Annals of the Association of American Geography , 2023
Abdel Omran's epidemiological transition theory has become a convenient heuristic device for expl... more Abdel Omran's epidemiological transition theory has become a convenient heuristic device for explaining shifts in the global distribution of disease. In turn, the temporal and geographic transition from "pandemics of infection" to "degenerative and man-made diseases" (Omran 1971, 161) as countries develop has become part of the mythology of global health. Such myths are powerful not because they are necessarily clearly true or false, but rather for what they naturalize or oversimplify (Essebro 2018). Drawing on the example of the work undertaken over the past three decades to ensure the prioritization of noncommunicable diseases (NCDs) as a problem of and for development within global health agendas, I draw on documentary and interview data to examine the origins and residual power of myths. Within this field, geographic myths (see Blaut 2006) about the social, economic, and spatial distribution of morbidity and mortality are a pervasive and persistent challenge for advocates trying to emphasize the threat of NCDs to the Global South. In examining the myth work undertaken by advocates, this article offers novel geographic perspectives to the critical global health field, while also arguing for the centrality of global health to geography as a discipline.
Transactions of the Insitute of British Geographers, 2022
COVID-19 is a multi-spectral crisis that has added an acute layer over a panoply of complex emerg... more COVID-19 is a multi-spectral crisis that has added an acute layer over a panoply of complex emergencies across the world. In the process, it has not only exposed actually-existing emergencies, but also exacerbated them as the global gaze has turned inward. As a crisis, COVID-19 straddles and challenges the boundaries between humanitarianism, development, and global health—the frames and categories through which emergencies are so often understood and intervened upon. Reflection on these fundamental categories is, we argue, an important geographical endeavour. Drawing on Geoffrey Bowker's analytical lens of the ‘infrastructural inversion’, we explore how humanitarianism has been upended by COVID-19 along two axes that are of core concern to geographers: (1) the spatial and (2) the temporal. We first contextualise current debates on the humanitarian endeavour and its future within recent geographical research. We then set out the complex structure by which COVID-19 has been both imagined and intervened upon as a humanitarian emergency. In so doing, we then pave the way for a deeper empirical analysis of the spatial and temporal inversions that have been brought forth by COVID-19. The paper concludes by examining the conceptual value of the ‘inversion’ in developing geographical research agendas better attuned to the increasing porosity of humanitarianism, development, and global health.
In this paper, I first explore the actors, events, evidence and arguments that enabled noncommuni... more In this paper, I first explore the actors, events, evidence and arguments that enabled noncommunicable diseases (NCDs) to be constructed, from the 1990s onwards, as a 'global epidemic' and 'global crisis' that threatened social and economic development. I then examine how two decades of action since the Global Strategy on the Prevention and Control of Noncommunicable Diseases (World Health Organization, 2000) has revealed the limits to that problematisation. In so doing, I actively trace the purposeful and inadvertent interplays between simplicity and complexity that have characterised the path of the NCD agenda since the early 1990s. As I argue, 'clean problems' may be deeply oxymoronic, but they are also a way of parsing complexity and simplicity and for key actors to explain why other disease constituencies have been relatively more successful in attracting global health funding. To support these arguments, I draw on interviews with forty key actors from the global 'NCD community' identified as playing an essential role in working towards the achievement of the first United Nations High Level Meeting in 2011. In critically exploring the oscillations of complexity and simplicity that characterise three decades of NCD advocacy, this paper brings analytical depth and qualitative rigour to a fascinating period of contemporary public health history.
The UK response to Covid-19 has been unusually complex in its evershifting classifications of cli... more The UK response to Covid-19 has been unusually complex in its evershifting classifications of clinical vulnerability. By May 2020, 2.2 million people had been identified as 'clinically extremely vulnerable' (CEV) and were asked to 'shield' at home for over four months. To adhere to this strict guidance, they were enfolded within the patchy infrastructure of the 'shielding programme'. However, membership of the 'shielded list' has changed-often without warning or explanation-through time and across space. Drawing on policy and evidentiary documents, government speeches, reports, press conferences and media analysis of Covid-19 coverage between March 2020 and April 1, 2021, this paper traces the shifting delineations of clinical vulnerability in the UK response across three lockdowns. It argues that the complexities and confusions generated by the transience of the CEV category have fed into forms of biosociality that have been as much about making practical sense of government guidance as a form of mutual support amid crisis. This uncertainty has not eased as restrictions have been relaxed and vaccines rolled out. Instead, tracing individual immune response has become a burgeoning industry as 'the shielded' navigate the uneasy demands of taking 'personal responsibility' rather than being protected by 'the rules'.
The decolonisation agenda is gathering momentum in global health. Within this movement, one domai... more The decolonisation agenda is gathering momentum in global health. Within this movement, one domain of analysis has been the ways in which the geographies of scholarly knowledge production (re)produce the inequities of coloniality. Drawing on the example of noncommunicable diseases (NCDs), here we deviate from this and instead examine the authorship of the key global documents that were used to ignite and mobilise the NCD advocacy agenda from 2000 to 2020. In doing so, we reflect on the changing ecosystems of authorial expertise. It shows that while the geographic distribution of expertise has broadened over time, the NCD domain remains a fairly tight and circumscribed network. Importantly this research also shows the complexities of ascribing location to expertise, a finding that speaks back to the decolonisation debate.
The movement to decolonise global health is gathering pace. In its concern with the fundamental, ... more The movement to decolonise global health is gathering pace. In its concern with the fundamental, distal causes of inequality and its call for social justice, the decolonisation movement forces us to question how global health works, for whom, where it is located, its funding practices, power asymmetries, cultures of collaboration and publication. This paper uses a new book by Harvard-based physician-anthropologist Eugene T. Richardson, Epidemic Illusions, as a point of departure for a broader analysis of the nature of global health knowledge, science, authorship, research and practice. Written in a 'carnivalesque' style, the book proceeds through a series of 'ironic (re)descriptions' to argue that global public health is an 'apparatus of coloniality'. In so doing, the book is generative of four ironic turns that we explore through the themes of guilt, humility, privilege and ambiguity. In locating these ironic turns within the broader landscape of global health, we reflect on whether the means of such a book achieve the ends of decolonisation.
Noncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavio... more Noncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavioural and environmental risk factors. These are, in turn, represented by multiple constituencies and communities of expertise and interest. This fractured landscape is evidenced by and magnified through an abject lack of conferences devoted to the category of NCDs. One of the very few is the NCD Alliance Forum, most recently held in February 2020 in Sharjah, United Arab Emirates. With the first Forum held in 2015 and another in 2017, these events offer powerful insight into the key actors, advocacy strategies, debates and aspirations of those working in the ‘NCD space’. Using the Forum as its object of research and analysis, this paper critically reflects on two persistent questions facing NCD advocates. First, how might NCDs be more like infectious diseases in cultivating a sense of urgency and action? Second, is NCD advocacy a ‘movement’ or a ‘community’ of loosely connected actors? Set against the emerging COVID-19 outbreak, which at the time of the Forum was limited to China and a handful of other countries, the Forum offered a unique opportunity to reflect upon the significant challenges facing NCD advocates across global north and south. COVID-19 only highlights how rising rates of NCDs have made global populations vulnerable to emerging infectious diseases. Yet, as the paper concludes, with the COVID-19 pandemic continuing to rage, the future of NCD advocacy and funding looks ever more fragile even as evidence of its need continues to grow.
It has long been recognised that human health is indelibly shaped by a variety of factors. These ... more It has long been recognised that human health is indelibly shaped by a variety of factors. These include pathogens such as bacteria and viruses, but also broad-ranging social, economic and political forces operating at different spatial scales. In seeking to understand the nature and effects of these forces, two concepts have become particularly influential: the ‘social determinants of health’ and ‘structural violence’. In this paper, we critically examine their origins, tracing their ‘prehistory’ and little-recognised intersections, based on searches of both concepts in PubMed and Google Scholar, and a critical reading of the range of texts our searches produced. This forms the groundwork from which we examine their similarities and differences, and their potentialities and limitations. We demonstrate that both concepts operate largely as black boxes. Their usage has thus become tied to disciplinary and methodological projects, with attendant implications for their wider usage – especially given the respective statuses of the fields of medical anthropology and social epidemiology in public health. We conclude that structural violence and the social determinants of health have both been influential in research and policy, but have struggled to effect the kinds of political change that their moral commitment to social justice promises and that further dialogue between them is required.
Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases ... more Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases (cancer, cardiovascular disease, diabetes and chronic respiratory disease) and four shared, ‘modifiable’ behavioural risk factors (smoking, diet, physical activity and alcohol). In late 2018, the NCD category was expanded to include mental health as an additional disease outcome and air pollution as an explicit environmental risk factor. The newly‐expanded NCD category connects behavioural and environmental readings of risk and shifts attention from individual acts of consumption to unequal and inescapable conditions of environmental exposure. It thus renders the increasing ‘toxicity’ of everyday life amid ubiquitous environmental contamination a new conceptual and empirical concern for NCD research. It also, as this paper explores, signals a new ‘optics’ of a much‐maligned disease category. This is particularly significant as chronic disease research has long been siloed between public and environmental health, with each discipline operationalising the notion of the ‘environment’ as a source of disease causation in contrasting ways. Given this, this paper is positioned as a significant contribution to both research on NCDs and environmental risk, bringing these interdisciplinary domains into a new critical conversation around the concept of toxicity.
The global burden of mortality and morbidity attributable to noncommunicable diseases (NCDs) now ... more The global burden of mortality and morbidity attributable to noncommunicable diseases (NCDs) now exceeds that of infectious disease. Yet, concern is mounting that global political prioritisation and action have stalled. The failure of NCDs to capture public and political imaginations has been ascribed to a number of reasons, with some recently contending that the very name of the disease classification is to blame. In this piece, I reflect critically on why discourse about NCDs has not compelled global action proportionate to the magnitude of the suffering these diseases cause. Failure to act on NCDs, I argue, is not a failure of terminology alone.
Global health volunteering is premised on a comparative understanding of development: hospitals i... more Global health volunteering is premised on a comparative understanding of development: hospitals in developing countries are ‘behind’ modern institutions in developed nations, and sharing volunteers’ skills will enable the latter to ‘catch-up’. We argue for a ‘relational comparison’ in development studies, which draws upon a geographical conception of inequality premised on understanding places in relation to one another rather than reifying differences between countries. We place a particular hospital within a dialectical totality of combined and uneven development. Health workers’ experiences of volunteering in Sierra Leone demonstrate that local problems, including staff shortages and corruption, are enveloped within global processes.
Global health partnerships (GHPs) are the conceptual cousin of partnerships in the development sp... more Global health partnerships (GHPs) are the conceptual cousin of partnerships in the development sphere. Since their emergence in the 1990s, the GHP mode of working and funding has mainly been applied to single-disease, vertical interventions. However, GHPs are increasingly being used to enact health systems strengthening and to address the global health worker shortage. In contrast to other critical explorations of GHPs, we explore in this paper how the fact, act and aspiration of binding different actors together around the ideology and modes of partnership working produces the perpetual state of being in a bind. This is an original analytical framework drawing on research in Sierra Leone and London. We offer new insights into the ways in which GHPs function and are experienced, showing that along with the successes of partnership work such arrangements are often and unavoidably tense, uncomfortable and a source of frustration and angst.
The rise of global health as a field of study and site of intervention has animated significant c... more The rise of global health as a field of study and site of intervention has animated significant critical social science engagements. Of these, medical anthropology has arguably emerged as the ascendant in the field with its growing corpus of writing and advocacy largely animated by the discipline’s ‘suffering slot’. This paper thus applies a geographical critique to anthropology’s moral, humanitarian impulse to give voice to suffering by exploring the spatial consequences of this mode of scholarship. It argues that the suffering slot inevitably leads global health researchers to certain archetypal spaces and that, in turn, these places: (i) are overwhelmingly biomedical; (ii) come to function as ‘truth spots’ in the production and circulation of global health knowledge and (iii) perpetuate a global health riddled with ‘ignorance spots’. Given this, the paper asks what happens if we look beyond suffering to consider the hidden geographies of global health that might then be revealed. It argues that in order to develop a richer topography of global health knowledge and critique, we must also consider those spaces where pleasure and suffering intersect in ways that challenge the humanitarian impulse and crisis-led readings of health. These other archetypal spaces of global health – gyms, bars, supermarkets and more – are not flippant distractions from the grave reality of human suffering, but rather spaces that condition the genesis of suffering and where affliction is put aside in favour of pleasure. In arguing that we need to be far more attuned to the non-medical spaces where global health is produced, experienced and challenged, the paper also articulates how geography might productively meet anthropology in critical studies of global health.
Global health partnerships have been hailed as a means of addressing the global health worker sho... more Global health partnerships have been hailed as a means of addressing the global health worker shortage, bringing forth health systems strengthening and, therefore, the universal health coverage aspirations of the Sustainable Development Goals. In contrast to other critical engagements with partnerships which have tended to focus on experiences and effects of GHPs in situ; this paper draws on the example of the UK to explore how GHPs and development agendas have become entwined. Moreover, this entwinement has ensured that GHPs are far from “global” and instead exhibit geographies that are far more representative of the geopolitics of overseas development assistance than biomedical need.
Annals of the Association of American Geography , 2023
Abdel Omran's epidemiological transition theory has become a convenient heuristic device for expl... more Abdel Omran's epidemiological transition theory has become a convenient heuristic device for explaining shifts in the global distribution of disease. In turn, the temporal and geographic transition from "pandemics of infection" to "degenerative and man-made diseases" (Omran 1971, 161) as countries develop has become part of the mythology of global health. Such myths are powerful not because they are necessarily clearly true or false, but rather for what they naturalize or oversimplify (Essebro 2018). Drawing on the example of the work undertaken over the past three decades to ensure the prioritization of noncommunicable diseases (NCDs) as a problem of and for development within global health agendas, I draw on documentary and interview data to examine the origins and residual power of myths. Within this field, geographic myths (see Blaut 2006) about the social, economic, and spatial distribution of morbidity and mortality are a pervasive and persistent challenge for advocates trying to emphasize the threat of NCDs to the Global South. In examining the myth work undertaken by advocates, this article offers novel geographic perspectives to the critical global health field, while also arguing for the centrality of global health to geography as a discipline.
Transactions of the Insitute of British Geographers, 2022
COVID-19 is a multi-spectral crisis that has added an acute layer over a panoply of complex emerg... more COVID-19 is a multi-spectral crisis that has added an acute layer over a panoply of complex emergencies across the world. In the process, it has not only exposed actually-existing emergencies, but also exacerbated them as the global gaze has turned inward. As a crisis, COVID-19 straddles and challenges the boundaries between humanitarianism, development, and global health—the frames and categories through which emergencies are so often understood and intervened upon. Reflection on these fundamental categories is, we argue, an important geographical endeavour. Drawing on Geoffrey Bowker's analytical lens of the ‘infrastructural inversion’, we explore how humanitarianism has been upended by COVID-19 along two axes that are of core concern to geographers: (1) the spatial and (2) the temporal. We first contextualise current debates on the humanitarian endeavour and its future within recent geographical research. We then set out the complex structure by which COVID-19 has been both imagined and intervened upon as a humanitarian emergency. In so doing, we then pave the way for a deeper empirical analysis of the spatial and temporal inversions that have been brought forth by COVID-19. The paper concludes by examining the conceptual value of the ‘inversion’ in developing geographical research agendas better attuned to the increasing porosity of humanitarianism, development, and global health.
In this paper, I first explore the actors, events, evidence and arguments that enabled noncommuni... more In this paper, I first explore the actors, events, evidence and arguments that enabled noncommunicable diseases (NCDs) to be constructed, from the 1990s onwards, as a 'global epidemic' and 'global crisis' that threatened social and economic development. I then examine how two decades of action since the Global Strategy on the Prevention and Control of Noncommunicable Diseases (World Health Organization, 2000) has revealed the limits to that problematisation. In so doing, I actively trace the purposeful and inadvertent interplays between simplicity and complexity that have characterised the path of the NCD agenda since the early 1990s. As I argue, 'clean problems' may be deeply oxymoronic, but they are also a way of parsing complexity and simplicity and for key actors to explain why other disease constituencies have been relatively more successful in attracting global health funding. To support these arguments, I draw on interviews with forty key actors from the global 'NCD community' identified as playing an essential role in working towards the achievement of the first United Nations High Level Meeting in 2011. In critically exploring the oscillations of complexity and simplicity that characterise three decades of NCD advocacy, this paper brings analytical depth and qualitative rigour to a fascinating period of contemporary public health history.
The UK response to Covid-19 has been unusually complex in its evershifting classifications of cli... more The UK response to Covid-19 has been unusually complex in its evershifting classifications of clinical vulnerability. By May 2020, 2.2 million people had been identified as 'clinically extremely vulnerable' (CEV) and were asked to 'shield' at home for over four months. To adhere to this strict guidance, they were enfolded within the patchy infrastructure of the 'shielding programme'. However, membership of the 'shielded list' has changed-often without warning or explanation-through time and across space. Drawing on policy and evidentiary documents, government speeches, reports, press conferences and media analysis of Covid-19 coverage between March 2020 and April 1, 2021, this paper traces the shifting delineations of clinical vulnerability in the UK response across three lockdowns. It argues that the complexities and confusions generated by the transience of the CEV category have fed into forms of biosociality that have been as much about making practical sense of government guidance as a form of mutual support amid crisis. This uncertainty has not eased as restrictions have been relaxed and vaccines rolled out. Instead, tracing individual immune response has become a burgeoning industry as 'the shielded' navigate the uneasy demands of taking 'personal responsibility' rather than being protected by 'the rules'.
The decolonisation agenda is gathering momentum in global health. Within this movement, one domai... more The decolonisation agenda is gathering momentum in global health. Within this movement, one domain of analysis has been the ways in which the geographies of scholarly knowledge production (re)produce the inequities of coloniality. Drawing on the example of noncommunicable diseases (NCDs), here we deviate from this and instead examine the authorship of the key global documents that were used to ignite and mobilise the NCD advocacy agenda from 2000 to 2020. In doing so, we reflect on the changing ecosystems of authorial expertise. It shows that while the geographic distribution of expertise has broadened over time, the NCD domain remains a fairly tight and circumscribed network. Importantly this research also shows the complexities of ascribing location to expertise, a finding that speaks back to the decolonisation debate.
The movement to decolonise global health is gathering pace. In its concern with the fundamental, ... more The movement to decolonise global health is gathering pace. In its concern with the fundamental, distal causes of inequality and its call for social justice, the decolonisation movement forces us to question how global health works, for whom, where it is located, its funding practices, power asymmetries, cultures of collaboration and publication. This paper uses a new book by Harvard-based physician-anthropologist Eugene T. Richardson, Epidemic Illusions, as a point of departure for a broader analysis of the nature of global health knowledge, science, authorship, research and practice. Written in a 'carnivalesque' style, the book proceeds through a series of 'ironic (re)descriptions' to argue that global public health is an 'apparatus of coloniality'. In so doing, the book is generative of four ironic turns that we explore through the themes of guilt, humility, privilege and ambiguity. In locating these ironic turns within the broader landscape of global health, we reflect on whether the means of such a book achieve the ends of decolonisation.
Noncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavio... more Noncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavioural and environmental risk factors. These are, in turn, represented by multiple constituencies and communities of expertise and interest. This fractured landscape is evidenced by and magnified through an abject lack of conferences devoted to the category of NCDs. One of the very few is the NCD Alliance Forum, most recently held in February 2020 in Sharjah, United Arab Emirates. With the first Forum held in 2015 and another in 2017, these events offer powerful insight into the key actors, advocacy strategies, debates and aspirations of those working in the ‘NCD space’. Using the Forum as its object of research and analysis, this paper critically reflects on two persistent questions facing NCD advocates. First, how might NCDs be more like infectious diseases in cultivating a sense of urgency and action? Second, is NCD advocacy a ‘movement’ or a ‘community’ of loosely connected actors? Set against the emerging COVID-19 outbreak, which at the time of the Forum was limited to China and a handful of other countries, the Forum offered a unique opportunity to reflect upon the significant challenges facing NCD advocates across global north and south. COVID-19 only highlights how rising rates of NCDs have made global populations vulnerable to emerging infectious diseases. Yet, as the paper concludes, with the COVID-19 pandemic continuing to rage, the future of NCD advocacy and funding looks ever more fragile even as evidence of its need continues to grow.
It has long been recognised that human health is indelibly shaped by a variety of factors. These ... more It has long been recognised that human health is indelibly shaped by a variety of factors. These include pathogens such as bacteria and viruses, but also broad-ranging social, economic and political forces operating at different spatial scales. In seeking to understand the nature and effects of these forces, two concepts have become particularly influential: the ‘social determinants of health’ and ‘structural violence’. In this paper, we critically examine their origins, tracing their ‘prehistory’ and little-recognised intersections, based on searches of both concepts in PubMed and Google Scholar, and a critical reading of the range of texts our searches produced. This forms the groundwork from which we examine their similarities and differences, and their potentialities and limitations. We demonstrate that both concepts operate largely as black boxes. Their usage has thus become tied to disciplinary and methodological projects, with attendant implications for their wider usage – especially given the respective statuses of the fields of medical anthropology and social epidemiology in public health. We conclude that structural violence and the social determinants of health have both been influential in research and policy, but have struggled to effect the kinds of political change that their moral commitment to social justice promises and that further dialogue between them is required.
Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases ... more Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases (cancer, cardiovascular disease, diabetes and chronic respiratory disease) and four shared, ‘modifiable’ behavioural risk factors (smoking, diet, physical activity and alcohol). In late 2018, the NCD category was expanded to include mental health as an additional disease outcome and air pollution as an explicit environmental risk factor. The newly‐expanded NCD category connects behavioural and environmental readings of risk and shifts attention from individual acts of consumption to unequal and inescapable conditions of environmental exposure. It thus renders the increasing ‘toxicity’ of everyday life amid ubiquitous environmental contamination a new conceptual and empirical concern for NCD research. It also, as this paper explores, signals a new ‘optics’ of a much‐maligned disease category. This is particularly significant as chronic disease research has long been siloed between public and environmental health, with each discipline operationalising the notion of the ‘environment’ as a source of disease causation in contrasting ways. Given this, this paper is positioned as a significant contribution to both research on NCDs and environmental risk, bringing these interdisciplinary domains into a new critical conversation around the concept of toxicity.
The global burden of mortality and morbidity attributable to noncommunicable diseases (NCDs) now ... more The global burden of mortality and morbidity attributable to noncommunicable diseases (NCDs) now exceeds that of infectious disease. Yet, concern is mounting that global political prioritisation and action have stalled. The failure of NCDs to capture public and political imaginations has been ascribed to a number of reasons, with some recently contending that the very name of the disease classification is to blame. In this piece, I reflect critically on why discourse about NCDs has not compelled global action proportionate to the magnitude of the suffering these diseases cause. Failure to act on NCDs, I argue, is not a failure of terminology alone.
Global health volunteering is premised on a comparative understanding of development: hospitals i... more Global health volunteering is premised on a comparative understanding of development: hospitals in developing countries are ‘behind’ modern institutions in developed nations, and sharing volunteers’ skills will enable the latter to ‘catch-up’. We argue for a ‘relational comparison’ in development studies, which draws upon a geographical conception of inequality premised on understanding places in relation to one another rather than reifying differences between countries. We place a particular hospital within a dialectical totality of combined and uneven development. Health workers’ experiences of volunteering in Sierra Leone demonstrate that local problems, including staff shortages and corruption, are enveloped within global processes.
Global health partnerships (GHPs) are the conceptual cousin of partnerships in the development sp... more Global health partnerships (GHPs) are the conceptual cousin of partnerships in the development sphere. Since their emergence in the 1990s, the GHP mode of working and funding has mainly been applied to single-disease, vertical interventions. However, GHPs are increasingly being used to enact health systems strengthening and to address the global health worker shortage. In contrast to other critical explorations of GHPs, we explore in this paper how the fact, act and aspiration of binding different actors together around the ideology and modes of partnership working produces the perpetual state of being in a bind. This is an original analytical framework drawing on research in Sierra Leone and London. We offer new insights into the ways in which GHPs function and are experienced, showing that along with the successes of partnership work such arrangements are often and unavoidably tense, uncomfortable and a source of frustration and angst.
The rise of global health as a field of study and site of intervention has animated significant c... more The rise of global health as a field of study and site of intervention has animated significant critical social science engagements. Of these, medical anthropology has arguably emerged as the ascendant in the field with its growing corpus of writing and advocacy largely animated by the discipline’s ‘suffering slot’. This paper thus applies a geographical critique to anthropology’s moral, humanitarian impulse to give voice to suffering by exploring the spatial consequences of this mode of scholarship. It argues that the suffering slot inevitably leads global health researchers to certain archetypal spaces and that, in turn, these places: (i) are overwhelmingly biomedical; (ii) come to function as ‘truth spots’ in the production and circulation of global health knowledge and (iii) perpetuate a global health riddled with ‘ignorance spots’. Given this, the paper asks what happens if we look beyond suffering to consider the hidden geographies of global health that might then be revealed. It argues that in order to develop a richer topography of global health knowledge and critique, we must also consider those spaces where pleasure and suffering intersect in ways that challenge the humanitarian impulse and crisis-led readings of health. These other archetypal spaces of global health – gyms, bars, supermarkets and more – are not flippant distractions from the grave reality of human suffering, but rather spaces that condition the genesis of suffering and where affliction is put aside in favour of pleasure. In arguing that we need to be far more attuned to the non-medical spaces where global health is produced, experienced and challenged, the paper also articulates how geography might productively meet anthropology in critical studies of global health.
Global health partnerships have been hailed as a means of addressing the global health worker sho... more Global health partnerships have been hailed as a means of addressing the global health worker shortage, bringing forth health systems strengthening and, therefore, the universal health coverage aspirations of the Sustainable Development Goals. In contrast to other critical engagements with partnerships which have tended to focus on experiences and effects of GHPs in situ; this paper draws on the example of the UK to explore how GHPs and development agendas have become entwined. Moreover, this entwinement has ensured that GHPs are far from “global” and instead exhibit geographies that are far more representative of the geopolitics of overseas development assistance than biomedical need.
Forthcoming edited collection with contributions from:
1. Clare Herrick: Geographies of global ... more Forthcoming edited collection with contributions from:
1. Clare Herrick: Geographies of global health. 2. David Reubi (QMUL): Epidemiological Rule – Epidemiologists, Numbers and the Bloomberg Initiative to Reduce Tobacco Control in the Global South 3. Nele Jensen (QMUL): A geneaology of evidence at the WHO 4. Matthew Sparke (University of Washington): Redlining global health: Targets, enclaves and the limits of investing in life 5. Stephen Taylor (QMUL): After clinical trials: enrolment and abandonment in global health research 6. Emma Laurie (Edinburgh): ‘A politics (t)here too…’: Embodied Politics of health for the global majority 7. Betsey Brada (Princeton): Exemplary or Exceptional? The Production and Dismantling of Global Health in Botswana 8. Paul Jackson (Dartmouth): The AIDS Research Model: How political advocacy became central to biomedical funding and research 9. Susan Craddock (University of Minnesota): Making Ties through Making Drugs: Partnerships for tuberculosis drug and vaccine development 10. Gerry Kearns (Maynooth) : Global AIDS and international responsibility 11. Stephen Hinchliffe (Exeter): More than one world, more than one health: re-configuring inter-species health 12. Jamie Lorimer (Oxford): Worms North and South: A probiotic biopolitics 13. Uli Beisel (Beyreuth University): Towards an affirmative biopolitics of malaria: human-mosquito interactions and the development of immunity and resistance 14. Sarah Atkinson (Durham): Mixing and fixing: managing and imagining the body in a global world 15. Clare Herrick (King’s College London): The (non)charisma of non-communicable disease 16. Tim Brown (QMUL): Healthy interventions: tracing the place of green space in an international movement for health. 17. Jane Battersby (UCT): Eat your greens. Buy some chips: Contesting articulations of food and food security in children’s lives.
The UN-HABITAT III conference held in Quito in late 2016 enshrined the first Sustainable Developm... more The UN-HABITAT III conference held in Quito in late 2016 enshrined the first Sustainable Development Goal (SDG) with an exclusively urban focus. SDG 11, as it became known, aims to make cities more inclusive, safe, resilient and sustainable through a range of metrics, indicators, and evaluation systems. It also became part of a post-Quito 'New Urban Agenda' that is still taking shape. This paper raises questions around the potential for reductionism in this new agenda, and argues for the reflexive need to be aware of the types of urban space that are potentially sidelined by the new trends in global urban policy.
Lencucha and Thow’s paper offers an important addition and corrective to the burgeoning body of w... more Lencucha and Thow’s paper offers an important addition and corrective to the burgeoning body of work in public health on the ‘commercial determinants of health’ in the context of non-communicable diseases (NCDs). Rather than tracing the origins of incoherence across policy sectors to the nefarious actions of industry, they argue that we need to be better attuned to the neoliberal ideologies that underpin these policies. In this commentary I explore two aspects of their argument that I find to be problematic: First, the suggestion that neoliberalism itself has some kind of deterministic or explanatory capacity across vastly different social, spatial, economic and political contexts. Second, I explore their concept of ‘product-based NCD risk,’ a perspective that disembodies and detaches risk from the social and structural conditions of their making.
Focussing on the UK, this paper explores how COVID-19 has reframed and recreated the question and... more Focussing on the UK, this paper explores how COVID-19 has reframed and recreated the question and category of individual ‘risk’ and ‘vulnerability’ through government requests for the self-isolation or shielding of particular groups by age or health status. Whether ‘officially’ defined as vulnerable or self-defined by virtue of perceived risk, COVID-19 has created new processes of subjectification that splice together epidemiological, behavioural, moral and political readings of risk. Older people that had never once considered themselves vulnerable must now be shielded for their own protection. Those suffering from chronic diseases have been redefined as vulnerable and must protect themselves. Drawing on policy and evidentiary documents, government speeches, press conferences, and media analysis of COVID-19 coverage between March and July 2020, this paper thus critically explores the epidemic of subjectification that has both emerged from and is reshaping notions and categories of ‘clinical’ vulnerability in relation to emergent and uncertain forms of biomedical risk. In so doing, it also questions those persistent, chronic forms of ‘structural’ vulnerability that are not only magnified by COVID-19 but also simultaneously reinforced by and obscured in the UK government response.
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Papers by Clare Herrick
The burden of noncommunicable diseases (NCDs) across the world is known, but concrete action is lacking.
Covid-19 has made the risks of and vulnerabilities from NCDs more visible.
The future of the global NCD agenda is uncertain, but needs to be included in pandemic preparedness.
The burden of noncommunicable diseases (NCDs) across the world is known, but concrete action is lacking.
Covid-19 has made the risks of and vulnerabilities from NCDs more visible.
The future of the global NCD agenda is uncertain, but needs to be included in pandemic preparedness.
1. Clare Herrick: Geographies of global health.
2. David Reubi (QMUL): Epidemiological Rule – Epidemiologists, Numbers and the Bloomberg Initiative to Reduce Tobacco Control in the Global South
3. Nele Jensen (QMUL): A geneaology of evidence at the WHO
4. Matthew Sparke (University of Washington): Redlining global health: Targets, enclaves and the limits of investing in life
5. Stephen Taylor (QMUL): After clinical trials: enrolment and abandonment in global health research
6. Emma Laurie (Edinburgh): ‘A politics (t)here too…’: Embodied Politics of health for the global majority
7. Betsey Brada (Princeton): Exemplary or Exceptional? The Production and Dismantling of Global Health in Botswana
8. Paul Jackson (Dartmouth): The AIDS Research Model: How political advocacy became central to biomedical funding and research
9. Susan Craddock (University of Minnesota): Making Ties through Making Drugs: Partnerships for tuberculosis drug and vaccine development
10. Gerry Kearns (Maynooth) : Global AIDS and international responsibility
11. Stephen Hinchliffe (Exeter): More than one world, more than one health: re-configuring inter-species health
12. Jamie Lorimer (Oxford): Worms North and South: A probiotic biopolitics
13. Uli Beisel (Beyreuth University): Towards an affirmative biopolitics of malaria: human-mosquito interactions and the development of immunity and resistance
14. Sarah Atkinson (Durham): Mixing and fixing: managing and imagining the body in a global world
15. Clare Herrick (King’s College London): The (non)charisma of non-communicable disease
16. Tim Brown (QMUL): Healthy interventions: tracing the place of green space in an international movement for health.
17. Jane Battersby (UCT): Eat your greens. Buy some chips: Contesting articulations of food and food security in children’s lives.