Paper short abstract:

The figure of the superspreader, arising out of the SARS outbreak, has been catalytic in emerging biopolitical and geopolitical entanglements around pandemic preparedness. The paper examines the impact of the displacement of processes of heterogeneous transmissibility by a super-infectious subject.

Paper long abstract:

In the course of the 2002-2003 SARS outbreak, epidemiologists observed phenomena of heterogeneous transmissibility, which were believed to account to a significant extent for the rapid spread of SARS-CoV across the globe. Although these phenomena were the result of situational and infrastructural singularities, attention was drawn to the individuals involved. Coined as "superspreaders" these were presented in both the medical and lay press as persons possessing the ability to infect more people than the usual individual. Seen not simply as implicated in but as responsible for instances of heterogeneous transmissibility, these alleged super-infectors have since become a regular figure in outbreak narratives. Moving attention away from infrastructural aspects of infection, and focusing it on supposedly hyper-virulent individuals, this has in turn led to calls for the predictive identification and isolation of the latter. This paper examines critically the rise of the superspreader in epidemiological models and discourse. In particular it focuses on its impact on biopolitical and geopolitical aspects of pandemic preparedness within the wider rubric of global health. The paper argues that the figure of the superspreader has played a crucial role in the entanglement of biopolitical and geopolitical configurations of the "next pandemic" as a potentially catastrophic global event.

Paper short abstract:

This paper proposes to examine the „violence of speed“ put forth by the philosopher Paul Virilio in developing a critical ethnography of global health. I will ask how humanitarian logistics prompts a set of technologies of speed which organize emergencies logistically

Paper long abstract:

This paper proposes to examine the "violence of speed" put forth by the philosopher Paul Virilio in developing a critical ethnography of global health (Virilio 2006; see also Rosa 1999). Taking a cue from Virilio's account of logistics in the make of modern war and peace, I will ask how humanitarian logistics prompts a set of technologies of speed which organize emergencies logistically. In the field of global health, logistics is increasingly a precondition for innovations and itself a ecology of creating innovation. Not only to transport things to any place, but continuously optimize logistical time for creating complex infrastructures to scale-up access to antiretrovirals or transport tons of material to construct Ebola treatment centers. The moral authority to act immediately is a powerful legitimation for global health interventions. In this paper I wish to engage anthropological debates on the biopolitical implications of global health interventions by examining the violence of speed resulting out of humanitarian logistics. This violence of speed will be captured by asking how humanitarian logistics enacts its populations to be saved. How are beginning and end of an epidemic defined? How is the race for global health shaping the biopolitics of making life and letting die? To situate the analysis of violence of speed, I will review medical anthropological debates on violence (e.g. Farmer 2004; McFalls 2010) and elaborate on the invisibility of the violence of speed to contribute to efforts to reclaim critique in the anthropology of global health (e.g. Adams, Burke, Whitmarsh 2014).

Paper short abstract:

My paper explores the ongoing interplay between local and global stakeholders to deal with and define measles in Sindh to further understand global health apparatus and bio-politics in a regional perspective.

Paper long abstract:

The present paper is based on my recent PhD fieldwork on two consecutive outbreaks of measles, which occurred in 2012 & 13 in Sindh. This paper deals with the ways global health is to be contested, negotiated, and used as an apparatus encompassing various local as well as global actors in Pakistan. For local actors measles is a sacred illness, while global actors - e.g. WHO - consider it a disease as well as a threat to inhabitants of other countries across the globe.

All stakeholders had different concerns and interests while dealing with the said outbreaks. Also, their envisioned worth and value, meanings and measures pertaining to life differed from each other.

The paper will highlight various justifications and responses given by involved actors regarding their interventions towards measles. The paper will present a critical analysis of interventions and their justifications for saving lives and devising prophylaxis against potential threats.

The originality of this paper lies in the analysis of an understudied case (Pakistan) in order to give a regional perspective regarding the ongoing interplay between geopolitics and biopolitics through the lenses of global health and 'global assemblages'.

Paper short abstract:

In this paper we explore the geo-political, ethical, social and technical issues that followed in the wake of a laboratory established in Nepal to screen Bhutanese refugees being relocated to the US.

Paper long abstract:

Drawing from ongoing research into the role of laboratories in TB control, this paper focuses on a laboratory established by the International Organisation of Migration (IOM) - an intergovernmental organization - in Eastern Nepal. Supported by the CDC, its primary purpose is for the screening of refugees. From the 1990s, following a process of ethnic cleansing in Bhutan, over 100,000 Bhutanese of Nepalese origin migrated to Nepal and were housed in refugee camps. In 2007 the U.S. announced that they would offer settlement to most of those remaining in the camps in Nepal. The state-of-the-art lab was installed near the camps to screen (and then treat) infectious diseases, in particular tuberculosis, in the refugees prior to resettlement. However, these services are far superior technically and medically than those provided to the surrounding population through the Government of Nepal Primary Health Care setup and it National Tuberculosis Programme, and were dependent on policies and practices developed by the CDC. Aware of this medical, ethical and political dilemma, the IOM started to draw up protocols for greater "harmonization" with local services, and to support local laboratories through the provision of GeneXpert machines, a new technology, recently sanctioned by the WHO, used for speeding up the diagnosis of TB. In this paper we explore the geo-political, ethical, social and technical issues that followed in the wake of this complex assemblage, to pose questions to current thinking around the emergence of ideas to what makes up "global health".

Paper short abstract:

This paper examines how Bolivian policy actors are striving to forge alternatives to global, neoliberal models of health and development. Tracing practices of collaboration, negotiation, and debate, it explores how Bolivians both challenge and reproduce dominant configurations of “global health.”

Paper long abstract:

Recent, state-led efforts to overhaul the healthcare system in Bolivia explicitly reject dominant, global models of health and development. Policies like the 2008 Family, Community, and Intercultural Healthcare law propose a socialized healthcare system that relies on the active participation of indigenous and labor movements. For policymakers, this new law presents a vital shift away from the neoliberal politics of care that characterize international development projects. Yet, due to resource shortages, Bolivian policymakers often end up forging pragmatic alliances with transnational institutions to implement this policy. They engage in a delicate balancing act, invoking the state's project of "de-neoliberalization" while also utilizing the resources and discourses of global health. This paper examines the tensions and collaborations that emerge as Bolivian policymakers, healthcare workers, and NGO officials strive to make health policy work in a rural municipality. How do these various groups draw on national and transnational discourses to make policy implementable? How do their practices both challenge and re-inscribe dominant configurations of "global health"?