Periodic Reporting for period 1 - Racializing Health (Coloniality and Speculation in Global Health: addressing the lived-experience of racialization among Honduran low-income urban residents through their encounters with public health services.)
Reporting period: 2023-04-01 to 2025-03-31
The overall purpose of the action was to address how global health, as a varied and malleable set of administrative and bureaucratic tools to organize transnational health projects and collaborations, enacts policies across varied national contexts that facilitate economic speculation. The action addressed the entanglement between global capitalist relations of production, local public health practice (as a site for global health policy implementation), and the re/production of social difference through speculative policy initiatives. The action also explored how the production of social difference in global health is not a corollary effect of global health practice, but rather a reflection of global health’s standing as a constitutive feature of contemporary transnational capitalism.
The action was comprised of three specific objectives. Objective 1 was to address the impact of persistent causal ideologies reminiscent of colonial tropical medicine within contemporary public health practice in Honduras. Objective 2 was to address how institutional public health policy mobilization and implementation produces and reproduces local ideas of health-related deservingness. Objective 3 was to explore how global health policy implementation in local public health facilitated speculation during epidemics.
The action was comprised of three specific objectives. Objective 1 was to address the impact of persistent causal ideologies reminiscent of colonial tropical medicine within contemporary public health practice in Honduras. Objective 2 was to address how institutional public health policy mobilization and implementation produces and reproduces local ideas of health-related deservingness. Objective 3 was to explore how global health policy implementation in local public health facilitated speculation during epidemics.
To address objective 1, in this action I teased apart some of the different definitions of justice in use within global health work and how articulated how these definitions reproduce or counteract ideologies reminiscent of earlier moments in transnational health (i.e. colonial tropical medicine, international health). Second, I explored persistent discriminative ideologies that continue to influence local public health practice in Honduras, and related local public health practice in Honduras to the larger and highly influential space transnational global health practice. Third, I addressed the tension between local public health, conceptions of care, infectious disease transmission, and an inability to separate economic speculation from the development of public health policy in Honduras.
To address objective 2, in this action I explored the relationship between One Health, justice, and global health practice, with a particular focus on how ethical presuppositions shape definitions on health and how these definitions in turn impact how we measure the success or suitability of given global health practices. Second, I addressed the limits to health-related deservingness in contexts marked by historically produced and ideologically maintained socio-racial hierarchies. I addressed the limits of health-related deservingness by highlighting how formal notions of rights in Honduras, in regards to public investments in health, are always already informed and shaped by emotional, relational, or “common sense” understandings of a given populations worth. In that sense, health-related deservingness should not be considered separate from formal conceptions of rights. Third, I sought to interrogate the origin of moral concepts like deservingness and to situate them within a large conversation on philosophical anthropology and how we define the limits of interpersonal ethical engagement.
To address objective 3, in this action I proposed alternatives to the decolonization of global public health both by situating global health within a set of wider practices towards justice and by suggesting some alternative models to global health. Second, I explored how disciplinary allegiances obfuscate novel theoretical production and may lead to conceiving of partial categories as absolute representations of reality (i.e. global health). Third, I addressed the relationship between speculation and colonial ideologies in Honduras beyond public health by focusing on how the Honduran state responded, and made space for, transnational projects that pitted future economic growth against the present sacrifice of the livelihood and wellbeing of given Honduran citizens.
To address objective 2, in this action I explored the relationship between One Health, justice, and global health practice, with a particular focus on how ethical presuppositions shape definitions on health and how these definitions in turn impact how we measure the success or suitability of given global health practices. Second, I addressed the limits to health-related deservingness in contexts marked by historically produced and ideologically maintained socio-racial hierarchies. I addressed the limits of health-related deservingness by highlighting how formal notions of rights in Honduras, in regards to public investments in health, are always already informed and shaped by emotional, relational, or “common sense” understandings of a given populations worth. In that sense, health-related deservingness should not be considered separate from formal conceptions of rights. Third, I sought to interrogate the origin of moral concepts like deservingness and to situate them within a large conversation on philosophical anthropology and how we define the limits of interpersonal ethical engagement.
To address objective 3, in this action I proposed alternatives to the decolonization of global public health both by situating global health within a set of wider practices towards justice and by suggesting some alternative models to global health. Second, I explored how disciplinary allegiances obfuscate novel theoretical production and may lead to conceiving of partial categories as absolute representations of reality (i.e. global health). Third, I addressed the relationship between speculation and colonial ideologies in Honduras beyond public health by focusing on how the Honduran state responded, and made space for, transnational projects that pitted future economic growth against the present sacrifice of the livelihood and wellbeing of given Honduran citizens.
The work that I carried out during the action will contribute to more critically defining how international health policy is developed. The work that I developed during the action addresses how justice and deservingness are conceptualized within international health policy and how differing metrics of justice and deservingness are informed by oft times poorly acknowledged and competing views on entitlements and socio-racial hierarchies. A clearer discussion on the expectations, aspirations, and historical residuals that inform views on justice and health-related deservingness will lead to the development of more equitable and locally sustainable health systems within the global south.
Particularly, in the final stage of the action I addressed the growing call for the decolonization of global health in anthropology. In a manuscript currently under review, I argue that the decolonization of global health is, at best, naive. Instead of striving for the decolonization of global health, I suggest decentering/displacing global health to make room for alternative world-building projects. I refer to one of these potential alternative world-building projects as fugitive wellbeing. Ultimately, I argue 1) that global health is a politically informed project that falls under a larger category of social responses to the dilemma of distribution: networked infrastructures for the distribution of public goods; 2) that our understanding of what constitutes public goods currently shapes the limits of global health; and 3) that our understanding of public goods is in turn shaped by our ideas of the human and the future. Finally, I suggest that to look beyond global health projects we have to initiate research in locales that contest both global health practice and specific forms of local governmental involvement that affect local forms of sovereignty.
Particularly, in the final stage of the action I addressed the growing call for the decolonization of global health in anthropology. In a manuscript currently under review, I argue that the decolonization of global health is, at best, naive. Instead of striving for the decolonization of global health, I suggest decentering/displacing global health to make room for alternative world-building projects. I refer to one of these potential alternative world-building projects as fugitive wellbeing. Ultimately, I argue 1) that global health is a politically informed project that falls under a larger category of social responses to the dilemma of distribution: networked infrastructures for the distribution of public goods; 2) that our understanding of what constitutes public goods currently shapes the limits of global health; and 3) that our understanding of public goods is in turn shaped by our ideas of the human and the future. Finally, I suggest that to look beyond global health projects we have to initiate research in locales that contest both global health practice and specific forms of local governmental involvement that affect local forms of sovereignty.