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The world's first attempts to co-operate internationally to prevent pandemics were driven by alarm among European countries about the spread of cholera from India in the 19th century. Fretting about nation-state sovereignty, rivalries for control, struggles to persuade countries to be open about outbreaks as soon as they emerge and politically contested interpretations of evidence bedevilled these efforts just as today. At the time, emerging evidence that cholera spread through contaminated water and food struggled for acceptance against a mistaken older theory that it was caused by "miasmas" or unhealthy vapours. Each theory had different implications for how the disease…
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