Epidemiologists warn of a global rise in non-communicable disease. In some settings, chronic infectious diseases add to the burden of illness identified as progressive. The panel invites reflection on notions of chronicity and care in the face of conditions understood to be lifelong.
At a summit in 2011, the UN declared the rising global burden of non-communicable disease "a threat to development", especially in contexts where public sector health systems are still angled towards acute illness, and where people pay out-of-pocket for health and social care. In settings with a significant HIV prevalence, policy makers have been experimenting with models of care that "retain" people on biomedical regimens and taking medication over the longer term. This experience is increasingly seen as relevant to the challenge of providing for a broader range of progressive illnesses, often with the intention of "integrating" all such care. These developments reveal disjuntures in understandings of chronicity and care, across biomedical settings and beyond, in contexts where people seek services and support in the face of affliction. This panel invites papers which explore different understandings of care for conditions that are thought to be chronic and lifelong. What might a greater presence of chronic illness mean in terms of notions of intergenerational support? What are the implications of biomedical framings that emphasise individual lifestyle change, and paradigms of care encouraging "self-management" of illness? How do people negotiate chronic ill health in their everyday lives and what support do they seek? How might commercial interests stand to gain from promoting categories of chronic disease? What are the implications of identifying those "at risk" of disease in contexts where access to treatment is limited, and how might the pragmatics of medicine in low resource settings shift the moral economy of care?