The Chronicle of Higher Education has an interesting piece on public intellectuals¹ and their role in “creating new publics” — groups that share a common interest, action, language, and purpose.

“The reason for this has less do with the elitism of the intellectual — mine is no brief for an avant garde or philosopher king — than with the existence, really, the nonexistence, of the public. Publics, as John Dewey argued, never simply exist; they are always created. Created out of groups of people who are made and mangled by the actions of other people. Capital acts upon labor, subjugating men and women at work, making them miserable at home. Those workers are not yet a public. But when someone says — someone writes — “Workers of the world, unite!,” they become a public that is willing and able to act upon its shared situation. It is in the writing of such words, the naming of such names — “Workers of the world” or “We, the People,” even “The Problem That Has No Name” — that a public is summoned into being. In the act of writing for a public, intellectuals create the public for which they write.” ²

This made me think about the work that has gone into forming the emerging discipline of global health equity and the “movement for the right to health” which is distinct from and actually in conflict with the broader field of global health and international development. In so many ways, the broader field of global health and international development has its roots in a history dominated by neoliberal economic dogma and powerful institutions that have shaped policies all the way down to local community clinics in poor and remote corners of the globe. How does an organization with a set of values and purpose that is perpendicular to the values of the broader field of power in which it is embedded continue to exist? How can it create a small pocket of space in the face of crushing pressure? A small platform on which to stand when powerful forces push in the opposite direction?

The notion of a public intellectual summoning a new language and therefor a new public into existence is crucial, I think, to understanding the nature of the right to health movement. Halfdan Mahler conjured “Health for All by the Year 2000”, Jim Kim called for “3×5”, or 3 million people on HIV treatment by the end of 2005, Larry Kramer and ACT UP mobilized powerful language and visual demonstration to politicize science and policy making around HIV in the U.S. Each confronted an unjust status quo, articulated a new vision for a possible future, and sought to mobilize the intellectual, political, cultural, and institutional capital in service of this alternative future.

“That’s also how public intellectuals work. By virtue of the demands they make upon the reader, they force a reckoning. They summon a public into being — if nothing else a public conjured out of opposition to their writing. Democratic publics are always formed in opposition and conflict: “to form itself,” wrote Dewey, “the public has to break existing political forms.” So are reading publics. Sometimes they are formed in opposition to the targets identified by the writer: Think of the readers of Rachel Carson’s Silent Spring or Michelle Alexander’s The New Jim Crow. Sometimes they are formed in opposition to the writer: Think of the readers of Hannah Arendt’s Eichmann in Jerusalem. Regardless of the fallout, the public intellectual forces a question, establishes a divide, and demands that her readers orient themselves around that divide.” ³

Few public intellectuals have created a broader organizational and intellectual foundation, new technical and moral language, than Paul Farmer. Chapter 5 of Pathologies of Power is a classic example of Farmer laying out an ethical, moral, political vision for the foundation of a rights-based global health agenda and forcing a choice.

“At the same time, the flabby moral relativism of our times would have us believe that we may now choose from a broad menu of approaches to delivering effective health care services to the poor. This is simply not true. Whether you are sitting in a clinic in rural Haiti, and thus a witness to stupid deaths from infection, or sitting in an emergency room in a U.S. city, and thus the provider of first resort for forty million uninsured, you must acknowledge that the commodification of medicine invariably punishes the vulnerable.” ⁴

Connecting back to social theory and social movements, it seems clear that Bourdieu, McAdam, Fligstein, and others would see this brand of public intellectual as necessary but not sufficient for the initiation and sustaining of contested social movements. Whether viewing these individuals as “skilled social actors” (field theory) ⁵, progenitors of “cognitive liberation” (political process) ⁶, or the collective intellectual striving for a “scholarship with commitment” ⁷ and working to accrue forms of symbolic/cultural/scientific capital sufficient to alter the field, social movements need individuals willing to break with dominant logic and language, articulate an alternative, and then work to mobilize a new public to organize for collective action.