GLOBAL PANDEMICS: HISTORY, SOCIETY, AND POLICY
Instructor: Elanah UretskyOffice: Brown 322
Office phone: 781-736-8741 Office Hours: Wednesday 2-4 or by appointment
Course Description: Infectious disease, often couched in terms of epidemics, is now increasingly moving into the realm of what we refer to as pandemics as the world becomes more globalized and hyper-connected. The term pandemicbecame popular in epidemiologic discourse as HIV spreadaround the world. In 2003,SARS launched the first pandemic of the twenty-first century. Now epidemiologists and other public health scientists spend much of their time tracking and preparing for the next pandemic like Ebola, MERS, Zika, or a new strain of bird flu like H7N9. Predicting the next pandemic and its effects has become big scientific business that extendsfrom strengthening health systems to genetically sequencing discovery of new or mysterious viruses. However, traditional science often neglects the political, social, and cultural aspects that promote the spread of these diseases.
This course explores global pandemics from a social scientific perspective that takes into account medical anthropologic theory and methods. Using a biosocial perspective, we will approach pandemics like HIV/AIDS, SARS, and Ebola as shaped not merely by biology, but also by culture,economics, politics, history, institutions, and individuals. Our focus encompasses the individual body and the body politic, sexualities and societies, religion and folk practices as well as local and global responses to disease. We will begin by discussing the history of pandemics. Following that we will discuss how diseases are categorized and prioritized in the eyes of global health funders. Much of this includes discussion of the public health identities that have been created around certain diseases like AIDS, including identities related to gender, sexuality, and drug use. We will also discuss how these diseases move across borders and how they are constructed within local medical models.
Course Learning Objectives: At the end of this course students will be expected to:
- Demonstrate knowledge of the history of how global pandemics have been shaped
- Demonstrate an understanding of how global health organizations categorize, assess, and respond to global pandemics
- Assess the importance and contribution that local understandings of disease andillness can offer to the global response to pandemics.
- Discuss the ways in which the historical development of global policies towards HIV/AIDS and other pandemic diseases have been shaped by public debates framed by law, religion, science, and human rights.
- Conceptualize the role and interests of state and intergovernmental agencies, in shaping the evolving history of global pandemics.
- Discuss cross-cultural approaches to responding to pandemic outbreaks.
- Critically assess the possibilities and limitations of pandemic interventions in globalpublic health.
- Exhibit familiarity with and articulate the value of the medical anthropologic approach toward global pandemics.
Success in this four- credit course is based on the expectation that students will spend a minimum of 9 hours of study time per week in preparation for class (readings, papers, online discussions, preparation for exams, field trips, etc.).
- Attendance and participation 20%
- Notebooks on current events in global pandemics20%
- Blogentry and responses15%
- Discussion leader10%
- Final paper35%
Attendance and participation: Given the intensive nature of this course, it is imperative that you come to class having done the readings and prepared to discuss them. Likewise, regular attendance is mandatory. If you know in advance that you will need to miss a class, please let me know. It is better to attend class unprepared than to skip a class meeting.
Class discussion and your ability to benefit from the course will be greatly enhanced by your level of preparedness to engage in discussion and debate. Consequently, I strongly encourage you to bring your notes and reflections on the course readings to discussduring the class. These can include: underlined sections that you were unable to fully understand, and/or underlined sections of the readings you would like to discuss orraise questions about. There is also a forum available for each session where students can post their thoughts and questions before class. This will allow me to better incorporate your thoughts and questions into our class discussion.
Notebooks on current events in global pandemics: Each student should monitor local and national media (newspapers, blogs, radio, and TV) for content on global pandemics and record any interesting stories in an electronic type written notebook. Entries can also be made in reaction to television shows you watch, podcasts you listen to, movies you see, propaganda you see on the street, or reading assignments you do for other classes. For each entry you should document the source promoting your reaction (source, date, and any other identifying information) and include a scanned copy if it is text based. Each entry should also be accompanied by a one-paragraph (approximately 200-300 words) reaction. Feel free to cite course reading assignments or comments from discussions in class. The aim here is to have you think critically about what is reported or presented on global pandemics in our national media and in your local area. Each student should submit a notebook with five entries.At least one entry should be submitted by the second week of class. Thereafter at least one other entry should be submitted by week 6 and every three weeks remaining in the semester (i.e. one more by week 9 and then week 12, and week 15). You should also bring your entries to class to include them as part of our discussion whenappropriate.
Blog entry and responses: During the first week of class, students will sign up for a class topic of their choice for which they will write a 400-500 word blog post on the course blog site. They will also sign up for three topics for which they will be expected to post comments on other students’ posts. Blog posts should tie together class discussion and current events related to global pandemics. Initial blog posts and comments will be due on the dates indicated on the sign-up sheet, but students are expected to post updates on their own post as appropriate and are encouraged to continue to respond to other posts throughout the semester. Students will be graded on 1) the quality of the initial post itself and any updates posted during the semester, including appropriate use of course materials; 2) the quality of the discussion it sparks, which the student is encouraged to facilitate; and 3) the quality of the student’s own responses to others’ blog posts. Students must submit at least one post or one comment before the end of October. Examples of health related blogs written by professional anthropologists can be found on the course website.
Discussion leader: Each student is required to lead discussion of one class session. In preparation for that session the student responsible for leading the discussion will read each of the reading assignments carefully and critically to determine the most salient threads of the argument important for discussing with the rest of the class during the class session. The student will be responsible for leading the class in discussion during that session and providing the class with interesting insights and questions that can promote a lively discussion and debate about the topic of the week. As part of this assignment the student leading discussion should come to class with:
- A one-page summary of the main points of the readings for the session, including a discussion of the author’s theoretical framework and methodology, and your own critique of the author’s argument.
- Links to other supplemental readings/examples/material, etc. related to the week’s readings
- Discussion questions for class (tips on writing good discussion questions can be found at the end of this syllabus).
Final paper (Due December 14th): Each student will write a 10-12 page final paper (12 point font, double spaced with one-inch margins) analyzing a public health response to a pandemic with special attention to the how anthropologic methods and theory could have enhanced the response. Papers should introduce the response and discuss how it could have been enhanced through knowledge and information of the local social, cultural, political, and economic contexts. In addition to library research for your final paper, you will interview a global professional to explore their understanding of the relationship between culture and diseaseand explore the websites and materials of global health organizations (this will be discussed further in class, including suggestions and ideas for identifying and contacting a global health professional. We will also reserve time during the semester to discuss methods for conducting this type of research project). With the permission of the informant, you will tape record the interview, transcribe the interview, and use the information to supplement your library research on a focused topic. Free mobile apps are available for voice recording. I can also make available a number of digital voice recorders for recording your interviews.
There will be a number of check-ins throughout the semester to keep you on track for completing your final paper.
Final paper check-in #1– DUE: September 28th
- 2-3 Overall research questions and/or thesis/hypothesis
- 8-10 Bibliographic References from:
- peer-reviewed journal articles
- Book chapter
- Grey literature
- Popular media
- Websites (with URL)
- Annotated bibliography – 3-4 sentence summary of each of your most important references
Final paper check-in #2 – DUE: October 24th
- 1 page discussion of project
- Choice of interview subject – name, contact information, why this person will be a good informant for your project, date and time interview is scheduled. Use form included in this syllabus.
- Detailed interview questions (8-12 main questions with possible follow-up probes) – consider the following topics you will need to address in your paper when designing your interview questions.
INTERVIEW INFORMATION SHEET
Informant job title______
Informant email address______
How informant was identified______
Dates informant contacted and summary of information from each preliminary conversation
Date of actual interview______
How interview was conducted (e.g in person, skype, telephone) ______
Time interview started______
Time interview ended______
Special notes on interview______
Computer and Cell Phone Use
In order to focus your full attention on the class and on each other, laptops are not allowed during class time. Flat tablets (such as Ipads) are an exception, but may be used only to pull up the readings and not for typing. The use of cell phones is of course prohibited.
If you are a student with a documented disability on record at Brandeis University and wish to have a reasonable accommodation made for you in this class, please come and see me.
In all of your written assignments, please make sure to cite properly any sources that you consulted, whether or not you use direct quotes. You may not simply lift text from any source and incorporate it into your own work, nor can you just change a few words here and there and claim it as your own, even if you do cite the source. You must thoroughly and carefully paraphrase any information that you include. We will go over proper citation style in class.
You are expected to be familiar with and to follow the University’s policies on academic integrity and plagiarism (see Faculty may refer any suspected instances of alleged dishonesty to the Office of Student Development and Conduct. Instances of academic dishonesty may result in sanctions, including but not limited to failing grades being issued, educational programs, and other consequences.
COURSE OUTLINE AND READING ASSIGNMENTS
Framing Pandemics Throughout History
8/31 (Thurs)Introduction to the course
Walsh, Bryan. 2017. “The World is Not Ready for the Next Pandemic.” Time Magazine, May 4.
Week 2 Historical Perspective
9/5 (Tues)Morens, David, Gregory Folkers, and Anthony Fauci. 2008. “Emerging Infections: A Perpetual Challenge.” The Lancet Infectious Disease 8(11):710-719.
Echenberg Myron, Plague Ports: The Global Urban Impact of Bubonic Plague, 1894-1901 (New York: New York University Press, 2007) – Part 1: Belle Époqueand the Bubonic Plague, pp. 1-14; Part 2: Asian Beginnings (1 – An Unexplained Calamity: Hong Kong, 1894; 2- City of the Plague: Bombay, 1896), pp. 15-78.
9/7 (Thurs)Echenberg Myron, Plague Ports: The Global Urban Impact of Bubonic Plague, 1894-1901 (New York: New York University Press, 2007) – Chapter 8: Black Plague Creeps into America: San Francisco, 1900/1901, pp.. 213-242; Plague’s Lessons, pp. 303-312.
Echenberg, Myron. 2011. Africa in the Time of Cholera: A History of Pandemics from 1815 to the Present. New York: Cambridge University Press. PAGES - TBA
Brandt, Alan. 2013. “How AIDS Invented Global Health.” New England Journal of Medicine. 368(23): 2149-2152.
Merson, Michael, Jeffrey O’Malley, David Serwadda, Chatawipa Apisuk. 2008. The history and challenge of HIV Prevention. American Journal of Public Health. 372:475-488.
Framing Disease at the Local and International levels
9/12 (Tues.) International Frames
Parker, Richard (2002) “The Global HIV/AIDS pandemic, structural inequalities, and the politics of international health,” American Journal of Public Health, 92.3: 343-346.
Lee, Kelly, and D. Fidler (2010). “Avian and pandemic influenza: Progress and problems with global health governance” Global Public Health: An International Journal for Research, Policy, and Practice. 2(3): 215-234
Christakis, Nicholas A. (1989). “Responding to a Pandemic: International Interests in AIDS Control” Daedalus Vol. 118, No. 2, Living with AIDS, pp. 113-134
Briggs, Charles and Mark Nichter (2009). “Biocommunicability and the Biopolitics of Pandemic Threats” Medical Anthropology: Cross-Cultural Studies in Health and Illness 28(3):189-198.
9/14 (Thurs)Local Frames
Goguen, Adam and Catherine Bolten (2017). “Ebola Through a Glass, Darkly: Ways of Knowing the State andEach Other” Anthropological Quarterly 90(2).
Shao, Jing (2006). “Fluid Labor and Blood Money: The Economy of HIV/AIDS in Rural Central China” Cultural Anthropology 21(4):535-569
Wilkinson, Anne (2017). “Emerging Disease or Emerging Diagnosis? Lassa Fever and Ebola in Sierra Leone.” Anthropological Quarterly 90(2).
Week 4International Responses to Pandemics
9/19 (Tues)Ruger, Jeniffer (2005) “The Changing Role of the World Bank in Global Health,” American Journal of Public Health 95.1: 60-70
Wagstaff, Adam (2001) “Economics, Health and Development: Some Ethical Dilemmas Facing the World Bank and the International Community,” Journal of Medical Ethics, Vol. 27, No. 4 (August): 262-67.
Claeson, Mariam and Ashok Alexander (2008) “Tackling HIV in India: Evidence-Based Priority Setting and Programming,” Health Affairs, Vol. 27, No. 4: 1091-1102.
Steinbrook, R. (2007) “HIV in India—A Complex Epidemic,” New England Journal of Medicine, 356.11: 1089-93
9/21 (Thurs)ROSH HASHANAH – NO UNIVERSITY EXERCISES
Week 5Local Responses to Pandemics
9/26Benedict, Carol. Bubonic Plague in Nineteenth-Century China (Stanford: Stanford University Press, 1996). –Introduction and Chapter 1: Origins of Plague, pp. 1-47, Chapter 4: Nineteenth Century, Medial, Religious, and Administrative Responses to Plague, pp. 101-130.
Liu .Shao-hua (2010) Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China. Stanford: Stanford University Press, pp. 11-80; 130-186.
Benedict, Carol. Bubonic Plague in Nineteenth-Century China (Stanford: Stanford University Press, 1996). – Chapter 2: The Interregional Spread of the Plague, pp. 49-71
Qian, H.-Z., et al., Injection drug use and HIV/AIDS in China: Review of current situation,prevention and policy implications. Harm Reduction Journal. 2006, 3(4):1-8.
Wang ,Longde (2007) “Overview of the HIV/AIDS epidemic, scientific research and government responses in China,” AIDS 21 (8): S3-S7.
9/28 (Thurs)FINAL PAPER CHECK-IN #1
Moran, Mary (2017). “Missing Bodies and Secret Funerals: The Production of ‘Safe andDignified Burials’ in the Liberian Ebola Crisis” Anthropological Quarterly 90(2).
Van Hollen, Cecilia (2013) Birth in the Age of AIDS: Women, Reproduction, and HIV/AIDS in India. Stanford, CA:Stanford University Press. Chapters 6: To Birth or Not to Birth?”, pp. 125-154.
The Heavy Hand of Global Health Agencies in Pandemic Response
10/3 (Tues) NOTE: THIS IS A DESIGNATED BRANDEIS THURSDAY
Pfeiffer, James. 2014How the aid and development industry helped cause Africa’s Ebola outbreak. Podcast.
Biesma, Regien G., Ruairi Brugha, Andrew Harmer, Aisling Walsh, Neil
Spicer, and Gill Walt “The Effects of Global Health Initiatives on Country
Health Systems: A Review of the Evidence from HIV/AIDS Control,”
Health Policy and Planning, 24: 239-252, 2009.
GM Foster. "World Health Organization behavioral science research: Problems and prospects." Social Science & Medicine 24:709-717, 1987.
Okie, Susan. 2006. “Global Health: The Gates-Buffett Effect. “ New England Journal of Medicine Sep 14; 355 (11):1084-1088.
10/5 (Thurs)SUKKOT – NO UNIVERSITY EXERCISES
Week 7AIDS Exceptionalism
10/10 (Tues)Parker, Richard, “Administering the Epidemic: HIV/AIDS Policy, Models of Development and International Health in the Late-Twentieth Century,” in Linda Whiteford and Lenore Manderson, eds., Globalization, Healthand Identity: The Fallacy of the Level Playing Field. Boulder, CO: Lynne Reiner Publishing Company, 2000.
Shiffman, Jeremy. “Has Donor Prioritization of HIV/AIDS Displaced Aid for
Other Health Issues?,” Health Policy Plan, 23:95-100, 2008.
Treichler, Paula A., “AIDS and HIV Infection in the Third World: A First World Chronicle,” in How to Have Theory in an Epidemic: CulturalChronicles of AIDS, Durham and London: Duke University Press, 1999, pp. 99-126.
10/11(Wed)NOTE: THIS IS A DESIGNATED BRANDEIS THURSDAY. NO CLASS THURSDAY OCTOBER 12 DUE TO SHMINI AZERET HOLIDAY
L. Garrett. Chapter 17 from The Coming Plague. New York: Penguin Books, 1994: pp. 592-620.
Oppenheimer, Gerald M. and Ronald Bayer, The Rise and Fall of AIDSExceptionalism, American Medical Association Journal of Ethics, 11(12):988-992, 2009.