The Ghost Is the Machine: How Can We Visibilize the Unseen Norms and Power of Global Health? Comment on "Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health"

Abstract

In his recent commentary, Gorik Ooms argues that "denying that researchers, like all humans, have personal opinions … drives researchers' personal opinion underground, turning global health science into unconscious dogmatism or stealth advocacy, avoiding the crucial debate about the politics and underlying normative premises of global health. " These 'unconscious' dimensions of global health are as Ooms and others suggest, rooted in its unacknowledged normative, political and power aspects. But why would these aspects be either unconscious or unacknowledged? In this commentary, I argue that the 'unconscious' and 'unacknowledged' nature of the norms, politics and power that drive global health is a direct byproduct of the processes through which power operates, and a primary mechanism by which power sustains and reinforces itself. To identify what is unconscious and unacknowledged requires more than broadening the disciplinary base of global health research to those social sciences with deep traditions of thought in the domains of power, politics and norms, albeit that doing so is a fundamental first step. I argue that it also requires individual and institutional commitments to adopt reflexive, humble and above all else, equitable practices within global health research. Keywords: Global Health, Norms, Power, Interdisciplinarity, Reflexivity, Equity Copyright: © 2016 by Kerman University of Medical Sciences Citation: Forman L. The ghost is the machine: how can we visibilize the unseen norms and power of global health? Comment on "Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health.

Politics, Power, Poverty and Global Health: Systems and Frames

“…In a series of articles in this journal many aspects of power and politics have been explicated in an attempt to better understand their roles in improving global health (Box 1). [3][4][5][6][7] To extend this debate beyond conventional boundaries, several additional considerations are introduced here: a critical perspective on the definition of poverty with a more ambitious resolve for poverty eradication; improved clarity in 'global health' terminology; the role of belief systems, framing and metaphors that shape our thinking; and the need to shift the dominant belief system towards an ecological conception of global/planetary health.…”

Analysing power and politics in health policies and systems

“…Others have found global health scholarship lacking in theories that can generate 'durable intellectual frameworks' to analyse health problems in different contexts, anticipate future situations, and educate practitioners (Kleinman, 2010(Kleinman, , p. 1518. Building such frameworks entails drawing on the humanities and social sciences to develop interdisciplinary research that can systematically investigate inequity, make structural power visible, generate dialogue between empirically and normatively focused global health researchers (Ooms, 2014), and obtain greater reflexivity among individuals and institutions about their own position in the field of global health (Forman, 2016).…”

Of Politicians and Technocrats, and Why Global Health Scholars Are Inevitably a Bit of Both: A Response to Recent Commentaries

“…2 Would such a scholarly analysis not obscure the unseen norms and powers of global health; would it not obscure the "primary mechanism by which power sustains and reinforces itself "? 3 In my defense: I never wrote that a scholarly analysis of international human rights law, and its integration in global health scholarship, would somehow 'solve the problem' in itself. But I may have implied it.…”

“…Which brings me to the comments by Clemet Askheim, Kristin Heggen, and Eivind Engebretsen, 2 and by Lisa Forman. 3 Although formulated in very different ways, the critiques of Askheim et al and of Forman point at a similar issue. Is it not naïve to think that a rational (scholarly) analysis of international human rights law will bring about a rational consensus and thus progress, without political conflicts?…”

“…My only hope is that the $86 figure will highlight the truly scandalous nature of all the human deaths and suffering that could be avoided, if only states acted upon the commitments they made in international human rights treaties. And, by highlighting the truly scandalous nature of all the human deaths and suffering that could be avoided if only states acted upon their promises, I hope it can fuel political struggle and unveil the "primary mechanism by which power sustains and reinforces itself " 3 and that makes us -global health scholars -look for solutions that fit into $10 budgets, solutions which we know are excluding people (like user fees) and suboptimal (like focusing on prevention when prevention and treatment are the only appropriate solution). That brings me to Robert Marten's comment.…”