Medicine, Conflict and Survival

ISSN: 1362-3699 (Print) 1743-9396 (Online) Journal homepage: http://www.tandfonline.com/loi/fmcs20

Moving health sovereignty in Africa – disease, governance, climate change Shirley Hodgson To cite this article: Shirley Hodgson (2015) Moving health sovereignty in Africa – disease, governance, climate change, Medicine, Conflict and Survival, 31:2, 134-136, DOI: 10.1080/13623699.2015.1032523 To link to this article: http://dx.doi.org/10.1080/13623699.2015.1032523

Published online: 27 Apr 2015.

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Book reviews

Those working with ‘imperceptible’ hazards and their related technologies must weigh the infrastructural commitments required to make a hazard or effect sustainably visible to the public. This has implications for our models of public engagement. Two-way, mutual dialogue emerges as essential because it reveals complex components to radiation protection that a top-down model cannot quantify (for example, the empirical effects of the socio-economics of contaminated communities). In this system, the public might engage with administrative workers to develop infrastructures for combating hazards that demand an empirically acceptable level of work from individuals and communities. The Politics of Invisibility raises some necessary questions about the ways ‘imperceptible’ hazards become publicly visible. It is often said that there is no such thing as a free lunch. In the case of Chernobyl, a free lunch means a radioactive lunch. Alexander Mankoo Department of Science & Technology Studies, University College London, UK [email protected] © 2015, Alexander Mankoo http://dx.doi.org/10.1080/13623699.2015.1032522 Moving health sovereignty in Africa – disease, governance, climate change, edited by John J. Kirton, University of Toronto, Canada, Andrew F. Cooper, University of Waterloo, Canada, Franklyn Lisk, University of Warwick, UK, and Hany Besada, University of Ottawa, Canada, Farnham, Ashgate Publishing Company, 2014, 324 pp., £65 (hardback), ISBN 978-1-4094-5048-1 (also as ebook PDF, ebook ePUB) This book results from the growing perception that addressing fast-moving changes in health issues in Africa, including increased cross-border movements and the worrying health effects of climate change, in the context of often limited state capacity, may be less appropriately addressed by the institutions and concepts of the state-centred ‘Westphalian’ world. It is the outcome of an international workshop held in South Africa in 2008, entitled ‘Moving Health Sovereignty: Global Challenge, African Perspective’ attended by the authors. The book addresses the general problems, concepts and applications of this problem based on the perceived challenge, response and innovation, and a second volume (Africa’s health challenges: sovereignty, mobility of people and healthcare governance) was also published after the conference to address more specific concepts of moving people across borders and aspects of sovereignty in relation to the migration of the healthcare workforce.

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Medicine, Conflict and Survival

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This volume is divided into an introduction, which helpfully sets the scene and explains the general outline of the ensuing chapters: Part II which discusses Africa’s health challenges in more detail, Part III which explores the responses of global governance bodies to these issues, Part IV which considers how the challenges from climate change can be integrated into the global governance response and lastly a very comprehensive overview and summary of the analysis presented in the book. There are a number of figures and tables presenting data on the numbers of people affected by natural disasters, relevant health statistics and details of global governance bodies and key conferences relating to these. The chapters are each from different authors, set out in similar style with a summary and recommendations at the end, which is helpful. However, as with most multi-authored books, there is inevitably some overlap in the ground covered in different chapters. The book highlights the way in which the increased mobility of people and their pathogens across borders and the challenges of the deleterious effects of climate change on disease incidence are increasing the need for a coordinated response to global health, and how the established health governance strategies need to be re-evaluated in the light if these new challenges. The first chapters emphasize the fact that the public health diplomacy which was set in place in response to European cholera epidemics was structured in a very different way to the present day global health diplomacy, which includes a potential conflict of interests between international global health bodies and the needs of sovereignty of the African countries affected. A particular example of the stresses that can exist in this context is given in Chapter 3, which addresses the relationship between the role of the state and the response to the HIV/AIDS epidemic and the resultant intervention from external state and non-state actors, further reducing the integration of the response to the health needs of the country. The recommendations set out in this chapter are helpful for more global thinking on these aspects of the problem. Subsequent chapters analyse the threat to global security from large-scale disease epidemics such as HIV/AIDS and more specific African aspects of how to assess the effects of this on health governance and global biopolitics and the development of local health systems. There is also a short chapter with interesting examples of ways to improve understanding and reduce conflicts of interest between different stakeholders. Part III contains a series of chapters outlining details of the different bodies involved in addressing the health problems previously outlined, providing useful and insightful details of the development and remit of the many international bodies involved, with an assessment of the areas in which they may not perform to maximum benefit due to conflicts of interest between their approaches and the needs of the countries in receipt of their aid. The concluding chapter is a very helpful overview of the thrust of this book and reviews the information presented in a succinct and helpful way. This book is a very interesting and important analysis of the evolving health

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challenges of Africa, how these are being addressed and the problems of evolving a new and integrative system of aid and healthcare reform within the constraints of the established regimes in the different countries, and the continuing constraints of ‘third world’ economies.

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Shirley Hodgson St. Georges, London, UK [email protected] © 2015, Shirley Hodgson http://dx.doi.org/10.1080/13623699.2015.1032523

The warrior, military ethics and contemporary warfare: Achilles goes symmetrical, by Pauline M, Kaurin, Farnham, Ashgate Publishing Limited, 2014, 154 pp., £60.00 (Hardback), ISBN 978-1-4094-6536-2, ebook PDF, ebook ePUB This is a thorough, honest and imaginative look at military ethics in the context of asymmetric conflict. The author roots the debate in universal concepts of loyalty and courage and draws on field experience, although almost exclusively of the US military. Recommendations are practical and clearly based on the analysis of challenges faced by both the military and their civilian counterparts. However, perhaps inevitably given the breadth and challenge of the subject, the foundations of the debate are not always clear and the perspectives of some actors are missing. It would have really helped if the usual list of acronyms had been included and the book has a surprising number of typos. The first half of the book addresses ‘jus in bello considerations often encountered in waging contemporary asymmetrical war’ (Chapter 1, 11 line 29) and covers military virtues (with chapters on courage and loyalty), the principle of discrimination, non-lethal and unmanned technologies and humanitarian intervention. Following a chapter on Warrior Ethos and Identity, the second half considers ‘how to train and educate to uphold these ideas and concepts’ (Chapter 1, 11 line 36), followed by the final conclusions. The characteristics of the Achilles of the title are contrasted with those of Hector, whose profile is considered closer to the ‘Guardian ethos’ (Chapter 7, 91 line 25), which is proposed to address some of the problematic issues in modern armed forces. These issues are clearly analysed and include ‘force protection as the highest expression of courage’ (Chapter 2, 20 line 27) and the ‘increased criminalisation of enemy combatants’ (Chapter 3, 35 line 26). Training is advocated which uses case studies in a way which, rather than having a ‘commentator who typically acts as a judge’ (Chapter 9 110 line 31) has a ‘community of inquirers’ (Chapter 9, 111 line 18) who work together to decide and justify what should or could have been done. One of the main conclusions in the final chapter ‘Navigating the Great Divide’ (Chapter 10, 123) is that there is a gap, which appears to be widening,

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