Germs, genes and postcolonial geographies: reading the return of tuberculosis to Leicester, UK, 2001

This paper is inspired by an outbreak of pulmonary tuberculosis in the British East Midlands city of Leicester in 2001. In an era characterized by unprecedented advances in Western medical science an event of this kind might appear surprising. It challenges the feeling of wellbeing held in many Western countries, particularly in relation to diseases that appear both temporally and spatially distant. The paper examines how the event was reported in regional and national newspaper media and considers the significance attached to scale in the interactions between experts, the media and the public. In our analysis we mobilize a particular reading based on two biological metaphors, the membrane and the gene. We use this reading to reconsider the connectivity between disease, nation and identity in a world that is increasingly fluid, mobile, anxious and uncertain

Knowledge nodes and international networks of connection: representations of private philanthropy by elite higher education institutions

This paper investigates the social and cultural geographies of large-scale individual giving in supporting the work of ‘elite’ international universities. With public funding of higher education in general decline, universities in countries of the global North are increasingly seeking funding from alternative sources, including private philanthropy. Although scholarly work has examined corporate and foundational giving to Higher Education Institutions (HEIs), there has been little enquiry into how donations from wealthy individuals are represented by universities in their official literature. Publications such as annual reports, giving reports and campaign reports are used strategically by HEIs to project a global image. We examine the official literature of 50 elite HEIs located across the globe, uncovering new discourses into the cross-cultural reach of universities. We draw attention to complex social and cultural relations between HEIs and philanthropists, describing their encounters with reference to debates on personal mobilities, world-making and global and social inequalities. We conclude by highlighting the implications for theoretical work on ‘strategic philanthropy’ and on the transformative nature of HEIs as global centres of knowledge

Off the couch and on the move: global public health and the medicalisation of nature

In May 2004 the World Health Organization officially launched the ‘Global Strategy on Diet, Physical Activity and Health’. Lying at its heart is the recognition that many of the risk factors associated with non-communicable diseases, particularly poor diet and physical inactivity, have begun to move beyond the confines of the West. It was this apparent shift in the epidemiological boundaries of such diseases, along with fears over the socalled ‘double burden’ that they presented to some nations, that finally prompted the WHO to develop such a far reaching strategy. This paper adds to the on-going debate surrounding this important issue by drawing on the concepts of medicalisation, governmentality and the spatiality of scientific knowledge to explore one particular element of it: namely, the identification of nature as a setting for the promotion of physical activity. We adopt this perspective because we are concerned to understand the ways in which the knowledge and practice of the new public health travels. As our analysis reveals, in many Western nations the natural environment has emerged as an important ‘transactional zone’ where the governmental imperative for the production of fit and active bodies coalesces with the individual desire to be healthy. However, while it is apparent that this physical activity discourse increasingly operates throughout the globe, there is less evidence of an equivalent discourse that promotes the health-related benefits of nature. We argue that this is significant because it helps us recognise that contemporary public health discourse has a distinct geography

From ‘shadowy cabal’ to new profession: networks of cooperation and competition in UK Higher Education fundraising

Recent UK government policy initiatives have encouraged universities to seek funding from philanthropic sources. Yet, there has been little investigation into the work of the emergent Higher Education professionals expected to deliver this additional income. In this paper, we consider the role of professional networks in facilitating knowledge exchange amongst university fundraisers. Through interviews with senior UK philanthropy professionals in the 1960s universities, we identify significant variations amongst professional networks and peer groups. We argue that professional networks are multi-layered and often exclusionary. Yet, among participants, these associations provide both open spaces of learning and a means of achieving competitive advantage. Moreover, the networks permit university philanthropy professionals to develop new distinctive identities, transcending the institutional and locational setting of their employing organisations. This paper advances theoretical debates on the complexities of knowledge exchange across spatial scales and the role of these networks in the establishment of a new profession

Scales of governance: the role of surveillance in facilitating new diplomacy during the 2009-2010 H1N1 pandemic

The 2009–2010 H1N1 influenza pandemic has highlighted the importance of global health surveillance. Increasingly, global alerts are based on 'unexpected’ 'events’ detected by surveillance systems grounded in particular places. An emerging global governance literature investigates the supposedly disruptive impact of public health emergencies on mobilities in an interdependent world. Little consideration has been given to the varied scales of governance – local, national and global – that operate at different stages in the unfolding of an 'event', together with the interactions and tensions between them. By tracking the chronology of the H1N1 pandemic, this paper highlights an emergent dialogue between local and global scales. It also draws attention to moments of national autonomy across the global North and South which undermined the WHO drive for transnational cooperation

Surveillance networks and spaces of governance: technological openness and international cooperation during the 2009 H1N1 pandemic

The ongoing 2009-10 H1N1 pandemic has highlighted the importance of global health surveillance. It has, in the words of WHO Director-General Margaret Chan, offered the opportunity to ‘watch a pandemic unfold […] in real time’. Moreover, it has allowed the international community to more fully prepare for major infectious disease outbreaks. Whilst there is an expanding literature on biosecurity and preparedness, we argue that little consideration has been given to the impact of increased reliance on event-based surveillance on global public health governance. Using Margaret Chan’s 2007 call for a ‘new’ international health diplomacy, we assess the importance of global surveillance networks (such as the Global Public Health Intelligence Network (GPHIN) and HealthMap) in informing national and transnational practices in relation to the risks posed by emerging infectious diseases. Our analysis is supported by empirical data supplied by GPHIN and by reference to national pandemic influenza preparedness plans. In conclusion, we argue that, by increasing availability of local reporting of disease outbreaks, these networks act as a powerful prompt in initiating global pandemic preparedness and, by extension, international cooperation. Yet, the ongoing H1N1 pandemic demonstrates their fragility as practices of preparedness vary between states across the global north and south

‘Value’, ‘cost’ and ethics: UK airports and the governance of pandemic H1N1 risk

The outbreak and subsequent worldwide spread of pandemic influenza H1N1, popularly known as ‘swine flu’, from the spring of 2009 has illustrated our continued microbial vulnerability in a highly interconnected aeromobile world. The UK has been particularly affected by the first ‘wave’ of infection, with some commentators suggesting this was an inevitable consequence of the country’s status as a hub of global air communications. Given that the virus was almost certainly brought to the UK by holidaymakers returning from Mexico, the role of the UK airport as the ‘first line’ of defence against the importation of infectious disease has been subject to particular scrutiny. An important debate has subsequently emerged surrounding the ‘rights’ of airline passengers to move unimpeded through the world’s airports (without being subjected to medical screening) against the ‘rights’ of individual nations to be protected from the spread of infection through the employment of ‘strict’ screening practices. Focusing on concepts of ‘value’ and ‘cost’, as applied to individual ‘forms of life’, we consider how the governance of H1N1 risk at UK airports has generated a set of complex and interlocking biopolitical and ethical concerns associated with the safeguarding of the national border. We conclude by indicating how this tension, between securing and ethically valuing life, may inform future UK policy responses to infectious disease control at its international airports. One means is through a process of policy transfer

Airports, localities and disease: representations of global travel during the H1N1 pandemic

During summer 2009, the UK experienced one of the highest incidences of H1N1 infection outside of the Americas and Australia. Building on existing research into biosecurity and the spread of infectious disease via the global airline network, this paper explores the biopolitics of public health in the UK through an in-depth empirical analysis of the representation of H1N1 in UK national and regional newspapers. We uncover new discourses relating to the significance of the airport as a site for control and the ethics of the treatment of the traveller as a potential transmitter of disease. We conclude by highlighting how the global spread of infectious diseases is grounded in particular localities associated with distinctive notions of biosecurity and the traveller

Maintaining the sanitary border: air transport liberalisation and health security practices at UK regional airports

This paper contributes to ongoing debates surrounding the governance and security of global mobility regimes through a theoretical and empirical examination of the extent to which air transport liberalisation and contemporary practices of infectious disease governance demand a reconceptualisation of national borders. Recent outbreaks of SARS and H1N1 influenza, which spread rapidly around the world via air travel, illustrated the ability of pathogens to disrupt patterns and practices of human mobility and directly led to the introduction of new health screening technologies at airports that were designed to restrict the spread of infection and maintain a sanitary border. Yet while medical specialists have debated the effectiveness of the various screening techniques, and privacy campaigners have expressed concern over some of the technologies that have been deployed in an attempt to intercept these disease threats, there has been no exploration of the extent to which recent regulatory and structural changes within the global aviation industry have exacerbated the challenges of safeguarding public health and simultaneously transformed practices and spatialities of sanitary border control by re-siting national borders within a range of offshore and domestic locations. Drawing on official airport passenger statistics from the UK, this paper contends that, in transforming the spatialities of contemporary patterns of aeromobility, the progressive liberalisation of the commercial aviation sector (and the dramatic rise in passenger numbers, flights, and airports handling international services it effected) – has had unintended and hitherto unexplored consequences for the governance of infectious disease mobility and the material deployment of sovereign sanitary territoriality by creating more points through which an infectious disease may enter or leave a country and moving the border inside UK regions

Safeguarding public health at UK airports: an examination of current health security practices

In response to the H1N1 influenza outbreak and the role of air travel in facilitating the virus’s rapid spread around the world, this paper contributes to debates concerning the governance of commercial aviation and infectious disease by examining the role of the Port Health Regulations and associated health security practices that are enacted at UK airports. Drawing on extensive action research and in-depth interviews that were conducted with key stakeholders in the aviation and health care sectors (including airport managers, ‘front line’ customer-facing airline staff, and public health clinicians) during the spring and early summer of 2009, we chart the development of sanitary regulations at UK airports and explore the challenges of performing health security screening at individual sites. In so doing, we identify a number of challenges that are associated with safeguarding public health against the dissemination of infectious diseases by air travel through UK airports. We also suggest that policy transfer may represent an effective mechanism through which best practice procedures from airports overseas could be adapted and incorporated in the UK