Tag: global health

Posted on

Do you want to write a COVID dissertation?

Professor Sophie Harman gives some advice about coming up with dissertation topics related to COVID.

Part of the joy and point of writing a dissertation is for students to come up with their own subject and research question. Both students and supervisors know this is often the most painful part of the process (second only to the week before deadline – start early, marathon not a sprint etc!). I know good supervisors can support students writing dissertations in all manner of subjects and this is what makes it so rewarding. However, in a year where we’re all dealing with increased pressure, demands on our time, and managing screen headaches, I thought I’d put my 15 years global health politics experience to good use and make some suggestions/pointers to help you when a student comes to you as says the inevitable:[1]

‘I was thinking of writing my dissertation on COVID-19’

Below are 10 suggested questions with suggested literature and methods, covering institutions, security, race, policy, vaccines, gender, aesthetics, expertise, knowledge. These by no means cover everything and by no means prescribe how I think a dissertation on that topic should be written. If helpful, see them as jump-off points to think about these topics. The only caution I have is make sure all projects are only focused on the start/first 6 months of COVID-19 – we are only at the end of the beginning. This is also a pre-emptive move to stop you getting your students to email me for ideas.

Institutions and Global Governance

  1. Is the WHO capable of preventing and responding to major pandemics?

Literature: WHO, IHR, GOARN, global health security + previous outbreaks (Ebola, pandemic flu, HIV/AIDS)

Methods: Case Studies – look at the tools/instruments e.g. IHR, GOARN, Regional offices etc

  • Why did states pursue different responses to the COVID-19 outbreak?

Literature: Global health security, state compliance in IR, international law and international organisations

Methods: Pick two contrasting case studies e.g. England/Scotland, Canada/US, Germany/UK, Sweden/Denmark and then look at different levels of policy and decision making per chapter – Global, National, Regional/local and rationales behind decisions from – expert evidence, speeches, policy decisions, policy timelines

Gender

  • How can we understand the gender dimensions of COVID-19?

Literature: Gender and global health, Feminist IPE, Black Feminism, WPS (if looking at violence)

Methods: Explore 1 – 3 key themes from the literature – Care and domestic burden, Health Care Workers, Domestic violence in depth. Depending on networks and contacts, could run focus groups (ethics! And definitely NOT if doing violence), or analyse survey data – lots of surveys done on this and the raw data is always made available if have the skills to play with it.

Political Economy

  • Are states the main barrier to vaccine equity?

Literature: Vaccine access and nationalism, access to treatment, IPE of health and trade, pharmaceutical companies, Bill and Melinda Gates Foundation

Methods: Look at the different stages of vaccine development for 2/3 trials and consider the role of States (where putting money, public statements, any actions e.g. email hacks), Researchers (where get money from, how collaborating, knowledge sharing), Institutions (CEPI, GAVI, WHO), and the Private Sector (pharma and foundations – who’s investing, what is their return – and private security companies – who protects the commodity?). Think: interests, investment, barriers/opportunities.

Security and Foreign Policy

  • Were state security strategies prepared for major pandemics prior to COVID-19? If not, why not?

Literature: Global health security, securitisation and desecuritisation of health

Methods: 2 – 3 state case studies or 1 in detail, think about Strategy, Training/Preparedness, Actors. Content analysis of security strategies and defence planning and budget allocations, speeches, training, simulations etc.

Aesthetics

  • What is the role of images in responding to outbreaks?

Literature: Aesthetics and IR, behaviour change communication and images in public health

Methods: 3 case studies on different types of images in COVID-19, e.g. 1. Global public health messaging; 2. National public health messaging; 3. Community Expression – OR pick one of these options and explore in depth.

Race and Racism

  • Could the racial inequalities of COVID-19 been foreseen and prevented?

Literature: Racism and global health, racism and domestic health systems, Black Feminism, Critical Trans Politics

Method: Option 1 – look maternal health as a proxy in three case study countries e.g. Brazil, US, UK; Option 2 – pick one country and look at three health issues prior to COVID-19 e.g. Maternal Health, Diabetes, Heart Disease.

Knowledge, Discourse, and Experts

  • Is COVID-19 the biggest global pandemic of a generation?

Literature: Postcolonial/decolonial theory, poststructuralism; Politics of HIV/AIDS, pandemic flu

Method: Discourse analysis around ‘once in a lifetime rhetoric’ – who says it, when, and why; contrast with discourse around COVID-19 from countries with previous outbreaks e.g. Sierra Leone, DRC, China, Indonesia, South Africa, Brazil (you’ll need to be selective as can’t measure discourse from all states! Think through why you make your choices here and how they relate to each other) OR contrast COVID-19 with a previous pandemic, e.g. HIV/AIDS

  • What knowledge counts in COVID-19?

Literature: Postcolonial/decolonial theory, post-structuralism, IR and Global Health, politics of experts

Methods: Review lessons learned from previous outbreaks (there are lots of source material on this after Ebola and SARS for example) and how they led to changes/what learned for COVID-19; Stakeholder mapping and/or network analysis – Who are the experts? Look at backgrounds, types of knowledge and expertise, did they work on the Ebola response/HIV/AIDS in the early 2000s for example?; Case Study – UK/US – where have high concentration of public health experts and institutions, export knowledge to low and middle income countries, evidence of importing knowledge from these countries, especially given the experience?

UK/State responses

  1. How can we understand/explain the first 6 months of the US/UK/Sweden/Australia/South Africa/China/Brazil/you choose! response to COVID-19?

WARNING! This is the question that could descend into a polemic so approach with absolute caution. I would strongly advise against, but have included to give a clearer steer.

Key with this question is to remember you are not submitting a public health or epidemiology dissertation, so bear in mind you probably don’t have the skills and knowledge to assess what was a good/bad public health decision (other than obvious ones such as PPE stocks for example). What you do have the skills to do is to look at the politics as to why a decision was taken and how is was taken – investigate what the different recommendations/guidance suggested and who followed/ignored/subverted it and what outcomes this produced.

Literature: health policy, public policy, state compliance IR

Methods: 1. Global – map what global advice there was and how did the state follow (or not) in preparedness and response and what was the rationale for doing so – political circumstances at the time, stated rationale for decision, who was making decision; 2. National – key public health decisions, commodities, social-economic consequences – how were these planned for/overlooked and why. To look at these two levels may require mixed methods of global and national policy timelines, stakeholder analysis, content analysis of speeches and recommendations, mapping changes to data presentation and access.

[1] For the first two years of my career I supervised countless projects loosely based around ‘Is the War in Iraq illegal?’ I’m hoping some of the variety here will stop two years of ‘Is the UK government’s respond to COVID-19 a national scandal?’ or ‘Is the WHO fit for purpose?’ – two great topics, but tiresome after a bit.

Posted on

New Research: QMUL’s Sophie Harman co-authors a new article for ISQ about reproductive health

Professor Sophie Harman and her co-author, Professor Sarah Davies of Griffith University (Australia) have co-authored an article for International Studies Quarterly, titled “Securing Reproductive Health: A Matter of International Peace and Security”

https://doi.org/10.1093/isq/sqaa020

Abstract: Failure to access reproductive health care is a threat to the security of women around the world. This article offers three propositions to recognize reproductive health as a matter of international peace and security. The first is to recognize current processes of advancement and backlash politics as a silent security dilemma that undermines rights, justice, and public health based approaches to reproductive health. The second is to draw on the human security origins of global health security to reorient the concept away from protecting states to protecting individuals. Finally, a feminist approach to security is incomplete without recognising reproductive health as a threat to women’s security and as a barrier to their participation in international peace and security processes. Reproductive health is central to effective peacebuilding yet remains curiously absent from the international peace and security discourse. We discuss how and why reproductive security should become integrated within the Women, Peace, and Security (WPS) agenda in order to hold states to account for reproductive health access. Reproductive security defines the urgency and threat of restricted reproductive health care to the lives of women, health-care providers, and sustained international peace and security.

The article can be found at https://academic.oup.com/isq/article/64/2/277/5819129

Posted on

New Research: QMUL’s Sophie Harman co-authors a new article for Nature about the lessons of past pandemics about the effect on women

The social and economic impacts of COVID-19 fall harder on women than on men. Governments need to gather data and target policy to keep all citizens equally safe, sheltered and secure.

Authors/editor(s): Clare Wenham, Julia Smith, Sara E. Davies, Huiyun Feng, Karen A. Grépin, Sophie Harman, Asha Herten-Crabb & Rosemary Morgan

Drawing on the experience of past pandemics new article in the journal Nature argues that

“Women are affected more than men by the social and economic effects of infectious-disease outbreaks. They bear the brunt of care responsibilities as schools close and family members fall ill. They are at greater risk of domestic violence and are disproportionately disadvantaged by reduced access to sexual- and reproductive-health services. Because women are more likely than men to have fewer hours of employed work and be on insecure or zero-hour contracts, they are more affected by job losses in times of economic instability.”

The article can be found at https://www.nature.com/articles/d41586-020-02006-z

Posted on

New Research: QMUL’s Sophie Harman co-authors a new article for UNWomen on COVID and gender equality

Authors/editor(s): Ginette Azcona, Antra Bhatt, Sara Davies, Sophie Harman, Julia Smith, and Clare Wenham

Original URL: https://www.unwomen.org/en/digital-library/publications/2020/07/spotlight-on-gender-covid-19-and-the-sdgs

Sophie is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

COVID-19 has been declared a public health emergency of international concern and a global pandemic by the World Health Organization. This global threat to health security underscores the urgent need to accelerate progress on achieving Sustainable Development Goal (SDG) 3 and the need to massively scale up international cooperation to deliver on SDG 3. It also reveals what is less obvious, but no less urgent: how health emergencies such as COVID-19, and the response to them, can exacerbate gender inequality and derail hard-won progress not only on SDG 3 but on all the SDGs.

This paper presents the latest evidence on the gendered impact of the pandemic, highlights potential and emerging trends, and reflects on the long-term impact of the crisis on the achievement of the 2030 Agenda for Sustainable Development.

The paper begins by presenting key facts and figures relating to the gendered impacts of COVID-19 followed by reflecting on the health impacts of COVID-19 on SDG 3 targets. Then, the paper explores the socioeconomic and political implications of COVID-19 on women and gender across five of the Goals: SDG 1 (poverty), 4 (quality education), 5 (gender equality), 8 (decent work and economic growth), and 10 (reduced inequalities).

The paper concludes by outlining policy priorities drawn from the evidence presented.

This paper is part of the “Spotlight on the SDGs” series.

View online/download

Bibliographic information

Subject area(s): 2030 Agenda for Sustainable Development; COVID-19; Gender equality and women’s empowerment; Gender statistics; Health; Sex-disaggregated data; Sexual and reproductive health and rights; Sustainable Development Goals (SDGs)

Posted on

Media: Mile End Institute video with Sophie Harman and Annie Wilkinson

By Sophie Harman

Sophie is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

The newest addition to the Mile End Institute at Queen Mary University of London video series on the #COVIDー19 crisis. In this episode, Professor Sophie Harman (QMUL) and Dr Annie Wilkinson (Institute of Development Studies) consider how simple COVID-19 prevention methods in slums and informal settlements are often difficult or impossible to administer. They also highlight how a lack of available data can impact the effectiveness of strategies for responding to the pandemic. The series is introduced by Professor Tim Bale:

Posted on

Media: Mile End Institute video with Sophie Harman and Daniel Kettor

By Sophie Harman

Sophie is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

The newest addition to the Mile End Institute at Queen Mary University of London video series on the #COVIDー19 crisis. In this episode, Professor Sophie Harman (QMUL) discusses lessons that can be learned from the Ebola response in relation to COVID-19 with Daniel Kettor (Rainbo Initiative). He highlights, from his experiences of Ebola in Sierra Leone, that social behaviours towards the end of the COVID-19 pandemic will be crucial in ending transmission. The series is introduced by Professor Tim Bale:

Posted on

Blog: Sophie Harman’s COVID-19 Global Health reading list

By Sophie Harman

Sophie is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

‘In time of trouble, I had been trained since childhood, read, learn, work it up, go to the literature. Information was control’ (Didion, 2005: 44).

As COVID19 spreads across the world and into our every aspect of our lives, I’ve been thinking a lot about this quote from Joan Didion. As someone who has conducted research and taught on global health politics for 15 years, I feel some control derived from knowing what to expect from a global health emergency and pandemic: the rapid shift from social distancing to lockdown to inevitable enforcement is not surprising and expected, it is also totally alien, discombobulating, and scary. I decided one helpful thing I could do would be to share my module reading list. This is for three reasons. First, if like Didion, you make sense in times of trouble through reading, I’m sharing this to both help you and better inform the public about pandemics as a means to gain some sense of knowledge and control. Second, there are aspects of International Relations who have just discovered (and in so doing announced this discovery) pandemics and that global health may have an impact on global peace and security: welcome friends, you have some catching up to do. Third, you may be looking for resources to teach your students or want to develop your own module on Global Politics of Health and Disease – please feel free to use this as your guide (and if you have the time to let me know, please do so, as will help my justification to share it!).

This reading list is drawn from over ten years teaching the Global Politics of Health and Disease. The module itself is divided into themes – e.g. global health governance, global health security, right to health – in the lectures, with students then focusing on specific health issues of topics e.g. Zika, HIV/AIDS, Pandemic Flu – in the seminars. I therefore encourage you to cross-read the sections e.g. if interested in pandemic flu, read across the flu, governance, international law, and global health security sections. I have also kept in the background reading I recommend to students and the essay questions to give you a sense of the topics and issues we explore across the module. Please also note that this is a Politics and International Relations module, so no epidemiology, mathematical modelling, or public health practices to be found here!

Global Health Politics is a flourishing field of research and there will definitely be excellent papers I have overlooked. This is not a deliberate snub, I also last updated the module in December 2018. The list misses work on Ebola and the DRC and any COVID19 work. Global Health is also subject to academic research and publication inequality, I have tried to address this as much as possible, but there is still more work to do.

Finally, if you’re looking for the must-reads on pandemic flu, a great place to start would be Sara E. Davies Containing Contagion, Christian Enemark Biosecurity Dilemmas, and Simon Rushton Security and Public Health. There are loads more excellent books (see Pandemic Flu section), these are just the three I grabbed off my shelf before heading to isolation.

To download the reading list in PDF form, go to: https://drive.google.com/open?id=1F5U4jSfVTGYzUlH82oDYP0OFjhE-Fjyz

Posted on

Media: Mile End Institute video series on the pandemic, with Sophie Harman

By Sophie Harman

Sophie is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

The Mile End Institute at Queen Mary University of London will be releasing a series of video updates addressing the #COVIDー19 crisis. In the first episode, Professor Sophie Harman explores whether we should have seen the current global health crisis coming. The series is introduced by Professor Tim Bale:

In the second episode, Prof Harman will focus on community involvement and responses to coronavirus.

https://www.youtube.com/watch?v=v1P15TcOg3E

In the third episode, Prof Harman speaks about the role of the military in relation to the COVID-19/coronavirus pandemic and other global health emergencies.

https://www.youtube.com/watch?v=S-QalKnsaI4

Posted on

Blog: Coronavirus: to avoid major humanitarian fallout, UK must act urgently

By Sophie Harman

Sophie is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

Without an appropriate response, health emergencies like the one the world is currently experiencing can tip over to become humanitarian crises. This tipping point often occurs when a health system is overwhelmed by large numbers of patients, combined with the acute societal effects of an outbreak – such as people’s inability to pay their rent or mortgage or get enough food.

Despite what many may think, humanitarian issues are not just limited to low and middle-income countries or conflict zones. They are a core part of responding to global health outbreaks and can happen in high-income countries in Europe. And right now the UK is at a tipping point of humanitarian concern.

Dame Louise Casey advises the government on homelessness. She announced on BBC Radio 4’s The Today Programme, that the outbreak of coronavirus is not just about health vulnerability, but that it’s also about welfare vulnerability. This outbreak is going to show how decimated the UK’s welfare system is. And it is the most vulnerable in society that will suffer most.

Stockpiling will hit food banks. Lack of sick pay in the gig economy will push workers into greater poverty. The disaster that is Universal Credit will not provide for the additional numbers of people seeking help. This does not even begin to cover the increased need for adult social care provision, vulnerable children, support services for domestic abuse (isolation and quarantine can be a huge risk for women), or the safety of workers that deliver these services.

These essential services in the UK are provided by local authorities. The same local authorities that have been subject to a cut of 49% in real terms between 2010 and 2018, according to the GMB Union and National Audit Office. Local authorities have already struggled to maintain essential services for the most vulnerable in society. It will be impossible for them to handle the humanitarian fallout brought about by coronavirus without extra government funding and support.

Funding questions

The UK government has pledged £5 billion to a COVID-19 response fund for the NHS “and other public services”. “Other public services” here refers to “local authority actions to support care services and vulnerable people”.

The government has also said that it will ensure “that funding is available so other public services are prepared and protected”. But it’s unclear how this £5 billion is to be divided up.

The NHS and Public Health England rightfully need as much money as they can get and it’s good the government recognises the need for greater cash for local authorities. But the UK government also needs to recognise that health emergencies have humanitarian effects and need separate budget allocation. To bundle all of this together under the £5 billion will lead to problems.

Competing responses

My own research with Clare Wenham, assistant professor of global health policy at London School of Economics, shows how failure to understand the difference between health crises and the humanitarian impacts of those crises can significantly delay, confuse, and intensify the response to the crisis.

In such instances, already overburdened health services may become responsible for addressing the humanitarian impacts. This can lead to two competing systems of governance –- the healthcare response and the humanitarian response – which can cause confusion and overlap if not fully understood from the outset.

Funding allocation also becomes confused and ends up creating tension between different sectors, all in desperate need of money and resources. And, ultimately, those most in need slip between the cracks of the health and humanitarian responses.

This will have significant consequences for the secondary health impacts of the outbreak – such as care for the vulnerable, homelessness and access to basic needs such as food.

Not just a health issue

So if the UK government is serious about responding to this health emergency it needs to stop seeing it in purely health terms and act now to stop it spilling over into a humanitarian concern.

Decades of austerity already mean that the UK is tackling the health and social impacts of the virus from a position of weakness. Tacking care of vulnerable adults and children and increasing numbers of people who will need welfare assistance on to NHS spending is not enough. Care and welfare provision must be valued as equally important to health rather than an afterthought.

Valuing care and welfare while allocating proper budgetary spending will help to minimise the impact of the outbreak in an already broken welfare system – and will help to protect the most vulnerable. This is important and is ultimately the way to stop a health emergency becoming a humanitarian crisis.

This blogpost was originally published at https://theconversation.com/amp/coronavirus-to-avoid-major-humanitarian-fallout-uk-must-act-urgently-133968

Posted on

Current research: The danger of stories in global health

By Sophie Harman

Sophie Harman is Professor of International Politics and a BAFTA-nominated film producer. She is interested in visual method and the politics of seeing, global health politics, African agency, and the politics of conspicuously invisible women. Her research has reflected these interests through projects on Global Health Governance, the World Bank and HIV/AIDS, partnerships in health in Africa, the 2014/15 Ebola response, the governance of HIV/AIDS, and her recent film project, Pili. These interests have informed her teaching on the modules Global Health Politics, Africa and International Relations, and Global Governance.

“The danger of stories in global health” published in the Lancet at DOI: https://doi.org/10.1016/S0140-6736(20)30427-X

Have you heard the story about Fidel Castro and the Ugandan army? You know the one where after years of fighting, Yoweri Museveni and the National Resistance Movement come to power in 1986 and shortly after sending the new Ugandan army to Cuba for army medicals find that some soldiers are HIV positive. On discovering this, so the story goes, Museveni decides to be a leading example in the global response to HIV/AIDS to avoid any stigma or accusations that his military is weak. Several people told me this story when I was researching HIV/AIDS in Kampala in 2005. I now tell it to my students, embellishing a phone call between Castro and Museveni. The story gets a bit distorted as I try to hold the attention of 90 undergraduate students but does not lose the power of what it communicates about the relationship between militaries, national security, and global health. The story could be made up, another folk tale spread by Museveni or his political opponents. But it makes sense to the people who believe it and provides an insight into why militaries became a focus of the HIV/AIDS response in the early 2000s.

To read the article, go to https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30427-X/fulltext