Open for Comments: TAS Statement on the End of AIDS

Dear CAGH Members,

The TAS Statement on the End of AIDS is looking for comments/feedback on their statement. Please send feedback by April 15, 2017 to Matthew Thomann (Matthew.Thomann@kzoo.edu), Richard Parker (rgp11@cumc.columbia.edu) or Nora Kenworthy (njk8@uw.edu). Please find the full draft below or download the Word doc here: https://drive.google.com/open?id=0B2GzTtH-fmWed09XMjZWYmJBRG8

——-
From a Global Crisis to the “End of Aids”: New Epidemics of Signification

Nora J. Kenworthy (University of Washington, Bothell), Matthew Thomann
(Kalamazoo College) and Richard G Parker (Columbia University)

Introduction

If the decade following the first Durban AIDS Conference in 2000 was marked by
discourses about an “epidemic out of control,” and a politics of emergency
that justified exceptional activism and action, the decade of AIDS responses
beginning in 2010 has been distinctly framed by declarations that an AIDS-free
generation is within our grasp, that the end of AIDS is not only possible, but
immanent, and that renewed optimism regarding an AIDS cure is justified. Crafted
in the wake of the 2008 financial crisis and honed by years of funding plateaus
and program retrenchments, the prominence of an “End of AIDS” discourse was
enshrined this past summer, first at the 2016 UNAIDS High-Level Meeting on
Ending AIDS in June, and subsequently at the International AIDS conference in
July. By the time the throngs of conference-goers were descending on Durban,
however, a forceful challenge to this discourse could be heard from academics,
activists, and commentators. Questioning the feasibility of an end to AIDS
without renewed long-term financial commitments, and highlighting the persistent
and frustrating challenges of sustaining effective treatment and prevention
programs, detractors moved to quickly unmask the appeal of this new campaign.
“Although the…strategy is carefully delineated and politically endorsed, it
is financially unsecured; and hard choices await,” writes Nana Poku (2016,
743), highlighting the urgency of a “strategic reckoning of expanding needs
and diminishing means.”
Yet triumphalist discourses about the End of AIDS show considerable durability,
particularly among the larger donors and organizations dominating the
policymaking field. In one video promotion created by Nike and (PRODUCT)RED, an
imagined end of AIDS is brought about by the purchase of goods related to
Nike’s “lace up and save lives” campaign, and a resulting storm of tweets
by celebrities and sports stars (ONE 2011). These then transform into ARVs and
fits of solidarity spreading across the globe, culminating in an imagined future
in which African schoolchildren are being taught the history of a disease that
once was, but is no longer, in existence. Though heavily commercial in its
messaging, Nike’s ad helps to expose a broader set of strikingly similar
discursive frames through which the futures of AIDS are imagined and its ends
are envisioned. These discursive frames include a focus on technological,
short-term interventions, an embrace of social media messaging and slogans as
measures of implementation, and a general avoidance of discussions about
long-term financial commitments by donors to comprehensive treatment, health
systems building, and patient-centered prevention modalities.
In this Take a Stand statement, we highlight the contested social terrain
surrounding the End of AIDS discourse by utilizing Treichler’s (1987) view of
AIDS as an “epidemic of signification.” What, we ask, does the End of AIDS
signify, and for whom? Who stands to benefit from a triumphalism that few
believe but many endorse? And most importantly, what kinds of AIDS response does
this discourse promote, and what forms of knowledge is it rooted in? As we will
argue below, the irony of this discourse is that, though intended to elicit
further commitments to the HIV/AIDS fight, it may instead elicit a complacency
among donors, who, as El-Sadr and colleagues (2014, 166) write, may perceive it
as “minimizing the challenges that remain.” It may thus provide a timely
exit strategy for donors fatigued by the long-term, hard work necessary to
feasibly make inroads against AIDS. As a result, the “End of AIDS” may
likely herald – and justify – two notable shifts in HIV policy: first, the
tapering of donor support for long-term treatment; and second, a pronounced
embrace of technical, short-term interventions–a “biomedical turn” that has
significant impacts on civil society, health systems, and the real futures of
the epidemic.

Discursive histories and the “End of AIDS” narrative

Nearly 30 years have now passed since Paula Treichler (1987) originally argued
that AIDS could be understood as “an epidemic of signification.”  She
emphasized that in AIDS, “meanings are overwhelming in their sheer volume and
often explicitly linked to extreme political agendas” (39). Precisely because
of this, she argued, “[w]e need an epidemiology of signification – a
comprehensive mapping and analysis of these multiple meanings – to form the
basis for official definition that will in turn constitute the policies,
regulations, rules, and practices that will govern our behavior for some time to
come.”  Writing from an explicitly activist perspective, she stressed that
“what AIDS signifies must be democratically determined:  we cannot afford to
let scientists or any other group of experts dismiss our meanings as
‘misconceptions’ and our alternative views as noise that interferes with the
pure processes of scientific inquiry” (39).  Now more than ever, Treichler’s
arguments ring true as we reflect critically on the discursive construction of
the “End of AIDS” narrative in recent years – and on the ways in which
this narrative has shaped policies and practices that constitute the response to
HIV mid-way through the fourth decade of the epidemic.
In examining the discursive history of the epidemic (and its relation to
material practices) over roughly the past decade, we can highlight a number of
key trends and events leading to the End of AIDS moment.  For example, just
shortly before 2007-8 financial crisis, we began to see important shifts towards
new modalities of prevention and treatment that in retrospect led to a massive
re-biomedicalization of the epidemic.  As a result of the financial crisis, a
series of important donor withdrawals marked the beginning of a shift from
“scale-up” to “scale-down” that is increasingly visible today.  In the
wake of this shift, donors’ fear of long-term treatment commitments, and of
the resource-intensive work to ensure treatment/prevention success, took form in
new discourses of sustainability, accountability, and country ownership, which
served as both prelude and justification for scale-down.  PEPFAR, and similar
agencies, redirected aid from earlier priorities (the “general” population
and treatment scale-up) towards a new set of targets (“key” populations and
biomedical prevention technologies and techniques). Simultaneously, the
financial crisis initiated a reassessment of donor commitments that would later
become visible in the failure to fully fund the Global Fund and other aid
shortages (Kates 2016).
The politics of shifting priorities and slogans in the definition of HIV
response strategies is hardly new.  It is important to remember that just prior
to the emergence of End of AIDS discourses, the so-called “AIDS Backlash”
was in full swing. Many in the global AIDS industry had become champions of
“health system strengthening” as a way of defending their funding streams
and averting attacks on scale-up as a vertical undertaking.  But it is
nonetheless striking to see how health system strengthening began to give way to
talk of Ending AIDS as we moved from the third decade of the epidemic into the
fourth.  Perhaps most vividly evident in UNAIDS’ battle to stay relevant, talk
of “crisis” shifted towards “winning the battle.”  Something resembling
what would later become the End of AIDS began to be constructed, for example, in
a 2010 UNAIDS document that first announced its 2011-2016 “getting to zero”
strategy (zero new infections, zero AIDS-related deaths and zero
discrimination).  That strategy, formally adopted by the UN General Assembly in
its 2011 UNGASS declaration, set a goal of getting to 50% (on the road to zero)
by 2015. The UNAIDS Fast Track Strategy, with the goal of 90-90-90 (90% of
people with HIV diagnosed, 90% of diagnosed people on treatment and 90% of
treated people with fully suppressed viral load) by 2020, was then issued in a
2014 UNAIDS document.  To our knowledge, this is the first explicit articulation
of the goal to end AIDS by 2030.  Finally, the 2016 UN General Assembly High
Level Meeting on Ending AIDS, held in June of this year, officially adopted the
“Political Declaration on HIV and AIDS: On the Fast-Track to Accelerate the
Fight against HIV and to End the AIDS Epidemic by 2030.”  So while the concept
of ending the epidemic began to be floated by global AIDS administrators as
early as 2010, it then took roughly five years of sloganeering and issuing lower
level UN documents to gradually get to the point where it would become an
official policy declaration adopted by the General Assembly.
Not wanting to be left out of the game, over roughly the same time period, the
US State Department also developed its own version of this goal, most clearly
articulated in Hillary Clinton’s 2011 speech (as US Secretary of State) at the
NIH, which initiated the US/PEPFAR push for “an AIDS-free generation.” This
goal quickly became the official discourse for President Obama and other US
officials, and an organizing call for the 2012 International AIDS Conference in
Washington, D.C.
The majority of other major donor agencies then began to endorse the UNAIDS Fast
Track Strategy starting in 2014.  As soon as the Fast Track Strategy was issued
(basking in the “success story” that had been told by the global scientific
community at the Melbourne AIDS conference in July of 2014), we find other major
players (the Global Fund, USAID, etc.) issuing statements that articulate “the
end of AIDS in 2030” goal, and at some level begin to turn it into a fait
accompli (at least in theory).  Private donors seemed slower, but by 2015 and
2016, we begin to have private donor buy-in (for example, people like David
Furnish made statements about it for the Elton John AIDS Foundation), and civil
society organizations rallying around the slogan (for example, UNAIDS sponsored
a large CSO meeting in Bangkok in 2015 where the clear goal was to get everyone
to sign on to the “90-90-90 by 2020” and “the end of AIDS by 2030”
goals).  Perhaps somewhat ironically, all this was happening at precisely the
same time as the elaboration of the post-2015 development goals, in which HIV
largely fell from the list of primary development concerns.

The biomedical turn and its impacts

All of these events of course develop in tandem with what might be described as
a “biomedical turn”:  an increasingly powerful biomedical triumphalism
regarding HIV treatment and prevention, whereby shorter-term, privatized,
technological, and, at least in some instances, (allegedly) more cost-effective
interventions are promoted, to the deficit of long-term support for lifetime
antiretroviral treatment.  This trend obviously moves in multiple directions at
the same time, ranging from large-scale biomedical prevention research trials
(such as the $45M iPREX studies) to the IAS Towards an HIV Cure Initiative
(championed by Françoise Barré-Sinoussi as well as many others).  But in all
of these directions, biomedical advances, in turn, become the “scientific”
justification for an End of AIDS discourse that has been articulated by public
health experts and policymakers. They play a key role in ensuring that the
biomedical community will endorse the End of AIDS story line, just as they
substantiate, with scientific validity, the feasibility of the policymakers’
claim that we really can end the epidemic by 2030.  These narratives thus become
key sources of mutual reinforcement that sustain a vision of the End of AIDS
that brings together policy-making, diplomacy, program implementation and
science in the transformation (or assemblage) of the End of AIDS narrative.
Defining what “Ending AIDS” will entail in practice has elicited a powerful
chorus of voices defending not one, but many, heavily biomedical programmatic
initiatives: from treatment as prevention (TasP) and test and treat initiatives,
to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), to
microbicides, and to renewed enthusiasm about vaccine and HIV cure research.
These biomedical strategies are based in declarations of faith in the powers of
bench science, big data, population targeting, implementation science, and
“smart investments” (Fauci and Marston 2013; PEPFAR 2012). Such initiatives
encrypt and occlude a neoliberal policy agenda that favors cutting costs
(particularly long-term financial commitments) by limiting broad-based scale-up
efforts and instead promoting targeted prevention and solely biomedical
treatment expansion as a means of halting the epidemic. Even as treatment
expansion has fallen far short of its goals, and patients are routinely lost to
follow-up because of the socioeconomic challenges that remain unacknowledged by
such an approach, donors and experts are doubling-down on a biomedical turn.
“Rather than seizing [the opportunity for reduced transmission and better
illness management created by treatment expansion] by demedicalizing the
provision of ART,” argues MSF’s Tom Ellman (2015, 304), “programs are
medicalizing HIV infection in the healthy.”
What is then ironic is that the End of AIDS discourse has managed to discredit
and open the door to de-funding the very interventions and investments that have
the potential to make treatment and prevention more successful. This includes
interventions rooted in health systems strengthening, community-based provision,
and an embrace of the right to health, as well as those which attend to the
broader social inequities and socioeconomic constraints that threaten the
success of solely biomedical interventions. The recent decade of increasingly
technocratic scale-ups of HIV treatment has left a legacy across many health
systems of defunded community-based care and prevention projects (Kalofonos
2014; Maes & Kalofonos 2013), overworked and overburdened health systems
(Pfeiffer & Chapman 2015; Pfeiffer et al. 2014), and increasingly fragmented and
disjointed landscapes of care (Geissler 2014; Moyer 2015; Whyte 2014).
In addition to these general and much-remarked upon trends, we wish to note
three crucial but under-examined impacts. The first is the especially perverse
impact of the biomedical turn on activism, whereby the far-reaching rights-based
dialogues of previous decades become distilled into a narrow focus on the right
to (biomedical) treatment, as access to rights-based prevention modalities,
structural interventions, and broad-based socio-economic support fall by the
wayside. The second impact, much related to the first, is the
institutionalization of a two-tiered system of treatment access. While access to
first-line treatments was ensured by earlier activist movements, many patients
in poorer countries today only retain access to the cheapest and most toxic drug
cocktails, a second-class first-line of treatments that fosters far more
side-effects. In turn, these are harder to address within depleted health
systems and more likely to result in treatment disruptions. Meanwhile, access to
second-line treatments and consistent viral-load monitoring is extremely
fragile. These trends point to the dual effects of an increasingly neutralized
and side-lined AIDS activism combined with the power of the pharmaceutical
industry, which has continued to wage battles around intellectual property,
trade, and pricing schemes while fueling End of AIDS discourses.
Finally, an acute environment of fiscal austerity following the 2008 financial
crisis, combined with the additional demands placed on health systems by uneven
and overly biomedical methods of HIV program scale-up, has produced a depleted,
overworked, and increasingly disillusioned health workforce in many countries.
Within underfunded health systems, mid-level policymakers and clinicians are
essential to keeping the basic machinery running and ensuring more broad-based
health system improvements. Combined with these other constraints and pressures,
the production of ever-more unrealistic public health policies related to Ending
AIDS (such as Lesotho’s claim to be implementing universal access to treatment
while less than 50% of its existing population in need of treatment has access
to it), produces dystopian health systems in which patients’ disruption or
“failure” on treatment is nearly ensured, while bureaucratic fantasies are
peddled at international meetings and summits.

Alternative futures?

It seems clear (at least to anyone with a minimally critical view), that the end
of AIDS is not around the corner, and that a future with AIDS will be with us
for some time to come. But we can help contribute to a better understanding of
these policies’ impacts as well as their alternatives.  We can also help to
call failed policies into question by documenting them, unmasking the
mystifications that are contained in the fictions being created about them, and
witnessing their real impact in the lives of people on the ground.  This is a
contribution that the anthropology of AIDS has been making since the very
beginning of the epidemic, and it is as relevant today as it ever was (Moyer
2015).  In closing, it is worth emphasizing some of the ways in which
anthropological research and analysis can build on this legacy and contribute to
the broader field of HIV research in the fourth decade of the epidemic.
Examples abound, but we offer a few for consideration:  anthropologists can link
analysis of policy/discourse with realities in geopolitically specific places,
revealing disjunctures and opportunities; we can continue documenting (through
careful, long-term ethnographic research) the experience of human suffering that
takes place at the grassroots, far from the meeting rooms of Geneva, New York
and Washington; we can reveal how populations – patients, clinicians, service
providers, policymakers, activists – are coping with AIDS, not as it ends, but
as it continues to unfold and evolve; and we can use ethnographic approaches to
call attention to the forms of community-based expertise that exist (albeit in
different ways and to different degrees) in affected communities everywhere
(remember who invented safe sex and harm reduction!) and ask how
re-biomedicalization of the epidemic undermines the promise of these local forms
of knowledge.  Real-world expertise still resides in the hands of affected
communities, and careful, long-term anthropological fieldwork can document this
like perhaps no other approach can.  We can also do a much better job than we
have thus far of studying up, and investigating the global health and AIDS
industries, the ways in which they operate, and the interests that they tend to
serve.  We can also do a better job of linking studying up to studying down,
drawing attention to the kinds of political mobilization and resistance that are
still possible to observe in some places in response to these industries.
This list could of course extend much further, but let us end by emphasizing the
importance of anthropology’s long-term focus on the dialectical relationship
between both continuity and change:  while there are striking similarities here
over time in the histories of signification that we have briefly analyzed here
(just think about the persistence of AIDS-related stigma and discrimination),
there is also remarkable evidence of affected communities’ ability to reinvent
themselves, even in the face of immense structural constraints.  Anthropological
research may be better able to document this than almost any other discipline
– but only if it remains critical, reflexive, and politically engaged.  This
is a project that is worth taking on.

Works Cited

Ellman, T. (2015). Demedicalizing AIDS prevention and treatment in Africa. The
New England Journal of Medicine, 372(4), 303-305.

El-Sadr, W., Harripersaud, K., & Bayer, R. (2014). End of AIDS–hype versus
hope. Science, 345(6193), 166.

Fauci, & Marston. (2013). Achieving an AIDS-free world: Science and
implementation. The Lancet, 382(9903), 1461-1462.

Geissler, Wenzel P. (2014). The archipelago of public health: Comments on the
landscape of medical research in twenty-first-century Africa.” In Making and
unmaking public health in Africa: Ethnographic and historical perspectives, Ruth
Prince and Rebecca Marsland, eds. Athens: Ohio University Press.

Kalofonos, I. (2014). ‘All they do is pray’: Community labour and the
narrowing of ‘care’ during Mozambique’s HIV scale-up. Global Public Health,
9(1-2), 7-24.

Kates, J., Wexler, A., & Lief, E. (2016). Financing the response to HIV in low-
and middle-income countries: International assistance from donor governments in
2015. Washington DC: Kaiser Family Foundation and UNAIDS.

Maes, K. & Kalofonos, I. (2013). Becoming and remaining community health
workers: Perspectives from Ethiopia and Mozambique. Social Science & Medicine,
87, 52-59.

Moyer, E. (2015). The anthropology of life after AIDS: Epistemological
continuities in the age of antiretroviral treatment. Annual Review of
Anthropology, 44, 259-75.

ONE. (2011). Write the future with (NIKE) RED: #EndAIDS. Youtube.
https://www.youtube.com/watch?v=sgE2yfs1s3A, Accessed 1 October 2016.

PEPFAR (2012). PEPFAR blueprint: Creating an AIDS-free generation. Washington,
DC: PEPFAR.

Pfeiffer, J., & Chapman, R. (2015). An anthropology of aid in Africa. The
Lancet, 385(9983), 2144-2145.

Pfeiffer, J., Robinson, J., Hagopian, A., Johnson, W., Fort, M., Gimbel-Sherr,
K., Rowden, R., Friedman, E., Davis, P., Adedokun, L., & Gloyd, S. (2014). The
end of AIDS and the NGO Code of Conduct. The Lancet, 384(9944), 639-640.

Poku, N. (2016). UN Political Declaration on HIV and AIDS: Where to begin? The
Lancet, 388(10046), 743-744.

Treichler, P. (1987). How to have theory in an epidemic: Cultural chronicles of
AIDS. Durham: Duke University Press.

Whyte, S. (2014). Second chances: Surviving AIDS in Uganda. Durham: Duke
University Press.

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Call for Submissions: 2017 SMSA Graduate Paper Prize

Due Date: Friday, June 2nd, 2017

The Science and Medicine in South Asia (SMSA) interest group of the Society for Medical Anthropology is pleased to welcome submissions for the 2017 SMSA Graduate Student Paper Prize. This will be the inaugural year for what will be an annual graduate paper prize awarded for a paper that offers an innovative approach to issues related to science and medicine in South Asia.

As an example, papers might address any of the following issues:
1. Contemporary developments in science and medicine in South Asia: What makes the situated and oftentimes rapid changes in these fields both exceptional and mundane?
2. Scalability and modularity of scientific & medical practice in South Asia: how are certain forms and interventions rendered generalizable and replicable in light of economic, ethical and political demands?
3. Multiplicity of science & medicine in South Asia: How do we know what is science, what is medicine, and what is not? What are the ethics and politics of such distinctions? What are the relationships between institutionalized and non-institutional forms of therapeutic practice? Are there distinctively South Asian forms of science & medicine, and how might they relate to both global and local epistemological regimes – for example, in the calls made for global public and mental health?
4. What forms of ethical concerns and debates are crystallizing around questions of science and medicine in South Asia, from controversies around organ transfer, stem cell science and patent law, to IVF, surrogacy and clinical trials?
5. Science, medicine & law: What are the ways in which legal reasoning comes to shape scientific and medical practice, and vice-versa?
6. Science, medicine & security: How are threats concerning the spread of infectious disease, and in particular, emerging zoonotic conditions, figured in relation to ideas of the population and the state?
7. How do various peoples and communities – understood along lines of caste, class, religion, race, ethnicity, region, gender, sexuality and bodily difference – access and relate to various forms of science and medicine in South Asia?

Submission rules:
• The word count should be 6,000-8,000
• All author(s) must be enrolled as graduate students at the time of submission
• The paper can be under review at the time of submission, but it cannot be at the revise and resubmit stage, in press or digitally published (with print publication pending).
• To enable a blind review process, the submission email should include two word documents: (1) a cover sheet with author name, affiliation(s) and acknowledgments, and (2) the paper (abstract included) with no identifying information listed.

The winner of the prize will be announced at the 2017 AAA Annual Meeting in Washington, DC. The winner will receive an award certificate, suggestions from the committee of judges on ways to prepare the article for publication, and a cash prize of $100 (or $75 in case of two winners).

Submissions should be emailed by Friday, June 2nd, 2017 to:
Nayantara Sheoran Appleton(nayantara.s.appleton@vuw.ac.nz)
And
Bharat Venkat (bvenkat@uoregon.edu)

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Virchow Awards 2016 announced!

Congratulations to the winners of the Virchow Awards, which was announced at the AAA 2016.

Maggie Acosta (Undergraduate winner – Bowdoin College) – “India’s Janani Suraksha Yojana: Global Transformations of a National Program and Dissipating the Right to Health.”
Thando Malambo (Graduate winner – Program Management Officer at International Development Research Center) –  “Worse than HIV”: The Political Economy of Cervical Screening in Swaziland.”
Katharine Mason (Professional winner – Brown University) – “H1N1 is Not a Chinese Virus: The Racialization of People and Viruses in Post-SARS China.”

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New SIG Alert: Research on U.S. Health and Healthcare (RUSH)

Research on U.S. Health and Healthcare (RUSH)
This proposed Special Interest Group would invite and encourage scholars from around the world to critically investigate U.S. health policy and practice. It would provide a space for anthropologists to engage with the urgent and growing national dialogue on health and healthcare disparities and a platform to interface with health authorities and policymakers.

We are proposing this Special Interest Group in Research on U.S. Health and Healthcare for scholars with interests in:
Health policy and administration (public and private)
Health insurance and insurers
The health workforce (inclusive of allied health professionals and clinical support staff)
Health professional education
The practice of nursing, pediatrics, primary care, hospitalist medicine, dentistry and pharmacy, among others
U.S. health activism
Migrant and refugee health in the U.S.
Environmental health
Race, class and gender in U.S. health and healthcare
LGBTQ health and healthcare
Bioethics
…and many other related issues

If you are interested in the group, please join our Facebook group: https://www.facebook.com/groups/203164206805630/

Please feel free to contact me (shannon.satterwhite@ucsf.edu) with questions, ideas or if you are interested in helping to organize the group.

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CAGH Business Meeting, AAA 2016

An agenda for the AAA 2016 business meeting can be found here. Please contact Sara Lewis (slewis7@wellesley.edu) with any suggestions.

CAGH Business Meeting, AAA 2016

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A message from CAGH Chairs

 

Dear CAGH members,

Warm greetings, and we hope your academic years are off to a wonderful start. We have some CAGH updates and hope many of you will be able to join us at AAA. Here are some AAA-related announcements:

1. The SMA is co-sponsoring a “speed mentoring” event with the Society of Psychological Anthropology on Thursday, November 17th, 2016 between 7:45 PM and 10:00 PM. If you are interested in signing up to be a mentor or a mentee for this great event, you will need to register in advance. More information is available at:
http://www.medanthro.net/sma-spa-speed-mentoring-reception-at-aaa/

2. Please consider attending the SMA Business Meeting and Awards Ceremony on Friday, November 18, 2016 between 7:45 PM and 9:00 PM. Of interest to our SIG of course, will be the Virchow Awards! The winners will be honored at this ceremony. A reception and cash bar will follow.

3. Finally, please join us for the CAGH business meeting on Saturday, Nov 19 from 12:15-1:30pm. As always, we ask that all members of the SIG (that’s you!!) come to this meeting, which is our annual time to reconnect and set our priorities for the year. Coming late or leaving early is completely fine if you have a competing event. Please contact us if there is anything you would like to add to the agenda.

Please do not hesitate to get in touch with any questions or inspirations, as we are very much a member-led study (and action) group.

Warm wishes,

Sara Lewis and Peter Brown

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CAGH Take a Stand Participation Announcement

 The Critical Anthropology for Global Health (CAGH) special interest group is excited to announce a recent online publication. The publication is a Takes-a-stand statement on the contribution of anthropology to e/m-health and telemedicine.

The full statement is available here.

The statement is a working document produced by a group of CAGH members investigating our potential role in this important area of Public and Global Health. It follows an AAA panel we organized in 2013. Our intent is to encourage anthropologists to look into this rapidly evolving field.

At present, the CAGH is in the process of expanding this text into a full article. It invites members to:
1) Contribute new ideas and references not yet covered in the statement – which is a work in progress; 2) Provide mini-ethnographies (from 2-10 pages) of your own research or observations of e/mhealth that we may post on the CAGH website as examples of research in progress.

Please contact Tanja Ahlin  (T.Ahlin@uva.nl) with any inquiries.

In the news:
— reprinted in Institut Culturele Antropologie. Leiden: Itiwana, p. 28-29, 2015.
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2016 Rudolf Virchow Awards

Rudolf Virchow, a 19th century German physician, was a key founder of social medicine. His contributions centered on his recognition that multiple intersecting factors – social, political, and economic – produce disease and illness. He argued that the circumstances and deprivations of poverty increase people’s susceptibility to disease and result in reduced life expectancy and quality of life. He eloquently articulated the limits of medicine in the absence of material security, a sentiment which informed his view that nation-states play an important role in ensuring health security for a citizenry. Virchow viewed advocacy as an essential part of health praxis, and, in keeping with this legacy, the Critical Anthropology for Global Health (CAGH) Special Interest Group honors Virchow’s work with three awards.

The annual Rudolf Virchow Awards are given by the Critical Anthropology for Global Health Caucus, a special interest group of the Society for Medical Anthropology. The Professional Award honors a recent published article, and the Graduate and Undergraduate Student Awards honor recent student papers that have not yet benefited from editorial review. Winning submissions combine a critical anthropology focus with rich ethnographic data, and best reflect, extend, and/or advance critical perspectives in medical anthropology.

Submissions
The submission deadline for the 2015 Rudolf Virchow Awards is July 1, 2016.
Awards are made in the following categories: 1) Professional, 2) Graduate Student and 3) Undergraduate Student (see below). We encourage you to submit your own work and/or to nominate papers of your students or articles of colleagues.
If you wish to submit a paper for consideration, please e-mail the paper and a cover letter of introduction to the Virchow Awards Chair, Dr. Alexa Dietrich, at virchowawards@gmail.com by July 1, 2016. Hard copies are no longer accepted. Confirmation of receipt will be sent. To ensure a prompt and fair review, papers will not be accepted after the July 1, 2016 11:59 pm PST deadline.

Professional Award Category
The professional award will be awarded for an article or chapter published during 2015 in a peer-reviewed journal (print or online) or peer-reviewed edited volume. Articles may be singly- or co-authored. Technical reports and other contracted works are not considered for this award. Professional articles must be submitted electronically in Adobe PDF format as they appeared in print.

Graduate Award Category
The graduate student award will be awarded for a paper that was written in 2015 or 2016 and that has not yet been subjected to editorial review. Papers that have been submitted to a journal or edited volume, but that have not yet benefited from review may be included in this category. Theses and dissertations will not be accepted. However, a summary no longer than 30 pages double-spaced (inclusive of references) of a thesis or a dissertation that can stand on its own, or a chapter that has been revised to stand on its own will be considered for this award. Papers from students who have graduated are still accepted in this category as long as the paper was written in 2015 or 2016. Graduate student papers must be submitted in Adobe PDF or Word format with a title-only first page. File sizes must be less than 2MB. The document must exclude the author’s name, author’s advisor, and university affiliation throughout. The cover letter should include this information. Only papers, not interactive media, will be considered for this award.

Undergraduate Award Category
The undergraduate student award will be awarded for a paper written in 2015 or 2016 while the student was still an undergraduate. Honors theses are not accepted. However, a shortened version no longer than 30 pages double-spaced (inclusive of references) of the thesis or a chapter from the thesis that has been revised to stand on its own will be considered for this award. Undergraduate student papers must be submitted in Adobe PDF or Word format with a title-only first page. File sizes must be less than 2MB. The document must exclude the author’s name, author’s advisor, and university affiliation throughout. The cover letter should include this information. Only papers, not interactive media, will be considered for this award.

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CFP AAA 2016: Articulating Human rights and Reproductive Governance

CFP: 115th AAA Annual Meeting, “Evidence, Accident, Discovery”, Minneapolis, MN, November 16-20, 2016.

Articulating Human Rights and Reproductive Governance: Critical Engagements in Transnational Perspective

Discussant: Elise Andaya, University at Albany, Suny. Organizer: Mounia El Kotni (University at Albany, SUNY). Chair: Elyse Singer (Washington University in St. Louis)

Engaging with human rights is never accidental. In recent years the human rights framework has risen to dominance, becoming the political and moral idiom par excellence for a diverse array of international social struggles. In the arena of reproduction, Non-Governmental Organizations, indigenous peoples, religious groups and the State, among other actors, are increasingly invoking a human rights framework to alternatively constrain and expand women’s reproductive choices. In this process of vernacularization, the “appropriation and local adoption of global ideas” (Levitt and Merry 2009:446), social actors at the local level often bring to light new meanings of human rights.

Contestation in human rights activism around reproduction is captured in the concept of “reproductive governance”, which calls attention to the ways in which entities including the state, religious institutions, NGOs, and social movements “use legislative controls, economic inducements, moral injunctions, direct coercion, and ethical incitements to produce, monitor, and control reproductive behaviors and population practices” (Morgan and Roberts 2012: 243). Such mechanisms of control can take overt form, such as population control campaigns, or be enacted through more subtle modes of moralization of women’s reproductive choices in healthcare institutions.

Building on emergent cross-cultural research in the field of reproduction, we ask: How do human rights and reproductive governance articulate with one another? In the ever more contested field of reproductive rights, how do they reinforce or disrupt each other? In this panel we seek to examine processes of “reproductive governance” in cross-cultural perspective with regards to issues including but not limited to abortion, birth, obstetric violence, sterilization abuse, adoption, assisted reproduction, population control, and the outbreak of Zika virus. We are interested in how diverse entities (such as feminist groups, NGOs, the Church, the state, midwives and anti-abortion activists) engage with and invoke the human rights perspective towards different and sometimes contradictory ends in their manifold struggles around reproduction.

We invite paper submissions that address the following questions:

o How do different entities invoke the human rights perspective around reproduction to struggle for diverse aims with regards to reproduction?

o What are the subjective effects of the human rights perspective on reproduction among those for whom activists advocate?

o How does the vernacularization of reproductive rights take shape in local settings?

o What might a human rights perspective on reproduction elide or obscure?

o How are reproductive rights and reproductive governance being engaged in light of the emergent outbreak of Zika virus?

Please submit your 250- word abstract (as a Word Doc or PDF) to Mounia El Kotni (SUNY Albany), melkotni@albany.edu or Elyse Singer (Washington University in St. Louis) esinger@wustl.edu, by Thursday, March 17st 2016.


Elyse Singer
Ph.D. Candidate
Department of Anthropology
Certificate in Women, Gender and Sexuality Studies
Washington University, St. Louis

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A Letter from new CAGH Co-Chairs Sara Lewis and Peter Brown

Dear Critical Anthropology of Global Health (CAGH) members:

We hope your new year is off to a great start. This is a (fairly long) email to update you on new and ongoing initiatives happening within CAGH. As a volunteer-run special interest group we warmly invite all to participate in crafting a dynamic and energizing forum to bring together critical medical anthropology and global health.

We would first like to honor and say thank you to Rachel Chapman, who has served as the chair of CAGH for the past 3 years. Those who know Rachel will attest that she has dedicated tremendous energy to leading us, and we particularly wish to thank her for including and encouraging students and junior scholars to join CAGH’s leadership. Thank you, Rachel, for your generosity.

CAGH Communication

This year we will focus on enhancing communication both within our group, and in coordinated efforts to disseminate our activities to the wider med anth/global health community. We are especially interested in publicizing and featuring work in progress. To better help us enhance our communication, please answer this 1-question survey about how you would prefer to interact (listserv, facebook, twitter, etc.): https://www.surveymonkey.com/r/B7S9QBQ

 We have a newly established facebook group, which will serve as a more “public” space of engagement for those who are not members of SMA. The group will be managed by Hugo Puerto, but you are all encouraged to post interesting articles or updates on your own work. Please join here.

Over the next year we will work to feature a series of live stream videos about members’ projects and other news to build up a media library about CAGH. If you are interested in being featured (it will be very short!), please email Sara Lewis (slewis8@uoregon.edu). Advanced graduate students and junior scholars on the job market might especially consider this as a way to get the word out about your work!

 

CAGH meeting at SfAA

During the Society for Applied Anthropology (SfAA) meeting in Vancouver, there will be a CAGH meeting on Thursday, March 31, 12-1:20, Arbutus Room.

 

End of AIDS

Richard Parker, Nora Kenworthy, and Matthew Thomann are co-chairing a new Takes a Stand initiative on the “End of AIDS.” Our aim is threefold: to bring a critical, anthropological voice to discourses surrounding the “end of AIDS” and declining funding for HIV/AIDS programs; to gather and disseminate key ethnographic evidence relating to the political and social contexts in which policies and discourses are being crafted and carried out; and to increase the voices of anthropologists in key debates surrounding the future of AIDS treatment and prevention programs. Please email Nora Kenworthy (njk8@uw.edu ) if you are interested in joining this effort or have research that relates to this issue.

 

Take a Stand on Global Health Education

The CAGH SIG is launching a Take a Stand initiative on global health education.  With the exponential growth of university-based global health training programs, critical anthropologists of global health have identified several trends that work against the goal of health equity.  This includes the treatment of patients in impoverished settings by visiting students and trainees as a means of gaining clinical experience. For this Take a Stand initiative, we intend to:
– ascertain current norms and guidelines governing the provision of clinical services by unqualified students and trainees
– build a database of anthropological literature that describes this phenomenon and its impacts
– create a policy statement that can be used to support existing efforts to prevent the instrumentalization of vulnerable populations for personal advancement
If you are interested in contributing to this initiative, please contact Pierre Minn: pierre.minn@umontreal.ca

 

Take a Stand on e/m-health and telemedicine

We are excited to announce a recent online publication from the Critical Anthropology of Global Health (CAGH) special interest group. The publication is a Takes-a-stand statement on the contribution of anthropology to e/m-health and telemedicine.

You can read it here: http://cagh.medanthro.net/?page_id=158

The statement is a working document produced by a group of CAGH members investigating our potential role in this important area of  Public and Global Health. It follows an AAA panel we organized in 2013. Our intent is to encourage anthropologists to look into this rapidly evolving field.

At present we are in the process of expanding this text into a full article. We would like to invite you to:

1)  contribute new ideas and references not yet covered in the statement – which is a work in progress;

2)  provide mini-ethnographies (from 2-10 pages) of your own research or observations of e/m-health that we may post on the CAGH  website as examples of research in progress.

To submit, or in case of having questions, please contact Tanja Ahlin at T.Ahlin@uva.nl

 

Member recognition

A very special thank you to Sarah Raskin for taking on the role as membership coordinator, and to Hugo Puerto for joining Amy Dao on website, social media and communications.

Thank you all, and please do not hesitate to get in touch!

 

Warmly,

Sara Lewis (slewis8@uoregon.edu)

Peter Brown (antpjb@emory.edu)

Co-chairs of CAGH

 

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