The Epistemic Politics of Snakebite Envenomation: a social science study of the digitally-mediated governance of a One Health challenge

该项目研究了“一个健康”公共卫生治理范式-想象动物，人类和环境形成一个相互依存的系统，其健康应该以跨学科的方式进行治理-如何在实践中实现其目标。它通过蛇咬伤毒液蛰入（SBE）的案例研究来做到这一点;这是一种每年造成约10万人死亡的疾病，主要发生在全球南部的贫困人口中。由于蛇咬伤对多物种健康的影响和包括社会因素（如劳动条件）和环境因素（如气候变化）在内的多种驱动因素，蛇咬伤越来越多地被纳入“一个健康”的框架。这一“同一健康”框架促使世卫组织采取小规模生物学领域的治理干预措施，将来自不同领域（如生态学、医学和药学）的专家知识与经历过这种疾病影响的非专业人员的知识结合起来。世卫组织最近发布的蛇咬伤信息数据平台（SIDP）试图通过综合来自专家和面临SBE风险的社区的蛇咬伤数据来推荐治疗方案，从而实现这一愿景。然而，目前还不清楚这种“一个健康”的方法是否能公正地代表人类、蛇和环境的不同观点和公平的健康结果。因此，该项目将调查：1）不同群体如何“知道”蛇咬伤; 2）这些知识实践如何告知疾病的管理;以及3）这些治理方案对多物种健康的影响。要做到这一点，我将采用混合方法的方法，包括：文件分析（询问学术和灰色文献有关蛇咬伤的全球治理）;专家访谈（询问更制度化的手段，通过公共卫生行为体治理SBE）;和参与者观察（分析现场的知识和做法，通过外行和专家社区知道，生活，并管理SBE）。这将涉及在哥斯达黎加的Clodomiro Picado研究所进行实地考察（一个领先的蛇咬伤研究中心）和世卫组织的SIDP团队，以探讨不同的认识社区-包括生态学家，卫生政策制定者，蛇咬伤临床医生和具有蛇咬伤风险谈判经验的外行-对蛇咬伤是什么，它是由什么引起的，它的影响是什么有不同的理解，以及这些知识如何为SBE管理策略提供信息，并对蛇和与它们生活在一起的社区产生不同的后果。作为蛇咬伤的认知政治的第一个实质性研究，该项目代表了一个主要的测试案例，数字化的全球卫生干预措施是否促进或限制认知多元化，产生产生可用的流行病学数据和响应网络的关系，并确保更公平的多物种健康结果。该项目将包括在危地马拉的语言培训和在南美洲的实地工作培训。

This project investigates how the 'One Health' public health governance paradigm - which imagines that animals, humans, and the environment form an interdependent system whose health should be governed in an interdisciplinary manner - realises its aims in practice. It does so through the case study of snakebite envenomation (SBE); a disease causing ~100,000 deaths annually, mostly in poor populations in the Global South. Snakebite has become increasing framed in One Health terms due to its multispecies health impacts and diverse drivers including social factors (such as labour conditions) and environmental factors (such as climate change). This One Health framing has led the WHO to pursue SBE governance interventions that integrate expert knowledge from diverse fields (such as ecology, medicine, and pharmacy) alongside knowledge from laypeople who experience the disease's effects. The WHO's recently released Snakebite Information Data Platform (SIDP) attempts to realise this vision by synthesising snakebite data from experts and communities living at risk of SBE to recommend treatment protocols. However, it is unclear whether this One Health approach has led to just representation of diverse perspectives and equitable health outcomes for humans, snakes, and the environment. Thus, this project will investigate: 1) how different groups 'know' snakebite; 2) how these knowledge practices inform the disease's management; and 3) the implications of these governance programmes for multispecies health. To do this, I will employ a mixed-methods approach comprising: document analysis (interrogating academic and grey literature concerning snakebite's global governance); expert interviews (enquiring into the more institutionalised means through which public health actors govern SBE); and participant observation (analysing the situated knowledges and practices through which lay and expert communities know, live with, and manage SBE). This will involve fieldwork at the Instituto Clodomiro Picado in Costa Rica (a leading snakebite research hub) and the WHO's SIDP team to probe how diverse epistemic communities - including ecologists, health policymakers, snakebite clinicians, and laypeople with experience negotiating the risks of snakebite - have different understandings of what snakebite is, what it is caused by, what its effects are, and how these knowledges inform SBE management strategies with varying consequences for snakes and the communities who live with them. As the first substantial study of snakebite's epistemic politics, this project represents a major test case for whether digitised global health interventions facilitate or constrain epistemic pluralism, generate relationships that produce usable epidemiological data and responsive networks, and secure more equitable multispecies health outcomes. This project will involve language training in Guatemala and fieldwork training in south America.