From Under the Wheels of the Juggernaut: Global Health Networks, Gold Standards and the Possibilities for Social Science Critique

From Under the Wheels of the Juggernaut: Global Health Networks, Gold Standards and the Possibilities for Social Science Critique
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来自主宰者的车轮下:全球卫生网络、黄金标准和社会科学批评的可能性

DOI:
10.1080/09505431.2016.1238889
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发表时间:
2016
期刊:
影响因子:
2.6
通讯作者:
Holden K
Holden K
中科院分区:
人文科学3区
文献类型:
--
作者:
Holden K

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虽然社会科学家继续质疑全球健康的具体性质或存在(Brown et al., 2012; Fassin, 2012),但不断增加的会议、期刊标题、学位课程、专家、政策等证明了它作为一个持久和主导的框架的持久性,通过它,世界人口的日常现实和活力被了解和干预。社会科学家和人文学者一直在努力批判全球健康的方法、认识论和影响(Petryna, 2009; Biehl和Petryna, 2013; Mold和Reubi, 2013),然而,关于参与其复杂机制的最佳方式的问题仍然存在。正在审查的两本专著质疑全球健康的无缝外观及其生物医学知识生产模式。这组作者阐述了全球卫生规划和干预措施中固有的复杂性和紧张关系,在经验上与跨越错综复杂的国际网络化机构、诊所和研究中心的从业人员和研究人员保持密切联系。克兰的书《争夺非洲》关注的是全球卫生体系及其行政框架。Crane将全球健康视为一股强大的力量(2013年,第149页),暗指其不可阻挡和不可抗拒的力量。之所以势不可挡,是因为全球卫生吸收了越来越多的联网机构、规划、专家和政策,扩大了其全球覆盖面和影响力。这是不可抗拒的,因为它吸引了越来越多的实践者,这些实践者是出于人道主义的考虑,但也可以说是由于吉祥的资金机会的可用性。然而,这个强大的比喻意味着全球健康可能具有破坏性;正如正在接受审查的两本专著所警告的那样,全球卫生还抹去、粉碎、抛弃了一些知识和生活方式,这些知识和生活方式不容易符合其客观、可衡量和具有成本效益的解决方案的普遍要求,也不符合其改善世界人口健康和福祉的总体使命。克莱恩特别提请我们注意国际合作网络的跨度及其隐含的排斥政治。排斥也是Michael和Rosengarten的《创新与生物医学》所关注的关键问题,它分析了根据国际认可的“黄金标准”标准标准化生物医学测试和治疗的努力,以及由此给现场的从业者造成的紧张局势。虽然全球健康经常呈现出一种不可阻挡的“强大力量”(Crane,第149页),但这两本书都揭示了全球科学网络传播和黄金标准设定所涉及的紧张和矛盾,从而开拓出新的和创新的社会科学批评。
While social scientists continue to query the concrete nature—or very existence—of global health (Brown et al., 2012; Fassin, 2012), the ever-multiplying conferences, journal titles, degree programmes, experts, policies and so on testify to its persistence as an enduring and dominant framework through which the everyday realities and vitality of world populations are known and intervened upon. Social scientists and humanities scholars have been at pains to critique the methods, epistemologies and effects of global health (Petryna, 2009; Biehl and Petryna, 2013; Mold and Reubi, 2013), and yet questions persist about the best ways to engage with its intricate machinery. The two monographs under review interrogate the seamless appearance of global health and its modes of biomedical knowledge production. The authors illustrate the complexities and tensions inherent in global health programmes and interventions, staying empirically close to practitioners and researchers working across intricate webs of internationally networked institutions, clinics and research centres. Crane’s book Scrambling for Africa attends to the architecture of global health and its administrative scaffolding. Crane refers to global health as a juggernaut (2013, p. 149), alluding to what often appears to be its unstoppable and irresistible force. Unstoppable because global health absorbs an ever-growing number of networked institutions, programmes, experts, and policies that extend its global reach and influence. Irresistible, because it attracts growing numbers of practitioners that are driven by humanitarian concerns, but arguably also by the availability of auspicious funding opportunities. And yet, the juggernaut metaphor implies that global health can be destructive; as both monographs under review caution, global health also erases, crushes, brushes aside forms of knowledge and ways of living that do not readily comply with its prevailing imperative for objective, measurable, and cost-effective solutions, and its overall mission to improve the health and wellbeing of world populations.Crane specifically draws our attention to the span of international collaborative networks and their implicit politics of exclusion. Exclusion is also the key concern of Michael and Rosengarten’s Innovation and Biomedicine, which analyses efforts to standardise biomedical tests and treatments according to internationally sanctioned ‘gold-standard’criteria, and the consequent tensions this creates for practitioners on the ground. While global health often takes on the appearance of an unstoppable ‘juggernaut’(Crane, p. 149), both books expose the tensions and contradictions involved in the spread of global scientific networks and setting of gold standards, and thus carve out new and innovative social science critiques.
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