The sacrificial international : the war on drugs and the imperial violence of law

The United Nations Single Convention on Narcotic Drugs, 1961 is presumed to be a testament to the progressive teleology of post-war liberal international law. In establishing the prohibition of the illegitimate trade of drugs as a global norm, this treaty serves as the legal grounding for what is popularly referred to as the War on Drugs. International drug prohibition offers a potent exemple of the humanitarian discourse taken to anchor the international legal order in the second half of the twentieth century. In practice, the failure of realising ‘A Drug Free World’ has been outright; international law’s declaration of a War on Drugs has produced little more than the same mass of casualties that all wars tend to produce. In an attempt to enforce the unenforceable, the drug war has visited social death (through mass imprisonment) and material death (through violent state enforcement) onto untold millions. Moreover, empirical studies reveal a sharp racial and geographical asymmetry in the violence that emerged through drug prohibition In this thesis, I will theoretically unpack the apparent contradiction between the humanitarian rhetoric of the international laws governing drug prohibition and the racialised violence of the War on Drugs in practice. Rejecting the orthodoxies that seek to decouple the violence of the war from the law itself, I read the drug war as a telling instantiation of a violence that is not only consistent with but also productive of the liberal international legal order. Through unpacking the discursive association that has been produced between drugs and racial others posited as the negation of idealised ‘human’ underlying liberal international law’s humanitarianism, this thesis will employ a critical study of the War on Drugs in order demonstrate how the operative coherence of twentieth-century liberal international law remained indebted to a violence that I have termed as ‘sacrificial.

Responding to the COVID-19 pandemic in Ghana

On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China. The disease was christened COVID-19 and the pathogen (an RNA virus) identified as SARS-Coronavirus-2 (SARS-CoV-2).1,2 The virus is primarily spread through contact with small droplets produced from coughing, sneezing, or talking by an infected person. While a substantial proportion of infected individuals may remain asymptomatic, the most common symptoms in clinical cases include, fever, cough, acute respiratory distress, fatigue, and failure to resolve over 3 to 5 days of antibiotic treatment. Complications may include pneumonia and acute respiratory distress syndrome.3 Over five million confirmed cases of COVID-19 has been recorded globally with more than 300,000 deaths as at 25th May 2020. The United States of America has recorded the highest number of cases with more than 1.5 million and over 100,000 deaths.4 In Africa, more than 90,0000 cases have been reported with about 3,000 deaths. South Africa has recorded the highest number of cases with 23,615 cases and 481 deaths. Ghana confirmed its first cases of COVID-19 on 12th March 2020 and had as at 25 May 2020 recorded over 7,000 cases with 34 deaths.5 &nbsp

The sacrificial international : the war on drugs and the imperial violence of law

The United Nations Single Convention on Narcotic Drugs, 1961 is presumed to be a testament to the progressive teleology of post-war liberal international law. In establishing the prohibition of the illegitimate trade of drugs as a global norm, this treaty serves as the legal grounding for what is popularly referred to as the War on Drugs. International drug prohibition offers a potent exemple of the humanitarian discourse taken to anchor the international legal order in the second half of the twentieth century. In practice, the failure of realising ‘A Drug Free World’ has been outright; international law’s declaration of a War on Drugs has produced little more than the same mass of casualties that all wars tend to produce. In an attempt to enforce the unenforceable, the drug war has visited social death (through mass imprisonment) and material death (through violent state enforcement) onto untold millions. Moreover, empirical studies reveal a sharp racial and geographical asymmetry in the violence that emerged through drug prohibition In this thesis, I will theoretically unpack the apparent contradiction between the humanitarian rhetoric of the international laws governing drug prohibition and the racialised violence of the War on Drugs in practice. Rejecting the orthodoxies that seek to decouple the violence of the war from the law itself, I read the drug war as a telling instantiation of a violence that is not only consistent with but also productive of the liberal international legal order. Through unpacking the discursive association that has been produced between drugs and racial others posited as the negation of idealised ‘human’ underlying liberal international law’s humanitarianism, this thesis will employ a critical study of the War on Drugs in order demonstrate how the operative coherence of twentieth-century liberal international law remained indebted to a violence that I have termed as ‘sacrificial.

Ghana and the COVID-19 pandemic

A new virus causing predominantly respiratory tract infection was described in China late 2019. The virus was subsequently named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes as COVID-19. Subsequently the virus spread to many parts of the world. This resulted in the World Health Organisation declaring COVID-19 a global pandemic on 11th March 2020

Malaria vaccine deployment in Africa: focus on Ghana

The announcement by the Ghana Health Service /Ministry of Health at the beginning of May to begin the pilot implementation of the malaria vaccine – RTS,S/AS01 (Mosquirix®) – manufactured by GSK Biologicals was greeted with rumours about conspiracy theories of secretagenda to depopulate Africa through the use of vaccines and all the other stories that are often propagated by the anti vaxxers. This was not unlike the fear and panic spread throughout the country that prevented investigators from conducting clinical trials on new vaccines against the Ebola virus disease a few years ago

Re: Musings on malaria morbidity and mortality after the new Mosquirix® vaccine

Importance of pilot implementation and Phase IV studies and pending questions: The Malaria Vaccine Implementation Project (MVIP) is coordinated by the World HealthOrganisation (WHO) and led by African health authorities in Ghana, Kenya and Malawi. In Ghana, the MVIP is led by Ministry of Health/Ghana Health Service and evaluatedby a consortium of researchers from University of Ghana, University of Health and Allied Sciences, Agogo Malaria Centre, and the Research and Development Division of Ghana Health Service. The project is designed to address several outstanding questions related to the public health use of the vaccine. Additionally, Phase IV studies are ongoing to further assess the safety of the vaccine in Ghana (Kintampo and Navrongo) as a standardregulatory requirement for new vaccines. Indeed, this approach has been used for the introduction of other vaccines in Ghana such as the human papilloma virus vaccine.2 Specifically, the MVIP will provide data to the Ministry of Health and partners on how best to deliver the required four doses of the vaccine in routine settings; assess the vaccine’s full potential role in reducing childhood deaths; and establish the vaccine’s safety profile inthe context of routine use. Since the Phase III study was not intended to measure the impact of the vaccine on mortality, the data from MVIP will confirm or refute theimpact of the malaria vaccine on mortality as determined in the mathematical models outlined by Penny M et. al.

Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana

BACKGROUND: The rising burden of chronic non-communicable diseases in low and middle income countries has major implications on the ability of these countries to achieve universal health coverage. In this paper we discuss the impact of cardiovascular diseases (CVD) on primary healthcare services in urban poor communities in Accra, Ghana. METHODS: We review the evidence on the evolution of universal health coverage in Ghana and the central role of the community-based health planning services (CHPS) programme and the National Health Insurance Scheme in primary health care. We present preliminary findings from a study on community CVD knowledge, experiences, responses and access to services. RESULTS: The rising burden of NCDs in Ghana will affect the achievement of universal health coverage, particularly in urban areas. There is a significant unmet need for CVD care in the study communities. The provision of primary healthcare services for CVD is not accessible, equitable or responsive to the needs of target communities. CONCLUSIONS: We consider these findings in the context of the primary healthcare system and discuss the challenges and opportunities for strengthening health systems in low and middle-income countries

Monitoring malaria using health facility based surveys: challenges and limitations.

BACKGROUND: Health facility data are more readily accessible for operational planning and evaluation of disease control programmes. The importance, potential challenges and limitations of using facility based survey as an alternative tool for monitoring changes in local malaria epidemiology were examined. METHODS: The study involved six areas within the administrative divisions of The Gambia. The areas were selected to reflect socioeconomic and malaria transmission intensities across the country. The study design involved an age stratified cross sectional surveys that were conducted during the wet season in 2008 and in the 2009 during the dry season. Participants were patients attending clinics in six health centres and the representative populations from the catchment communities of the health centres. RESULTS: Overall participants' characteristics were mostly not comparable in the two methodological approaches in the different seasons and settings. More females than males were enrolled (55.8 vs. 44.2 %) in all the surveys. Malaria infection was higher in the surveys in health centres than in the communities (p < 0.0001) and also in males than in females (OR = 1.3; p < 0.001). Males were less likely than females to sleep under an insecticide treated net in the communities (OR = 1.6; 95 % CI 1.3, 1.9) and in the health centres (OR = 1.3; 95 % CI 1.1, 1.5). Representativeness of the ethnic groups was better in the health centre surveys than in the community surveys when compared to the 2003 national population census in The Gambia. CONCLUSION: Health facility based survey though a potential tool for monitoring changes in the local epidemiology of malaria will require continuous validation of the facility and participants sociodemograhic characteristics as these may change over time. The effects of health seeking practices on service utilization and health facility surveys as an approach will also need continuous review