The Deadliest of Plagues? Gary Slutkin on Violence as Our Most Contagious Disease
Keen On America
Violence and Self-Harm: Overlapping Syndromes
Slutkin explains overlap between suicide, mass shootings, and other syndromes and describes contagion in self-harm.
“Violence has been misdiagnosed. And there’s a misdiagnosis that has caused us to not be able to control it as we could.” — Dr. Gary Slutkin
Human violence appears ubiquitous. In Iran. In Gaza. In Ukraine. In Sudan. In American cities and homes. So widespread, indeed, that it seems naturally hardwired into us. Our species-being, so to speak.
But, for Dr. Gary Slutkin, there is nothing inevitable about human violence. Slutkin — an epidemiologist who spent years fighting cholera, tuberculosis, and AIDS in Africa before focusing his medical mind on violence — argues that violence is neither a character flaw nor a moral failing. Rather than being baked into our natures, Slutkin sees violence as a contagious disease. It meets the clinical definition of a plague, he says. The more violent our homes, communities, media, politics, the more virally it spreads.
Slutkin’s new book, The End of Violence: Eliminating the World’s Most Dangerous Epidemic, makes the case that violence has been misdiagnosed for centuries. We analyse it as a crime problem, a character problem, an inter-state problem. So we punish, incarcerate and bomb. But none of these approaches confront the contagion. This can only be done, Slutkin argues, with what he calls “violence interrupters” — people from within the infected community who find the most at-risk individuals and cool things down before they escalate. Communities that have applied this approach have seen reductions in violence of 40 to 70 percent, Slutkin boasts, with Cherry Hill, one of Chicago’s most dangerous neighbourhoods, experiencing 450 days without a shooting.
There will be a time, he promises, when the plague of human violence will be mostly overcome. I hope Dr. Slutkin is correct. But suspect that his brave new violence-free world, like Huxley’s, might be simultaneously utopian and dystopian.
Five Takeaways
• Violence Meets the Clinical Definition of a Contagious Disease: Slutkin is not speaking metaphorically. Violence meets the definition of a disease: characteristic signs and symptoms causing morbidity and mortality. It meets the definition of contagious: it causes more of itself. One violent event leads to another — in a home, in a community, in a region, in a war. The more you are exposed to it, the more likely you are to do it. This is the same mechanism as measles, as cholera, as COVID. Susceptibility varies — for violence, it has to do with how much you feel humiliated, how much social pain you carry, how much grievance a leader has taught you to feel. But the operating system is the same.
• Violence Has Been Misdiagnosed: For centuries, we have treated violence as a moral failing: a matter of bad people making bad choices. The response has been punishment, incarceration, war. None of these interrupt the contagion. In fact, incarceration concentrates the infection. The misdiagnosis has cost millions of lives. The correct diagnosis — epidemic disease spreading through exposure — changes everything. You don’t blame a cholera patient for drinking contaminated water. You don’t punish a COVID patient for breathing. You interrupt the spread. You treat the susceptibility. You cool it down.
• Violence Interrupters: The Epidemic Control Playbook: Cure Violence Global trains and deploys violence interrupters: people from the same community, who speak the same language, who have often been involved in violence themselves. Their job is to find the most at-risk individuals — the ones most likely to shoot or be shot next — and intervene before the next event. The approach works. Communities that have applied it have seen reductions of 40 to 70 percent. Over a dozen American cities are at fifty- or sixty-year historic lows. Cherry Hill in Chicago went 450 days without a shooting. Baltimore, New York, and other cities have had similar results.
• Authoritarian Violence Disorder: Chapter eight of The End of Violence is called “Infections of the State.” Slutkin’s argument: authoritarian leadership is itself a form of epidemic violence. It spreads violence outward into its own population — through ICE raids, through threats, through the approval and scripting of violence by others. It also spreads it abroad, through war. Violence doesn’t know borders. The mechanism is the same: exposure increases transmission; grievance and humiliation increase susceptibility. Trump’s Iran war is not just a war. It is authoritarianism causing war. And the spread doesn’t stop at the border.
• Uganda Dropped HIV 85 Percent with Behavior Change Alone: In 1987, Slutkin arrived in Uganda, then the most infected country in the world, where a third of the population had what was then a 100 percent lethal disease. Using the epidemic control playbook — no medicines, just behaviour change interventions — they dropped the rate 85 percent. The same approach drove down Ebola, drove down TB long before medication existed. Slutkin’s point: we do not need pharmacological intervention to eliminate violence. We need the right people doing the right interventions with the right understanding of how contagion works. We have done it. We can do it again.
About the Guest
Dr. Gary Slutkin is an epidemiologist and the founder and CEO of Cure Violence Global. He is the author of The End of Violence: Eliminating the World’s Most Dangerous Epidemic (Health Communications, Inc., 2026). He is a Professor of Epidemiology and Global Health at the University of Illinois Chicago and a former WHO epidemiologist.
References:
• The End of Violence: Eliminating the World’s Most Dangerous Epidemic by Gary Slutkin (2026).
• Cure Violence Global — Slutkin’s organisation. cvg.org.
• Episode 2887: Steven J. Ross on The Secret War Against Hate — the historical companion on American violence and authoritarian disorder.
About Keen On America
Nobody asks more awkward questions than the Anglo-American writer and filmmaker Andrew Keen. In Keen On America, Andrew brings his pointed Transatlantic wit to making sense of the United States — hosting daily interviews about the history and future of this now venerable Republic. With nearly 2,900 episodes since the show launched on TechCrunch in 2010, Keen On America is the most prolific intellectual interview show in the history of podcasting.
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