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- Convenors:
-
Deborah Nadal
(Ca' Foscari University of Venice)
Kevin Bardosh (University of Washington)
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- Stream:
- Health, Disease and Wellbeing
- Sessions:
- Monday 29 March, -
Time zone: Europe/London
Short Abstract:
We will discuss the tensions inherent in the anthropology of Neglected Tropical Diseases and the future of interdisciplinary engagement. We will situate this discussion in contemporary ideas of what it means to be "interconnected" in an increasingly fragile and vulnerable world.
Long Abstract:
The world is becoming increasingly tropical, whilst economic inequality, social antagonism and political blindness are growing as well. Neglected Tropical Diseases (NTDs) are not only an unsolved problem of our past and present, but especially a threat to the future of humans and other species on this planet. As anthropologists of NTDs in the Anthropocene, our involvement in global health is increasingly accepted as "important" by the biomedical and political establishment, which raises other equally important existential and disciplinary questions: should our (small) sub-field become more and more applied, or should it remain mainly reflexive? How should it approach the ever-growing roadmaps of "disease elimination" being promoted, from trachoma, rabies and sleeping sickness? Should it align itself with the growing interdisciplinary research on epidemic response and emergency interventions, or should it strive to keep the attention focused on the need to tackle long-term, structural, contextual causes of NTDs? Should it join the enthusiastic (and generally well-funded) rush for tools and technological solutions or should it push us—both as researchers and humans of the Anthropocene—to rethink what we want to be, not what we want to do? We propose a discussion on the tensions inherent in the anthropology of NTDs and the future of interdisciplinary engagement and anthropological intervention. We will situate this discussion in contemporary ideas of what it means to be "interconnected" in an increasingly fragile and vulnerable world.
Accepted papers:
Session 1 Monday 29 March, 2021, -Aphaluck Bhatiasevi (University of Edinburgh)
Paper short abstract:
As anthropologists of Neglected Tropical Diseases we should reconsider our framing of NTDs. This paper argues for anthropological framings to be independent of global health categories, to include infectious tropical diseases neglected by the NTD brand, such as meliondosis.
Paper long abstract:
Melioidosis is an infectious tropical disease neglected by the Neglected Tropical Disease (NTD) brand. Despite causing high impact among rice farmers, the disease is not visible in the public sphere. Infections vary from mild flulike symptoms, to tuberculosis like prolonged illness. Patients contract the bacteria through exposure to soil and water in rice paddies in tropical countries. Melioidosis is an example of an infectious disease that has fallen through the cracks of global health framings such as NTDs. This paper argues for anthropological framings on infectious tropical diseases to be independent of global health categories. It calls for more inter-disciplinary dialogue between infectious diseases, the environment, and human and non-human species, to address a wide variety of infectious diseases impacting marginalised communities in tropical countries. Anthropologists can play a critical role in studying infectious diseases largely invisible in global health with high impact to local communities. With global warming and the complex and constantly evolving entangled relations between humans, the environment, and non-humans, there is a need for more engagement between anthropologies of infectious diseases, the environment, and human and non-humans species. Our inquiry needs a critical consideration of the constantly evolving entanglements and relations between the biological, the ecological and the social lives of humans and non-humans. As anthropologists in the contemporary world, we need to take an active role in applying anthropological insights, while at the same time advance the ontology and epistemology of the field. The production and application of knowledge go hand-in-hand.
Peter Brown (Emory University)
Paper short abstract:
Anthropologists in GH face the challenge of having two potentially contradictory roles: to find pragmatic solutions to problems of health programs and to analyze the ultimate causes of health inequities. This dilemma can be resolved using a strategy of Constructively Critical Medical Anthropology.
Paper long abstract:
Anthropologists working in the interdisciplinary field of Global Health (GH) face the challenge of having two potentially contradictory roles in research. The first role is to find pragmatic solutions to on-the-ground proximate problems in the disease prevention and health care, often by examining sociocultural beliefs and practices of local people (“recipients”) that might be in conflict with those of people who design and implement GH programs. The second role is to provide critical analyses of the ultimate causes and contexts of health inequities, such as structural violence, differences in priorities, or the retention of colonial attitudes and practices of Biomedicine. The balance of these two roles depends on the source of funding for the anthropological research. The decision of which diseases to tackle depends on implicit cost/benefit algorithms in which eradication are theoretically the most cost efficient, since benefits would last in perpetuity. Neglected Tropical Diseases persist despite being scientifically understood of over 100 years. The challenge of the two roles has a long history in Medical Anthropology. This paper suggests that the approach labelled “Constructively Critical Medical Anthropology” may help resolve the dilemma of two responsibilities.
Mari Webel (University of Pittsburgh)
Paper short abstract:
This paper explores the emergence of the NTDs as an operative and imaginative category in global health, focusing on its intellectual and institutional development in the 1970s and subsequent clinical and diagnostic interventions in the 1980s, connecting this history to the present initiatives.
Paper long abstract:
The NTD category has become central to current global health practice, meaningful for the weight of its moral and ethical arguments about health equity and economic disparities. Yet we have little historical perspective on the development of the NTD category since its advent in the 1970s, nor of its wider impacts, despite robust scholarship in critical studies of global health. Just as the diseases comprising the NTDs have changed over time, so, too, have understandings of “neglect” and what was needed for its amelioration also shifted. Central to the NTDs’ initial capacity to animate diverse energies were claims in the 1970s about parasitic diseases and their place in new biotechnological approaches to medicine. Despite concerns about prioritizing the needs of “endemic” countries and the recognition of a widening cohort of experts from both high- and low-income nations, NTD advocates often recapitulated historic power dynamics privileging research institutions in the U.S. and Europe. But advocates and researchers also resisted prevailing enthusiasm in medicine and public health for only low-tech solutions to parasitic diseases, or exclusively social or environmental approaches, seeking instead cutting-edge possibilities akin to those for cancer or cardiovascular disease. Historical research suggests that the capacious utility of the NTD category drove innovation, while also reinforcing structures of global health disparities. How might understanding the unresolved tensions around research, funding, and implementation in the category’s history offer traction for thinking about the role of critical social science researchers in the present and future of NTD interventions?
Kevin Bardosh (University of Washington)
Paper short abstract:
This paper will critically reflect on the use of rapid group ethnography by research teams focused on onchocerciasis control in Benin and lymphatic filariasis control in India and Nepal. It will discuss issues of sampling, saturation, generalizability & the politics of knowledge.
Paper long abstract:
This paper will reflect on the use of rapid group ethnography by research teams focused on onchocerciasis control in Benin and lymphatic filariasis control in India and Nepal. It will explore the development of this methodology, comparative lessons on MDA compliance from the three research projects, challenges encountered in the field, and the translation of research into program change. The paper will also critically discuss the strengths and weaknesses of rapid group ethnography by drawing upon a systematic review and a comparative analysis in Nepal, where we have explored insights generated from traditional qualitative data collection, large-scale surveys and rapid ethnography. I will conclude by discussing sampling, saturation, generalizability and the politics of knowledge in applied research for NTDs.