Medical Populism and the Future of Global Health

Leveraging the positives from the pandemic to strengthen infectious disease care in low-income and middle-income countries

Background: The COVID-19 pandemic is a global phenomenon to which state governments have been forced to take unprecedented action. According to the scientific community, the most effective way to return to normalcy is to vaccinate a large percentage of citizens. However, the short period of time in which the first types of vaccines were created creates an insecurity and reluctance towards vaccines, which, however, is evolving into a global phenomenon. Of course, vaccine-related misinformation on coronavirus, which poses a serious threat not only to public health but also to national security and the global economy, also plays a role. Objective: The purpose of this study is to investigate and clarify the risk of misinformation arising in relation to the COVID-19 pandemic vaccination. In addition, it carries out a development of the reasons that push the population to movements of distrust and challenge through a literature review in research studies that collect data on the anti-vaccination movement during the COVID-19 pandemic. This issue is a burning issue in everyday life and is of particular interest because it undermines the impact of media misinformation on disseminating false news and shaping views against public health and the well-being of the population, promoting panic and fear. Methods & Material: The material used for this study is a product of systematic review and critical evaluation of the most important published articles and studies in the international printed and electronic literature, as well as technical manuals and legislation by international governmental and non-governmental organizations regarding the risk of misinformation arising in connection with the COVID-19 pandemic vaccination. In order to approach the development of the anti-vaccination movement and its presentation through the media, as well as the risk posed by this issue for Public Health, the methodology of the systematic literature review was chosen, using the PRISMA analysis, studies of the international literature related to the issue. The search was conducted through the online academic research databases of Google Scholar, PubMed and Scopus, with the limitation that the studies have been carried out in the last 4 years. Results: Following the methodology of the PRISMA analysis and after the exclusion of some articles, the research ended up focusing on 11 articles that met the criteria of the research and which were included in the review. The results of the research showed that participants are not able to distinguish between true and false content of events and news posted and shared on social networks related to the COVID-19 pandemic and vaccination issues. In addition, the dissemination of information seems to be guided by the interaction that characterizes each social media as well as by the specific patterns of interaction of user groups dealing with the issue. However, although social media is recognized as a major source of misinformation regarding COVID-19 and vaccination issues, the same problem is found in the print media and a more rigorous evaluation of the information by their authors is recommended. Finally, when the use of the Internet poses risks to public health, governments should develop strategies for controlling health information on the Internet, but without censoring the population. Conclusions: In the present systematic literature review, misinformation is evaluated as an important factor in dealing with the pandemic. Accompanied by false information, the content of the media and social networking is hampering the efforts of the global community. Although the World Health Organization (WHO) and other stakeholders are aware of the misinformation and are trying to reduce it, myths and rumors are widespread. This review identifies the carriers of misinformation and its possible effects during the COVID-19 pandemic. Eleven research articles published from 2017 to 2020 were selected, the findings of which misinformation appears to be a strong risk factor and a significant obstacle to tackling the global health crisis. Myths and rumors through traditional and new platforms of news and social media cause xenophobia, human rights violations and psychological disorders in the population. Despite the efforts of the World Health Organization, much more is needed to neutralize the effects of misinformation. Improved global health care policies and strategies are therefore recommended to combat misinformation and mitigate the related effects of COVID-19. Key-words: Vaccine Movement, COVID-19 Legislation, Misinformation, Mass Media, Public Health, Fake News, Conspiracy Theories

Political casualties of the COVID-19 pandemic

Contents Introduction Section I: Fundamentals 1. A brief history of advances towards health John Last 2. The health, poverty and development merry-go-round: the tribulations of WHO Socrates Litsios 3. Old and new pestilences Andrew A. Arata 4. Value systems and healthcare ethics Bernard M. Dickens 5. World health: a mobilizing utopia? M. Manciaux T. M. Fliedner Section II: Systems 6. Health policies versus public policies Andrzej Wojtczak 7. A medicine based on evidence J. Szczerban 8. The promise of technology P. B. Mansourian 9. Critical inquiries on technology utilization Arminee Kazanjian 10. Therapeutic patient education for chronic diseases Jean-Philippe Assal Section III: The Dynamics 11. The humanitarian imperative in major health crises and disasters S. W. A. Gunn 12. Dealing with global infectious disease emergencies David L. Heymann 13. Knowledge-based methodologies in the health sector B. McA. Sayers Juan J. Angulo 14. Food safety - a pressing public health and economic issue Fritz Kaferstein 15. Future health in an ageing world A. Michael Davies Section IV: The Controversies 16. Disease and health in the cultural context Assen Jablensky 17. Global issues and health interactions: reflexions from the south A. P. R. Aluwihare 18. The coming storm: health system planning versus free market enterprise Anthony Piel 19. Education, understanding, and eudaemonia: a contrarian view on global health Gerhard W. Brauer Postscript 'The Present and the Future of Global Health' A. Michael Davies The Contributors Index

Effective Approaches to Combat Vaccine Hesitancy.

Global health efforts and opportunities related to the Belt and Road Initiative

Confronting the evolution and expansion of anti-vaccine activism in the USA in the COVID-19 era

This chapter, “Economic Development Policy,” focuses on the critical role of development decision-making and poverty alleviation in the realization of public health outcomes. Economic development policy shapes public health, insofar as economic development policy influences determinants of health, including the persistence of intersectional inequalities faced by the most vulnerable communities that materially affect health outcomes. Economic development policy, as set by international financial institutions such as the International Monetary Fund (IMF) and the International Bank for Reconstruction and Development (World Bank), can be viewed as global health policy, particularly when development lending facilities and programs are purposely designed toward realizing desired population health targets and community health needs. Multidimensional development governance to advance public health—which considers medical, scientific, economic, environmental, and social determinants for overall public health—emerged to a large extent from the international reconceptualization of economic development policy as global public health policy. The World Bank has since begun to address intersectional concerns in framing its funding policies to advance global health—through a multidimensional approach to understanding social inclusion, public health, and human rights in economic development—but these global health efforts have faced implementation challenges in regional, national, and local contexts.

National armies for global health?

Chapter 16 - Global health

The changes wrought by Donald Trump’s second administration have already been momentous, and the changes in global health are among the biggest: The United States has withdrawn from the World Health Organization (WHO), and US global health policy is being destroyed—as seen in the closure of USAID and the anti-HIV initiative known by its acronym PEPFAR. Global health, dramatically improved by what may be the most successful international aid effort ever mounted, will be gravely harmed, with serious death tolls attributable to US policy changes. The WHO will suffer from the withdrawal of US resources and is likely to become a less effective and more European-led institution. The world will, overall, face greater health risks, have less resilience, and be less able to mount an effective response to health threats.

Reviewed by: Vaccine Hesitancy: Public Trust, Expertise, and the War on Science by Maya J. Goldenberg Jacob Steere-Williams Maya J. Goldenberg. Vaccine Hesitancy: Public Trust, Expertise, and the War on Science. Science, Values, and the Public. Pittsburgh: University of Pittsburgh Press, 2021. xii + 251 pp. Ill. $32.00 (978-0-8229-6690-6). In December of 2020 the United States Food and Drug Administration authorized two mRNA vaccinations for emergency use to protect individuals sixteen and older from SARS CoV-2, the causative virus of the COVID-19 pandemic. The New York Times called it a “turning point in the pandemic,” and many in the scientific and public health community believed that the technological solution of safe, effective, and widely available vaccines would either end, or drastically-reduce rising COVID-19 infections and deaths. The majority of the public, in other words, would trust the science and get vaccinated. But that did not happen, and as of August 2022, only 67 percent of the American population is vaccinated against the disease. Leading up to the rollout of the COVID-19 vaccine, historians and philosophers of public health warned that technological solutions alone do not solve public health crises. As Mark Largent and Elena Conis have argued, vaccine hesitancy, skepticism, and anxiety have long been entrenched in American public health [End Page 171] debates. Even if we did not listen to the historians, our collective hubris might have been a product of short-term memory loss; in January of 2019, for example, the World Health Organization listed vaccine hesitancy as one of the leading global health threats, alongside the likes of air pollution, climate change, and warfare. In the words of philosopher of science and medicine Maya Goldenberg, the COVID-19 pandemic has been a “clear global test case in public trust between health and government bodies and members of society” (p. ix). But what frameworks do we have for understanding the broader patterns of scientific mistrust that have risen to levels of palpable public health crisis in the past two and a half years? Maya Goldenberg’s new book, Vaccine Hesitancy: Public Trust, Expertise, and the War on Science, is the siren call for critical health studies scholarship that we all need right now. Historians, public health practitioners, ethicists, and clinicians will all find this book relevant. Written in the years leading up to the COVID-19 pandemic, but published in the pandemic crisis year of 2021, Vaccine Hesitancy is a cogently-written and lucidly-argued account of the rise of vaccine hesitancy as both a public attitude and an analytical concept. So where does the public mistrust of the science of public health stem from, and why are so many Americans skeptical of the safety and efficacy of vaccines? Many public health practitioners, Goldenberg argues, have relied on a “knowledge deficit model,” which suggests that public mistrust is a product of the misunderstanding and ignorance of scientific ideas. The policy implications which follow from this approach, Goldenberg maintains, are broad-based attempts at science education in order to reinvigorate the idea that scientific experts should guide public policy. In other words, vaccine hesitators are often dismissed as morally-bankrupt, confused, ignorant, or ideologically-driven. This war-laden set of metaphors, which Goldenberg argues are common in the public health community, create a false dichotomy between righteous, bias-free ‘science’, on one side, and an irrational public on the other. Goldenberg rejects the knowledge deficit model, resolving that “characterizing vaccine hesitancy and refusal as a war on science is both descriptively inaccurate and normatively unhelpful” (p. 12). In place of this dichotomous framing, Goldenberg argues for a contextualist reading of vaccine hesitancy, one which focuses on the historical and structural reasons for public mistrust that lie in a wide-range of factors that comprise social identity. In this way, debates around vaccine hesitancy need to be understood alongside those about climate change and genetically-modified organisms. What is at stake is not a war on science, but a negotiation about deeper cultural values of democracy, the environment, and governance. Vaccine Hesitancy is organized into two parts. The first four chapters in Part 1 analyze and disambiguate the war on...

Short- term experiences in global health (STEGH), also known as short-term medical missions continue to be a popular mode of engagement in global health activities for students, healthcare providers, and religious groups, driven primarily by organizations from high-income countries. While STEGH have the potential to be beneficial, a large proportion of these do not sustainably benefit the communities they intend to serve, may undermine local health systems, operate without appropriate licenses, go beyond their intended purposes, and may cause harm to patients. With heightened calls to “decolonize” global health, and to achieve ethical, sustainable, and practical engagements, there is a need to establish strong guiding principles for global health engagements. The Advocacy for Global Health Partnerships (AGHP), a multi-sectoral coalition, was established to reflect on and address the concerns relating to STEGH. Towards this end, AGHP created the Brocher Declaration to lay out six main principles that should guide ethical and appropriate STEGH practices. A variety of organizations have accepted the Declaration and are using it to provide guidance for effective implementation of appropriate global health efforts. The Declaration joins broader efforts to promote equity in global health and a critical reevaluation of volunteer-centric, charity-based missions. The current state of the world’s health demands a new model of collaboration – one that sparks deep discussions of shared innovation and builds ethical partnerships to address pressing issues in global health.

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health.

The emergence of COVID-19 has provided a new vigor to addressed global health issues. In this regard, global health diplomacy initiatives have seen a considerable surge. Countries around the world are using the opportunity to harness the potential of global health diplomacy in cultivating relations with several countries and also building a soft power projection. A case in point is how China has been spearheading global health efforts to improve relations while projecting a soft power about how China aims to act as global savior. Chinese efforts were able to gain significant traction owing to the fact that the United States under the administration of President Trump suspended its global leadership role, the first such instance in the post-World War-II era. This paper explains the concept of global health diplomacy by conducting a comparative analysis of the global health efforts and policies undertaken by both the United States and China by following qualitative research technique and secondary sources to explain the phenomenon. The study found that China led the response to COVID-19 not only domestically but globally as well. The U.S. lagged but gradually started to compete China in health diplomacy. There is an evident struggle for dominance in health sector between China and the U.S., however, it is not expected to lead into hard power struggle. The paper has concluded that it is important for both countries to work together in future in case of pandemic to spearhead an international effort against such crises. Moreover, it recommends Chinese authorities to include health corridor as a component with Belt and Road Initiative. On the other hand, the United States under the administration of President Joe Biden should invest in multilateral efforts so to empower global health institutions to better prepare for future health crises.