Search

Noncommunicable diseases (NCDs) are a complex category composed of five diseases and five behavioural and environmental risk factors. These are, in turn, represented by multiple constituencies and communities of expertise and interest. This fractured landscape is evidenced by and magnified through an abject lack of conferences devoted to the category of NCDs. One of the very few is the NCD Alliance Forum, most recently held in February 2020 in Sharjah, United Arab Emirates. With the first Forum held in 2015 and another in 2017, these events offer powerful insight into the key actors, advocacy strategies, debates and aspirations of those working in the 'NCD space'. Using the Forum as its object of research and analysis, this paper critically reflects on two persistent questions facing NCD advocates. First, how might NCDs be more like infectious diseases in cultivating a sense of urgency and action? Second, is NCD advocacy a 'movement' or a 'community' of loosely connected actors? Set against the emerging COVID-19 outbreak, which at the time of the Forum was limited to China and a handful of other countries, the Forum offered a unique opportunity to reflect upon the significant challenges facing NCD advocates across global north and south. COVID-19 only highlights how rising rates of NCDs have made global populations vulnerable to emerging infectious diseases. Yet, as the paper concludes, with the COVID-19 pandemic continuing to rage, the future of NCD advocacy and funding looks ever more fragile even as evidence of its need continues to grow. [ABSTRACT FROM AUTHOR]

Geographers have long been concerned with the spaces, scales, and conceptual significance of volunteering. They have, however, been slower to engage with the global surge in medical volunteering, whether in times of everyday or acute emergency. Volunteering is a crucial component of the architectures of global health and humanitarianism, but it remains marginal to the concerns of both health and development geographers. This paper seeks to address this lacuna through drawing on the case study of the 2013–2016 Ebola outbreak in Sierra Leone. When the outbreak was belatedly declared a Public Health Emergency of International Concern in 2014, volunteers flowed into Sierra Leone to aid in the response. In drawing on qualitative research with volunteers from a small, Freetown‐based NGO, we aim to close two explicit theoretical gaps. First, we draw out the geographical significance of volunteering during an outbreak of such exceptionality that the modalities, methods and architectures of global health and humanitarianism closed in on one another. Second, we explore how the act and experience of volunteering during the Ebola outbreak helped those involved apprehend what global health might mean and be. In so doing, we also reflect on the instrumental use of humanitarianism within a global health field whose professional contours are often remarkably difficult to navigate. In empirical terms, this intervention is rendered even more significant given the discipline's wider neglect of the Ebola outbreak as a crucial moment where the failures of global health were exposed and the toolkits of humanitarian intervention were pushed to their limits. This paper explores the 2013–2016 Ebola outbreak in Sierra Leone to examine (1) the geographical significance of volunteering during an exceptional outbreak and (2) how the act and experience of volunteering helped those involved apprehend what global health might mean and be. In so doing, we reflect on the instrumental use of humanitarianism within a global health field whose professional contours are often remarkably difficult to navigate. [ABSTRACT FROM AUTHOR]

Lencucha and Thow's paper offers an important addition and corrective to the burgeoning body of work in public health on the 'commercial determinants of health' in the context of non-communicable diseases (NCDs). Rather than tracing the origins of incoherence across policy sectors to the nefarious actions of industry, they argue that we need to be better attuned to the neoliberal ideologies that underpin these policies. In this commentary I explore two aspects of their argument that I find to be problematic: First, the suggestion that neoliberalism itself has some kind of deterministic or explanatory capacity across vastly different social, spatial, economic and political contexts. Second, I explore their concept of 'product-based NCD risk,' a perspective that disembodies and detaches risk from the social and structural conditions of their making. [ABSTRACT FROM AUTHOR]

This paper explores the intersections between the newly agreed urban and health Sustainable Development Goals (SDGs 3 and 11). It argues that while burgeoning studies theorizing cities of the global South have thus far largely failed to engage with the formative role of health in the experience of urban life and politics, concern with "global" health (health in the global South) has been slow to engage with the specific importance of urban issues. As these two interlinked domains skirt past each other, the potentially unifying field of urban health remains arguably marginal and under-theorized within both biomedicine and social science. The paper therefore asserts that a reinvigorated urban heath is crucial not only to realize the urban and health SDGs, but also to capitalize on new, emergent research and opportunities that may emerge as global health work shifts to better reflect the contours of the SDGs. [ABSTRACT FROM AUTHOR]

Consensus is fast building in the public health community around the need to research and address the ‘industrial epidemics’ of non-communicable disease across both Global North and South. However, while it is agreed that the effects of corporate behaviour on health are serious, there have been limited attempts to map out what a ‘science’ of these interrelationships might be. To do this requires actively engaging with the ways in which corporate actors generate and shape risk behaviours, public perceptions and influence policy. Moving forward, this ‘science’ will inevitably require critical reflection on the consequences of the deepening ‘ideological schism’ within the public health community in its attitudes towards industry. To date, of all the ‘unhealthy commodities industries’, alcohol has arguably received the least empirical attention from researchers. This gap is even more significant given the growing adversity between the public health community and the industry from the national scale to that of the WHO. This paper explores the nature of the ideological schism within alcohol research and its significance for the future development both of a ‘science’ of the effects of corporate behaviour on health and the advocacy that will be needed to change future regulatory and business environments in more health-promoting ways. [ABSTRACT FROM PUBLISHER]

This commentary explores how household economic necessity and the public health aspirations set out in the WHO’s global strategy to reduce the harmful use of alcohol might be reconciled in the context of alcohol control in developing countries. The ‘ambiguity’ of alcohol’s role in social and economic development is clear, but, as yet, little progress has been made on how best to integrate alcohol control within development policies in low- and middle-income countries. Without this holistic thinking, alcohol control efforts are likely to be thwarted by liquor’s allure as an accessible micro-enterprise opportunity. Similarly, developmental efforts will be undermined by the severity of alcohol-related harms that now disproportionately affect middle-income countries. Drawing on the example of South Africa, this short commentary explores the complexities of controlling the supply of alcohol when its sale represents a major livelihood strategy amid conditions of high unemployment and constrained access to formal employment markets. The policy preference for closing illegal bars or shebeens in South Africa does not address the ‘causes of the causes’ of why people drink, and therefore why its sale continues to be an attractive livelihood choice. It also does little to provide alternative leisure or employment opportunities, which ultimately threatens the longer term sustainability of policy. We need to better appreciate why selling alcohol is a seductive business opportunity and the potential consequences of this for realising public health aspirations. [ABSTRACT FROM PUBLISHER]

Media coverage of the "problems" associated with alcohol is widespread in countries of the global North and now, increasingly, in those of the global South. However, despite this mounting ubiquity, there have been very few analyses either of newspaper coverage of alcohol or of media coverage of alcohol policy, especially outside Europe and North America. This article argues that given international concern with the long-term health, economic, social, and developmental consequences of risky drinking in the global South, an exploration of newspaper coverage of nascent alcohol policy in such a context is both timely and valuable. Indeed, such analyses bring to the fore the deeply contextual and contingent nature of alcohol's problematization in politics, policy, and public life. To examine these assertions, we explore the "attention allocation" processes of two South African alcohol control policies-the Western Cape Liquor Bill and the city of Cape Town's liquor bylaws-in two regional English-language newspapers between 2007 and 2011. In so doing, the article highlights the particularities of the political valence of alcohol in the South African context. Furthermore, it also draws out the tensions between alcohol as a source of livelihoods in a context of endemic unemployment and chronic poverty and alcohol as a causal factor in poverty, crime, violence, and social disintegration. In contrast to media coverage of alcohol policy in Europe and North America, this analysis of the South African press suggests that liquor consumption is far less likely to be framed as an express health risk, forcing us to question how preventative policy efforts should best proceed. [ABSTRACT FROM AUTHOR]

Recent liquor legislation has centred on shebeens as conduits for crime and violence. In contrast to this perspective, we argue that shebeens form part of a complex constellation of relationships influencing alcohol-related violence. Drawing on a survey of shebeen owners in one community in Cape Town, this article explores how their experiences of crime and police raids are reshaping the dynamics of the liquor trade amid conditions of poverty. It argues that inconsistent and often arbitrary policing is driving many shebeens into adopting covert strategies to manage the risks of closure, fines, temporary imprisonment and bribes demanded by the police. In so doing, liquor law enforcement may have inadvertently precipitated new types of violence in township drinking environments. The paper explores the broader implications of these processes for efforts to address alcohol and violence in sustainable and equitable ways that improve quality of life and wellbeing for all. [ABSTRACT FROM AUTHOR]

The alcohol policy debate demands greater critical reflection on the complex and disaggregated nature of the alcohol industries in contrast to their frequent characterization as a coherent, monolithic and singular entity with a common goal. Such reflection is necessary in order to rethink the linked assumption that drinkers are vulnerable victims of the activities of industry and, in so doing, to start moving beyond the UK's current policy development impasse in creative and plausible ways. [ABSTRACT FROM AUTHOR]

The author draws on a case study of Austin, Texas, to argue that the emerging cannon of critical obesity studies should be situated in and interrogated with reference to empirical research undertaken in the urban spaces that enable or constrain healthy behavior. With federal, state, and city-scale government departments calling for concerted obesity-prevention efforts, it is suggested that this enterprise has now rendered Austin a space of philanthropic entrepreneurialism. Drawing on stakeholder interviews with those charged with healthy-lifestyle promotion, the author contends that the city’s bifurcation by Interstate-35 marks a clear real and imagined socioeconomic and racial divide. Moreover, this divide permits the delineation of East Austin as at risk by virtue of its Hispanic population and the assumption that higher prevalent rates of obesity among Hispanic residents are an outcome of certain cultural norms. As a result, East Austin has been legitimized as a strategic place of intervention to help boost the city’s image as a healthy, and therefore good, place to live. However, such interventions favor changing personal behavior and therefore neglect to address the environmental and structural factors which, it is asserted, often have far more immediate and profound effects on health. [ABSTRACT FROM AUTHOR]