The politics of non-communicable diseases in the global South

Abstract

In this paper, we explore the emergence of non-communicable diseases (NCDs) as an object of political concern in and for countries of the global South. While epidemiologists and public health practitioners and scholars have long expressed concern with the changing global distribution of the burden of NCDs, it is only in more recent years that the aetiology, politics and consequences of these shifts have become an object of critical social scientific enquiry. These shifts mark the starting point for this special issue on ‘The Politics of NCDs in the Global South’ and act as the basis for new, critical interventions in how we understand NCDs. In this paper, we aim not only to introduce and contextualise the six contributions that form this special issue, but also to identify and explore three themes – problematisation, care and culture – that index the main areas of analytical and empirical concern that have motivated analyses of NCDs in the global South and are central to critical engagement with their political contours.

When places come first: suffering, archetypal space and the problematic production of global health

“…Lifestyles and lifestyle diseases are painfully relevant to global health (Garrett ), even if the dots between non‐communicable diseases and the global south are so rarely connected in research, practice or funding (Reubi et al . ). As I have argued here, critical medical anthropology's drive to ensure that blame is re‐routed from vulnerable individuals to the structural conditions driving suffering too often evades the uncomfortable reality that sometimes people may be complicit in their own (poor) health, even if inadvertently.…”

“…The ambiguity of suffering in relation to non‐communicable diseases, human health and wellbeing thus begs reflection on anthropological arguments that attention to the ‘distal pathogenic effects’ of structural inequities is needed to ensure that individuals are not held to blame for their poor health (Reubi et al . , 5). The aetiology of non‐communicable diseases can be far more complex than many of the infectious conditions that are the mainstay of global health.…”

Global Shifts in Cardiovascular Disease, the Epidemiologic Transition, and Other Contributing Factors

“…Other challenges include sustaining an adequate political commitment as a source of legitimate concern to mainstream cardiovascular diseases, particularly in the global South [102]. …”

Global Health, Geographical Contingency, and Contingent Geographies

“…As momentum gathers behind the post-2015 Sustainable Development Goals (SDGs), however, criticism of the current architecture, transparency, and funding priorities of global health is starting to mount. This is particularly true in relation to global health's relative silence on noncommunicable diseases (NCDs; Livingston 2012; Marrero, Bloom, and Adashi 2012), despite the Global Burden of Disease Study showing that they now cause two thirds of global mortality (Reubi, Herrick, and Brown 2015). Moreover, and crucially for the sustainability of global health, NCDs converge with infectious diseases and poverty in low-and middle-income countries (LMICs) to represent a particularly pernicious multidimensional burden of disease with significant implications for development (Bygbjerg 2012).…”