The politics of researching global health politics Comment on "Knowledge, moral claims and the exercise of power in global health"

Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example 'poverty eradication, ' can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term 'global health' is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on 'global health' should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions.

Section: Introductionmentioning

confidence: 99%

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

Benatar

2016

“…Several papers exploring the role of politics and power in global health have been published in this young journal recently [1][2][3][4][5][6][7][8][9][10][11][12][13] ; which suggests that a new journal may have been needed to allow for this important discussion. In my opinion, this debate is vital for global health science -and I mean vital: I do not think the academic arm of global health can 'survive' in any meaningful way without addressing the role of norms, politics and power in global health head on.…”

Section: Introductionmentioning

confidence: 99%

Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health

Ooms

2015

Global health research is essentially a normative undertaking: we use it to propose policies that ought to be implemented. To arrive at a normative conclusion in a logical way requires at least one normative premise, one that cannot be derived from empirical evidence alone. But there is no widely accepted normative premise for global health, and the actors with the power to set policies may use a different normative premise than the scholars that propose policies -which may explain the 'implementation gap' in global health. If global health scholars shy away from the normative debate -because it requires normative premises that cannot be derived from empirical evidence alone -they not only mislead each other, they also prevent and stymie debate on the role of the powerhouses of global health, their normative premises, and the rights and wrongs of these premises. The humanities and social sciences are better equipped -and less reluctant -to approach the normative debate in a scientifically valid manner, and ought to be better integrated in the interdisciplinary research that global health research is, or should be.

“…For instance, noting the term commonly employed to describe the field, global health, they point to the fact that, "To name an idea as global is to attribute universal legitimacy to the idea…an imperialistic act because it excludes diversity and local differences. " And Simon Rushton 9 calls for global health actors to engage in selfreflection-attention to their own positionality. He means this to apply not only to those widely understood to wield power in the field (such as the heads of the Gates Foundation, World Health Organization [WHO] and World Bank) but also scholars and nongovernmental organization (NGO) activists from high-and low-income countries in a position to criticize the field, including we who make these comments.…”

Section: Global Health Is a Field Of Power Relationsmentioning

confidence: 99%

“…I contended that we should not assume these forms of power are legitimate, but rather consider the circumstances under which they are justly derived. The editorial prompted 9 thoughtful commentaries, 8 in this journal [2][3][4][5][6][7][8][9] and 1 in the Lancet by that journal's editor. 10 The ideas in these commentaries are too rich and numerous to address thoroughly in one short response.…”

Section: Introductionmentioning

confidence: 99%

Global Health as a Field of Power Relations: A Response to Recent Commentaries

Shiffman¹

2015

Actors working in global health often portray it as an enterprise grounded in principled concerns, advanced by individuals and organizations who draw on scientific evidence to pursue health equity. This portrait is incomplete. It is also a field of power relations-a social arena in which actors claim and draw on expertise and moral authority to gain influence and pursue career, organizational and national interests. A clear understanding of how power operates in this field is necessary to ensure that it is used productively to serve the aims of health equity and improved population health. Responding to commentaries on an editorial published in this journal, I offer 3 ideas toward this end: (1) be skeptical of the global health rationality project-the effort to rescue the field from the alleged indignities of politics through the application of scientific methods; (2) analyze global health as a field of power relations, a concept developed by sociologist Pierre Bourdieu; and (3) elevate the place of input legitimacy-inclusive deliberation, fair process and transparency-to address legitimacy and knowledge deficits in this field.