Paper short abstract:

In critically engaging multiple possibilities for understanding "pathogenic-threat", medical anthropologists often invoke concepts of "layered-meanings". This general term encompasses multiple theoretical standpoints, from "local-biologies" to "cultural competence". Yet, utility of this term varies.

Paper long abstract:

Medical anthropology needs to re-establish some fundamental elements of “layered-meaning” when discussing so-called “pathogenic-threat”. To appropriately engage with “pathogenic-threat” from a medical anthropological perspective, “layered-meanings” cannot be employed only heuristically. Detail is significant (meaningfully-literally). “Layered-meanings” can reference supposedly “multiple” definitions/concepts/beliefs, located within an apparently “single” group/culture/individual-person. E.g., sometimes in rural Sudan, when suffering from the NTD mycetoma, it is fully understood that mycetoma has a “biomedical cause” (bacteria/fungi in soil), but it is equally believed to be caused by God as a consequence of “wrong-doing”.

Yet, relational “layered” local-perspectives on “pathogenic-threat” (sometimes “local-biologies”; e.g. Lock, Nguyen, 2011) can also fragment/diverge when bio-cultural meanings “spread” in similar ways to “pathogenic-threat” itself. E.g.: varying profiles of Influenza-A-H1N1 in Mexico/the United States, named “a mosaic” of divergent “local epidemics within the framework of the broader pandemic.” (Singer, 2018). Demonstrated on an even larger-scale by COVID-19 and its undeniable “global" influence, yet huge amount of “local” diversity. Including: differing levels of regional-infection; differing national-political responses/socio-economic impact(s); degrees of available treatment/care; and more ambiguous examples, incorporating what media calls: “Indian-COVID”, a microbiological-variation of “COVID-19” - intriguingly, otherwise considered a “global-disease”, persistently interpreted as both a “singular” viral-pathogenic-threat and an "all-encompassing" term or concept.

Global-local examples indicate forms of “physicalised-conceptual” layered-meanings and “variations” (verbal-conceptual-microbiological), demanding heightened, more "elastic", considerations of relationality from “new positions” of critical engagement within medical anthropology. Our “layered meanings-definitions-understandings” of "pathogenic-threat" clearly do not “stay in one place”, either literally or metaphorically. Yet they can also facilitate greater clarity to work towards-in-with.