-smoking", it all started with tobacco. The modern movement started from a genuine concern for the health effects of smoking, especially regarding lung cancer, and the rightful anger against the tobacco industry sowing doubt about the causality of these associations. During the 1980s and 1990s, this rightful anger was turned into demonization of the tobacco industry and, in its wake, of anyone defending smoking or otherwise consuming tobacco. The ultimate aim of the anti-smoking movement was always the gradual implementation of all-out prohibition of tobacco smoking. Research into passive smoking, or the risks of environmental tobacco smoke (ETS), was always strategic, in the sense that the movement was actively searching for the stick with which to beat the dog. A critical evaluation of the resulting science, which Snowdon has carried out, showed that the level of bias and even fanaticism among researchers and their funders has corrupted the science in a way that led to new terms, such as "policy-based evidence" and "junk science". Consequently, whereas the risks of smoking to the smoker have been conveyed pretty accurately, the risks of passive smoking have been grossly overstated by tobacco control organizations. This overstated risk is now being used as a basis for ever-increasing restrictions on the sale and consumption of tobacco products, with some countries planning a sort of phase-out by proposing a ban on the sale of tobacco to people born after a certain year. In the end, the anti-smoking movement has shown itself to be driven primarily not by health, but by hatred of smoking. It will therefore never be satisfied with anything less than the total elimination of smoking from society.

The anti-smoking playbook has since been copied by many other campaigns, such as those advocating against alcohol, fatty foods, sugar and salt, all supposedly in the name of health, but, on closer inspection, based on Puritanism. Carl Phillips documented the strange synergy between the medical establishment and the temperance movement in a long essay showing the overriding ethic of the movement: attaining maximum longevity of human bodies, everything else be damned. This may be a useful ethic in the hospital, where medics try to save people's lives, but as a norm for leading one's entire life it is ridiculous. No one leads their lives according to this principle.

The Public Health movement has a strange relationship with government. Most Public Health organizations are NGOs, but many of them — especially in Europe — are substantially funded by the government, leading to the bizarre construct of the state being lobbied by NGOs using taxpayer money. Other major sources of funding for Public Health lobby groups are pharmaceutical companies and billionaire philanthropists. Public Health also has a symbiotic relationship with the mainstream media, who are always willing to spread more interesting information on health risks or benefits of this or that product.

The scientific malpractice of the anti-smoking lobby has appeared to be contagious: debased epidemiology has since 2000 been applied to all the other major targets of Public Health, whether in the alcohol, food, drugs or cosmetics sectors. Even the environmental movement seems to have picked up some of these traits. Part of the presence of climate scepticism can be explained by the concern for junk science. (I have evaluated some of the IPCC reports, but I have to say those are generally of high quality. The power struggle there appears to revolve around the policy recommendations.)

So, in essence, the Public Health lobby revolves around branding products as healthy or unhealthy per se, without regard for dosage. And from that qualification it derives a moral norm as to whether these products should be consumed or not. In extension to that, Public Health lobbies for a government apparatus to control consumer behavior. And this control is to be applied progressively until a "perfectly healthy" population is reached. According to this ethic, the healthiest nation in the world in 2017 was Afghanistan, while the Czech Republic was deemed the most unhealthy. It makes you wonder what life is all about.

Evaluation I

Now, let's delve into the question if Public Health can be qualified as a fascist movement. What I can derive from the description I have just given, is that it is definitely a moral supremacist movement. And quite a fanatical one at that. But to what level is nihilism present in the movement, and to which extent is synergy between moral supremacy and nihilism driving its progress? That would be the main question to explore.

Public Health and its followers do have some tendencies to become violent. I remember the news story, several months ago, where some Dutch traveler at München train station in Germany, beat up a man who happened to be smoking on the platform when the traveler debarked the train with his wife and two children. This as an illustration of the shifting norms that are the consequence of the Public Health lobby. But not every form of violence is nihilist in nature. Moral supremacy can be enough of a driver for violence in and of itself.

Nihilist violence is applied to assert power for power's sake. This power can be asserted with different aims in mind: maximizing wealth (e.g. by robbing the other blind), maximizing physical domination (e.g. by hurting the other until they go limp), maximizing attentional value (e.g. by being so disproportionate that others will be frightened by the media reports). And it should show a lack of valuation of human life in general.

The type of violence that happened in München, I would not classify as nihilist. A more nihilist type of violence would be to withhold medical care from people based on the lifestyles they lead. Withholding necessary, life-saving care from people who need it, as a form of punishment, I would classify as torture and possibly a form of terrorism (scaring people into submission). I still doubt, however, whether I would classify this as nihilist. If it is, or can be, driven by moral zeal alone, then I would not consider it proof of nihilism. From what I have seen so far, the attempts at violence from Public Health quarters, or appeals in that direction, I can explain using moral zeal alone.

Nihilism could also show itself in attaining power for power's sake, as opposed to attaining power just to implement a morally superior society. In order to assert or prove this, I would need to pick out the individuals who are nihilists and who are actively co-opted by the Public Health movement in order to further their goals. I can think of some examples to evaluate: Gerard Hastings, Robert Mugabe, Rodrigo Duterte, Stanton Glantz.

Gerard Hastings is a Professor of Social Marketing at Stirling University and director of the Centre for Tobacco Control Research at that University. He is an ardently anti-capitalist campaigner for all sorts of restrictions to the sale and marketing of products, with Public Health mostly as a pretext for these types of restrictions. As Chris Snowdon puts it: "It is quite obvious that 'public health' is a political vehicle for him and his colleagues. It's all about the evils of capitalism and 'consumerism'." So yes, Gerard Hastings is very much into the good versus evil business of moral supremacism, and his lust for power appears to be a means to his moral ends. His views and opinions are more closely aligned with communism than fascism.

Robert Mugabe, the dictator of Zimbabwe, was appointed as goodwill ambassador of the WHO in October 2017. Because of the public outcry over such an act of blatant corruption, WHO revoked this appointment a day later. Even if Mugabe could be counted as a nihilist, one day is not enough for any synergy between moral supremacism and nihilism to occur.

Rodrigo Duterte, the authoritarian leader of the Philippines, was complimented by the WHO on his anti-smoking policy. Somehow, like Mugabe's appointment, this seems to tell more about the WHO than about Duterte. The admiration the WHO regularly shows for dictators who pursue a draconian Public Health policy shows a willingness among important Public Health organizations to cooperate with nihilist and fascist leaders. This is cause for concern, certainly, but as a proof of fascism it comes up short. The collaboration has not actually materialized yet. There may be factions within the Public Health movement that show fascist tendencies, but I do not yet see any synergy.

Stanton Glantz is a professor of tobacco control at the University of California at San Francisco (UCSF), with a degree in mechanical engineering. He was one of the prominent publishers of the "Tobacco Papers" back in the 1990s, which proved the machinations by the tobacco industry to downplay the risks of smoking. Since then, he has been a partisan researcher looking for all sorts of evidence in support of further restrictions on the use of tobacco and nicotine. One of his famous scams is the Helena heart miracle; back in 2004, when smoking bans were introduced, Glantz used a decline in heart attacks in Helena, Montana as proof of the immediate health effects of smoking bans. The methodology of the study was ridiculous: the location was cherry-picked, the timeframe measured was manipulated for maximum effect and the conclusions went way beyond what the data analysis could possibly show. Glantz is also an ardent campaigner against smoking in movies. Selling junk science as real science is his forte.

As for Public Health scientists, Glantz is about as bad as they come. So if any scientists boast nihilist behavior, he ought to be one of them. But is he? His being an anti-smoker is, in my opinion, fully explainable as a form of moral supremacism and zeal. Corrupting truth in order to fit pre-ordained moral convictions is not an unusual trait in moral supremacists. Thus, even Glantz's behavior cannot readily be identified as nihilist.

Neither of these four individuals are both nihilist and connected well enough into the Public Health movement to be able to assert a collaboration. 

From this evaluation, I cannot conclude that Public Health is a fascist movement. At least not yet, it has the potential to devolve into one. The most potent source of that would be collaboration between WHO and fascist dictatorships, that are eager to pursue WHO's goals as a vehicle for collecting more power. As of April 2020, I have not been able to identify such a collaboration.

Evaluation II

Now let me evaluate against the criteria of Umberto Eco.

 

1. The Cult of Tradition.

Yes, this applies to Public Health. It is a moral supremacist criterion. Public Health aims for society to go back to a pure, healthy lifestyle, untainted by modernity.

2. The Rejection of Modernism.

Yes, this applies to Public Health. It rejects all innovations, including genetic modification and electronic cigarettes, which could be beneficial from a health point of view if applied correctly.

3. The Cult of Action for Action's Sake

Yes, even though I have classified this as a nihilist characteristic, Public Health does have the tendency to choose any action as better than no action. Chris Snowdon has regularly evoked the famous line from Yes, Minister: "Something must be done! This is something, therefore we must do it!" Public Health has a tendency to choose any action that might work towards its goals, and doesn't really care whether these actions actually work. If they don't work, it will call for more action, or it'll perform junk science to show the actions do work.

4. Disagreement is Treason.

Yes, Public Health is very much adhering one true gospel, especially in tobacco control. Dissenters are excluded from their community, and outsiders are branded as enemies.

5. Fear of Difference.

Yes, Public Health is trying to cast unhealthy behavior as a threat to healthy people, especially through second-hand scares (e.g. second-hand obesity, third-hand smoke), thereby instilling fear and hatred in people for other people.

6. Appeal to a Frustrated Middle Class.

Yes, I think Public Health is trying to do this. They're not extremely successful at this, though; their popular support is not that great yet. I don't think this criterion is really decisive in evaluating my question, though.

7. Obsession with a Plot and Hyping up of an Enemy Threat

Yes, Public Health is obsessed with the threat and power of several Big Corporation sectors (Tobacco, Soda, Alcohol, Sugar...) They see conspiracies behind any arguments that go against their goals.

8. Enemies Are Portrayed as Both Too Strong and Too Weak

No. Public Health does divide its enemies into strong and weak groups, with corporations on the strong side and addicted consumers on the weak side, but they do not see the same enemies as both too strong and too weak depending on their audience.

9. Pacifism is Trafficking with the Enemy

Not really, Public Health does not really denounce pacifism, but tolerance of certain unwanted behaviors can be explained as allying with corporations. Support or defence of these behaviors certainly is explained that way. In the current climate, it is still possible to be neutral.

10. Contempt for the Weak

No, Public Health sees their weak (addicts)  not so much as worthy of oppression, but worthy of saving from the corporations pushing products unto them. I think contempt is not really the right word to describe this, and there is no tendency towards nihilism here.

11. Everybody Is Educated to Become a Hero

Yes, Public Health does have a tendency to do this, especially by indoctrinating children into campaigning for them. The educational system is very much a pathway for Public Health influencing and lobbying strategies.

12. Machismo

No, there is no element of male domination present in Public Health. Women play a prominent role in Public Health leadership, and have done so for a long time.

13. Selective Populism: the Leader Represents the Common Will

No, Public Health does not really have one leader, so it would be difficult for them to implement this. Some leaders, such as Gerard Hastings, do have tendencies towards this behavior, though, so it's not really clear-cut.

14. Newspeak

Yes, the most prominent example being the use of the word "Free" by Public Health in exactly the same meaning as proposed by George Orwell in 1984. Freedom is not really a relevant goal in Public Health, on the contrary; libertarianism is its main enemy. Public Health has its own discourse, detached from normal people's speech.

 

From the assessment of Eco's 14 characteristics of Ur-Fascism, I see 9 of 14 criteria being met, and 5 of 14 not being met, at least not fully. Most of those latter 5 are nihilist traits or propaganda-traits that are necessary to unite nihilists and supremacists. I would therefore classify Public Health as a moral supremacist movement, that has the potential to grow into a fascist movement if it attracts enough nihilists to its cause.

 

Conclusion

From both evaluations, I can conclude that Public Health is very much a moral supremacist movement, that boasts only very few characteristics that hint at nihilist behavior, none of which are indicative of a synergy between the power-hungriness of nihilism and the moral zeal of supremacism. This evaluation doesn't preclude the possibility of Public Health evolving into something more fascist in the future, especially given the tendencies of WHO to work with brutal autocrats. Health fascism as a theoretical concept is very much thinkable. But for now, there are no grounds for calling Public Health a fascist movement.

Michiel van de Sande, April 19, 2020