Abstract

The rise of health issues such as HIV, pandemic influenza and Ebola on international agendas has led to the framing of threats to health as security issues. This has created an uneasy relationship between politics and health, by moving national interests into an area traditionally dominated by scientific rationalities and a predisposition towards cosmopolitan norms. Framing global health threats as risks, however, appears to be less politically charged and divisive, combining an aura of scientific objectivity with a moral call to action. In this article we argue that, despite its technical use in public health, in the policy discourse on global health the risk frame is not immune to values and interests but inherently political. It privileges a specific approach to global health policy which focuses on potential future catastrophes rather than presently existing health problems, emphasizes technological solutions rather than addressing the socio-economic determinants of health, while there is no single risk frame, but rather multiple risk frames existing simultaneously, as seen during the 2014–15 west African Ebola outbreak. However, framing health in terms of risk is useful in understanding how health issues reflect and contribute to the wider Zeitgeist concerning societal vulnerability: that dangers exist which are uncontrollable and are the product of technical progress. The risk frame allows us to place health issues into this wider context, where disease is just one of a number of concurrent dangers, rather than a separately identifiable hazard.

Highlights

  • In October 2014, at the height of the west African Ebola outbreak, the DirectorGeneral of the World Health Organization (WHO), Margaret Chan, commented: ‘In my long career in public health

  • Communicable diseases are considered ‘threats’, requiring extraordinary responses which move them outside the realm of normal politics10—from the closing of borders, restrictions on travel and imposition of curfews to the deployment of militaries and other security personnel, all of which occurred during the west African Ebola outbreak of 2014–15

  • We examine an alternative framing of global health threats, namely risk

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Summary

Politics and global health

Especially risks from disease outbreaks, have risen ever higher on the international political agenda in the last two decades. There is a widely shared view among epidemiologists and public health experts that a pandemic of some kind is very likely to occur in the foreseeable future (though exact calculations even of this risk are difficult to come by) This assessment is based on the reasoning that, first, small outbreaks of highly contagious diseases with severe health impacts occur all the time; and, second, modern life has generated conditions that enhance the likelihood of small outbreaks spreading across countries, notably through global travel and trade, increased population density, and environmental and land-use changes. Foresee that could kill over a billion people’.54 It is worth noting that while the World Economic Forum’s Global Risks Reports have ranked pandemics among the top five global risks in terms of impact, they have not made it into the top five in terms of likelihood.[55]

Responding to global health risks through better preparedness
Competing risks in global health crises
Framing Ebola as a global risk
Findings
Conclusion
Full Text
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