Global Health: Local & International Disparities

Overview

Health is affected, for better or worse, by almost every human act.  Examining human health across the globe — and in our backyard — reveals wide variations in health burdens on communities and nations.  New knowledge and technologies have greatly advanced medicine and health care, yet life expectancy in Botswana is less than half what it is in Japan and Scandinavia, and within the United States infant mortality is twice as high for babies born to Black mothers than to White mothers.  Global Health is an expansive and interdisciplinary field that requires researchers, policy–makers, and practitioners to integrate knowledge from diverse fields to address disparities in health outcomes both at home and abroad.  This cluster challenges students to think outside the box for ways to understand and impact global health.

Courses

Seminar: Cultural Anthropology 80FCS International Law & Global Health

Catherine Admay, Visiting Professor, Sanford Institute of Public Policy

This course will examine where and how international law intersects with global health inequalities.  In what instances has international law been a positive force for addressing these inequalities and when has the law itself compounded and extended the problem?  Through two or three case studies, students will be challenged to critically assess whether the law — and what particular bodies of law — would be the most appropriate.  For example, if the families of working coffee farmers in the Sidamo region of Ethiopia are suffering from severe malnutrition while western coffee consumers pay top dollar for a bag of roasted Sidamo label beans, what legal regimes might apply?  Having a basic grasp of a handful of leading rules systems (human rights, trade, intellectual property, among others), students will then be asked to consider the legal, political and ethical merits of pursuing better health outcomes through resort to the law.  We will consider the law as lawyers must — attending to the technical elements and complexities — but we will also seek to understand the extent to which the law's power resides as much in its political punch or moral appeal.  In short, the course will work to situate international law and global health in the stream of strategic choices available to those who call for better health by demanding greater justice.
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Seminar: African & African-American Studies Journalism & Public Health

Stephen W. Smith, Visiting Professor, Department of African & African-American Studies

For a variety of reasons rooted in the natural environment, human agency, the local lack of institutional capacity and global disparities, public health in Africa is problematic.  Through the combined disciplinary lenses of medicine, media critique and anthropology, the class will assess how African and international journalists report this complex reality — and how they could possibly do a better job.

Public health concerns are not simply a given but a historical and social construct.  In Africa's case, the “discovery” of the continent’s “scourges” — malaria, sleeping sickness, river blindness, hemorrhagic fevers, the Guinea worm, the West Nile disease, leprosy — is linked to the colonial past.  As much as present-day epidemics such as AIDS, Ebola or the Marburg virus, Africa’s other diseases can only be understood in their — increasingly globalized — context.  However, the international Anatomy of Power (Alexander Butchart) remains as unfavorable to Africa as ever: the idiom in which the continent'’s maladies are being reported draws its vocabulary from European perceptions of “the African” and his body in the late 19th century; since, Western biomedical science and pharmaceutical companies have squashed indigenous etiologies.  Local explanations of sickness, and the causality thereof, have been disqualified as “superstition” or “witchcraft”. Millennium Goals are being set from outside, by G8 summits and international pressure to put an end to the continent’s sanitary plight — and to contagious threats to the outside world.  With only a few exceptions, what functional public health structure exists today in sub-Saharan Africa depends on foreign — public and private — funding.

How do African and international journalists work in this minefield of prejudice and state failure, of corporate interests and community-based identities?  How do they interact with local authorities, with donors, international organizations, NGOs and, last but not least, with scientists and patients?  May digitality (online social networks, blogs) help to overcome some of Africa’s historical handicaps?  How do warfare and migrations impact the continent’s public health system?  These are some of the questions the course will explore through a constant interweaving of medical knowledge, journalistic experience and anthropological questioning.
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Seminar: Biology 92S Global Disease

Sherryl Broverman, Associate Professor of the Practice, Department of Biology

Why are some infectious diseases easier to control or eliminate than others?  What factors — biological, social, and cultural — facilitate disease spread or reduction?   How can we use what we’ve learned from past attempts at disease eradication to improve current programs?  Students will learn the biology of major global diseases caused by a range of pathogens, including TB, malaria, and smallpox.  These diseases will be used as case studies to address the evolution of disease and antibiotic resistance; vaccine development and immunization programs; ethics of quarantine; and tropical diseases versus diseases of poverty.  Other potential topics include polio and current, controversial immunization programs in West Africa, as well as HIV control methods.  No previous background in biology is required.
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Seminar: History 89FCS Global Health History

Margaret Humphreys, Associate Clinical Professor, Departments of Medicine and History

This course will explore the major determinants of health over the course of human history.  Our study begins with Jared Diamond’s Guns, Germs and Steel, a book that sketches the health advantages and disadvantages of civilization, and the factors that allowed some cultures to grow in power.  From this introduction we’ll move to the great “traveling diseases” of human history — bubonic plague, smallpox, cholera, typhus, and yellow fever — examining the ecological reasons behind their success and the lessons that medical thinkers drew from their appearances.  The next section will consider the history of human nutrition, looking at how historians learn about malnutrition in the past, and at the discovery of the various specific deficiency diseases, such as scurvy and night blindness.  We’ll conclude with a focus on the U.S. South in the early 20th century, an era when “third world diseases” thrived on American soil.
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Focus 99 Special Topics in Focus: Disease in Time & Space

Sherryl Broverman, Associate Professor of the Practice, Department of Biology

Global Health is a rapidly growing field of study, but what is “global health” and how does it differ from international health?  Can one study global health issues in Durham, North Carolina?  This course will address the concept of “global health” and provide opportunities for students to explore global health issues in depth with their peers, faculty and guest speakers.  The relevant themes and methodologies from each course will be used to work through case studies and simulations as we explore the interrelationships between legal, economic, biological, and epidemiological perspectives on global health: the local, the global, and how they connect.
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