UNIT 1 : READING 2

ANTHROPOLOGY AND GLOBAL HEALTH

BY CRAIG R. JANES AND KITTY K. CORBETT

DEFINING GLOBAL HEALTH

Understanding global health in anthropology is tricky. People use the term in
different ways, making it hard to pin down. Sometimes it just means work in other
countries. Anthropologists like Nichter say that their field connects with global
health by studying how people view health and looking at ethics and governance.
Defining global health in anthropology is important, especially since more
discussions about it are happening now. It helps describe how health and culture
are linked in different parts of the world.

Kelley Lee, a political scientist, says global health is different from international
health because it deals with health issues that cross country borders. Unlike
international health, global health looks at problems that affect people regardless of
where they live. Lee sees health as connected to how people interact globally,
breaking down boundaries in space, time, and understanding. This idea of global
health fits into a unique political space, studying how health is influenced by power
dynamics in our interconnected world, similar to what anthropologists and
sociologists explore.

Burawoy, a sociologist, talks about globalization by breaking it down into three

things: global forces (like economic and political processes), global connections (like
social networks and relationships), and global imagination (adopting global values
and ideas). He applies these ideas to understand local situations, but what "local"
means in globalization is debated. Ethnographers ,like Rapp who study people in
specific contexts, define the local as any small-scale place where social meanings
are shaped, not just limited by geography.

Understanding health means looking at how global, national, and local factors
interact in a specific place. Ong & Collier term this the "actual global," emphasizing
its dynamic nature. Anthropologists study these interactions, influenced by
Burawoy's approach of "grounding globalization" through extended case methods,
moving from observation to active participation over time and place.

Global health is about understanding how health connects to various global

processes. This includes studying things like health inequalities, how resources for
well-being are distributed, and the impact of global health policies. Anthropologists
in global health aim to reduce health inequalities and promote sustainable systems.
As environmental challenges increase, there's a suggestion to redefine vulnerability
to include everyone. Key research areas include studying health inequalities, the
global impact of science and technology, analyzing international health programs,
and understanding the health consequences of changing international health
development.

EXPLAINING HEALTH INEQUITIES

Anthropologists study why some people face health problems more than others.
They look at how external factors affect communities, connecting local issues to
bigger structures and supporting public health. This research shows that health
disparities come from global politics, regional history, and development ideas.
Anthropologists shift attention from individual behaviors to broader factors affecting
health, challenging regular public health ideas. They promote a model that
considers how social conditions and diseases are connected, pointing out how social
inequality can harm people's health.

Researchers sometimes find it hard to balance local stories and global perspectives
when studying health. Farmer and others mix individual stories with bigger factors,
but some say the concept of structural violence isn't fully explained. Ecosocial
epidemiology and "intersectionality" are ways to look at these issues, considering
different social aspects together. Anthropologists have explored health equity
themes, but there's more to explore, like how global changes, such as climate
change and microbial resistance, affect people's health

GLOBAL TECHNOSCAPES

Technoscape" means the global arrangement of technology, including medicines

and medical procedures. In health, it involves the mix of things and ideas that make
up global science. Rather than making everything the same, global science
interacts with local communities, influencing and being influenced by their beliefs.
Scientific benefits are not distributed equally, affecting areas like biomedical
research, contraceptive technologies, organ transplantation, and medical tourism,
where corporate practices and the politics of biomedical knowledge play a role.

Researchers study how reproductive and prenatal technologies spread globally.

Treatments for infertility, like in-vitro fertilization, are influenced by cultural, social,
economic, and political factors in non-Western contexts. For instance, restrictions
on certain procedures increase demand for more expensive technologies.
Globalization also involves the movement of healthcare professionals, creating a
"brain drain," and medical tourists seeking affordable technologies. This global
spread of medical procedures creates unique markets and economies influenced by
cultural, social, and economic factors.

Medical practices aren't only based on Western ideas; alternative health practices
like Asian medicines also spread globally. The transformation of these traditions
often involves turning medicinal substances into commodities. Anthropologists
study how medicines, including those for HIV, are produced, distributed, and used
globally. This global flow creates complex social forms, shaping responses to health
challenges. The blending of local practices with global influences reflects changing
views on health, politics, and ethics, influenced by the globalization of biomedical
knowledge.

INTERROGATING HEALTH POLICY

Anthropologists study global health policy, looking at how experts make decisions
that affect people's well-being. Policymakers often oversimplify issues, and small
expert groups, called epistemic communities, have a big say in global health
agendas. Critics argue that policies, inspired by organizations like the World Health
Organization, may not effectively change local practices. Policymakers often focus
on quick solutions, known as "magic bullets," but this can lead to unintended
problems, like high drug prices. There's also a gap between creating policies and
putting them into action, impacting people's access to essential treatments and
overall health outcomes

Global health policies, shaped by a small group of experts, have shifted towards
market-oriented approaches, neglecting public governance. This leads to increased
problems, like selling medicines to those who can't afford them. The World Health
Organization is trying to focus on primary healthcare principles, but the dominance
of market-oriented policies poses a challenge to rights-based approaches in the
health sector

Global population and reproductive policies are shaped by beliefs about poverty and
scientific development, influencing health and social policies. In China, coercive
family planning linked Western population science with socialist planning. Despite
global calls to respect women's rights, some regions still enforce oppressive family
planning on poor women. Anthropological research reveals challenges in
implementing international health development policies, covering issues like child
immunization, tuberculosis treatment, disaster management, bioethics, monitoring
programs, community participation, and HIV/AIDS policies. This work exposes the
gap between global health policies and the lived experiences of local communities.

Since the 1980s, public health services shrank due to neoliberal policies. Non-
governmental organizations (NGOs), playing a major role, face issues like
competition and potentially undermining local control. In places like Mozambique,
NGOs may hinder health services. Understanding the dynamics of NGOs and
navigating various global health actors, including economic groups and
pharmaceutical companies, is crucial for effective global health work.

AN UNRULY MELANGE

Since the 1980s, changes in health policies reduced the size of public health
services. This led to a reliance on private organizations within civil society for health
development. These organizations include local NGOs, faith-based charities, and
international foundations. They are favored by donors but often operate
independently, creating competition and duplicating efforts. In Mozambique, NGO
operations may have even weakened local health services. Despite their significant
role, NGOs receive limited attention as social and cultural phenomena.

NGOs interact with local communities in ways that can exacerbate social
inequalities. The rise of NGOs is part of a larger trend involving various
transnational institutions in global health. These include economic interest groups,
philanthropic organizations, and multinational pharmaceutical companies.
Navigating these diverse and sometimes competing interest groups requires skills
for effective global health practice. Understanding these dynamics is crucial for
those working to improve health and well-being at both local and global levels
(Adams et al. 2008.

CONCLUSION

Anthropologists contribute significantly to global health by uncovering social

determinants of health and health inequities. Through ethnographic analysis, they
reveal the impact of global forces on local communities, emphasizing the
importance of addressing poverty and environmental issues. Anthropologists also
study global technoscience, examining how technology and biomedical science
influence and interact with local cultures. They investigate the globalization of
western bioscience, exploring policy-making processes and their unintended
consequences, especially for vulnerable populations. As the health development
landscape transforms with various nonstate actors and civil society organizations,
anthropologists play a vital role in coordinating efforts and understanding their
impact. Their work aims to promote social justice and contribute to improving global
well-being.