A WORLD DIVIDED: HISTORY AND THE COVID-19 SYNDEMICS OF THE GLOBAL SOUTH

Editors: Inayat Ali, Merrill Singer and Nicola Bulled

Critical medical anthropologists have paid significant attention to the structural factors that shape, produce and reproduce disease(s). They call it an entanglement of “biosocial” events that make some humans especially vulnerable to contract disease, and face severe outcomes. Paying attention to such interrelations and interplays reveals a significant difference prevailing in today’s world: unjust and preventable health disparities across populations and between population subgroups. This pattern is repeated in the case of COVID-19 despite the increasing (inter)connectedness in what remains a divided world. The effects of the pandemic differ between countries but have been especially impactful, although in varying ways, in the Global South. It is accurate to assert that it is not just one medical pandemic but “many pandemics” (Ali 2021). COVID-19 pandemics are exposing and multiplying the existing structural inequalities in this region. On the one hand, structural factors, such as poverty, population density, unequal access to healthcare, economic disparities, and social marginalization are significantly enhancing the effects of the pandemic. On the other hand, various and varying comorbidities have played a significant role in intensifying these effects.

Situating analyses within such a thematic arena, we extend the proposal of Singer and Rylko-Bauer (2020) that two key analytical concepts of critical medical anthropology— “structural violence” and “syndemics”—can be useful in understanding the spread and differential impacts of this virus at various scales, such as at an individual, community and national level, or regional level.  Structural violence pays attention to all of the socio-cultural, economic, and (geo-)political factors that are institutionalized in a way that creates vulnerable situations for some to be “infected” with COVID and be disproportionately affected by other diseases (Farmer 2003; Ali 2020). These structures often justify such “violence” and resultant “social suffering” (Kleinman, Das, & Lock 1997; Ali 2020). Likewise, a syndemics approach combines the idea of ”synergy” with “epidemic” and recognizes that diseases in a population are significantly related to socio-cultural, economic, political, and ecological factors. Going beyond micro-level enquires and explanations, a syndemics approach takes into account macro-level factors pertaining to health-related perceptions, beliefs, and practices and their interface with “local biologies” (Lock 1993), “societal memories” (Ali 2020), local ecologies, and socio-cultural configurations. Additionally, syndemics entail the adverse interaction of two or more diseases negatively impacted by socio-cultural, economic, ecological, and political conditions. Disease interactions can be unidirectional, bidirectional, or multidirectional, as well as concurrent or sequential. They can involve physical and behavioral health, as well as infectious and noncommunicable diseases. Applying the concept of syndemic involves showing how diseases or other health conditions (e.g., malnourishment) interact adversely to increase the burden of disease in a population that is promoted by socio-cultural conditions (e.g., structural violence).

We call for critical inquiries that pose unsettling questions and explorations regarding such issues that reveal various visible and invisible syndemic entanglements and interrelationships. We are seeking original chapters by social scientists—especially anthropologists, sociologists, and historians—and public health professionals, which explore, analyze, and entail the historic framing of the inequalities of the Global South that contribute to the expression of particular COVID-19 syndemics. Extending the proposal of Singer and Rylko-Bauer (2020) to study COVID-19 syndemics, chapters might focus on:

• The interplay between the virus and various forms of current and historical policies, institutionalized forms of inequalities, structural vulnerabilities, and their critical implications
• A relationship between specific behaviors, health patterns, politico-economic structures, and social relationships that produce and reproduce particular vulnerable contexts and resulting syndemics
• Synergistic interactions among various diseases and other health conditions that lead to an increased burden of disease at local, regional, national, and global levels beyond that resulting from mere comorbidity
• Interspecies interactions that lead to emergent and spreading infectious zoonotic diseases as the COVID-19 pandemic has revealed that several diseases are at play in tandem in socio-cultural and politico-economic contexts
• Health and social interactions and interplays contributing to the clustering of multiple diseases and risks in vulnerable populations, while reducing the capacity of the affected population to respond effectively to contagious or other health problems.

Submission Guidelines

We welcome your chapter proposal, which should be around 300-500 words and include the following parts:

• Name, affiliations, biographical sketches, and email address
• A working title for your chapter
• A brief detail of the rationale, conceptual and methodological framework
• Identification of the interacting two or more diseases/health conditions and one or more structural factors to be addressed
• Language: English
• Font: Times Roman 12

After reviewing each proposal, we would submit the Book Proposal to Routledge. With high hopes that it will be accepted, we will invite authors of accepted proposals to send the final chapter of around 6,500-7,000 words. Once accepted, we will offer you detailed guidelines for writing your chapter.

Preliminary Deadlines

Chapter proposals: 15th October 2021
Notifying successful proposals: To be announced
The first draft of chapter: To be announced
The revised version of chapter: To be announced
Chapters due to the publisher: To be announced

All submissions should be emailed to Inayat Ali: inayat_qau@yahoo.com, Merrill Singer: merrill.singer@uconn.edu, and Nicola Bulled: nicola.bulled@gmail.com with the subject title: A World Divided

Editor’s Bios

Inayat Ali, PhD is a Research Fellow at the Department of Social and Cultural Anthropology, University of Vienna, Austria. Receiving his doctoral degree in sociocultural anthropology from the University of Vienna, Austria, he has a medical anthropology specialization and a geographical focus on South Asia, especially Pakistan. His Ph.D. project studied measles and vaccinations in Sindh Province, Pakistan. Using (ill-)health as analytical entry points and significantly informed by critical medical anthropology, he explores, analyzes, and illuminates the interplay between health, disease, structured disparities, geopolitics, and biopolitics. He emphasizes applied research to produce anthropological knowledge that can contribute to current world problems. His most recent work focuses on COVID-19 in four countries: Pakistan, Bangladesh, Sri Lanka and Nigeria. In Pakistan, he is working as the Principal Investigator of the project, Exploring and Understanding the Impacts of COVID-19: A Qualitative Inquiry, approved by the National Bioethics Committee of Pakistan (Reference No.4-87/NBC-471-COVID-19-09/20/). He has authored numerous peer-reviewed articles in anthropology and public health journals. Moreover, he is the lead editor of the book Negotiating the Pandemic: Cultural, National, and Individual Constructions of COVID-19. London: Routledge, with Robbie Davis-Floyd as co-editor, forthcoming in 2022. And he is authoring his second book—Contesting Measles and Vaccination: Cultural Beliefs, Structured Vulnerabilities, Mistrust, and Geo-Politics in Pakistan. London: Routledge, forthcoming in 2022. In addition to his academic writing, he also writes op-eds in Pakistan’s leading English newspapers, e.g., Daily Times. ORCID ID: https://orcid.org/0000-0003-1659-8492.

Merrill Singer, PhD is a medical anthropologist with a focus on structural and biosocial factors in health, drug use and HIV/AIDS, infectious diseases, global warming and health, disease interactions, and the elimination of health disparities. He is an emeritus professor in the Department of Anthropology, University of Connecticut. In addition, over the years he has been affiliated with InCHIP, the Institut Interuniversitaire de Recherche (Haiti), the Global Health Research Center of Central Asia (Columbia University), and the Center for Interdisciplinary Research on AIDS (Yale), and is the former Director of the Center for Community Health Research at the Hispanic Health Council in Hartford, CT. He has been the PI/Co-PI on a series of basic and applied federally funded drinking, drug use, and AIDS prevention studies and related health research dating to 1984. Dr. Singer has published over 300 articles and chapters in health and social science journals and books and has authored or edited 30 books. He is the recipient of the Rudolph Virchow Prize, the AIDS and Anthropology Paper Prize, the George Foster Memorial Award in Practicing Anthropology from the Society for Medical Anthropology, and the Prize for Distinguished Achievement in the Critical Study from the North America from the Society for the Anthropology of North America.

Nicola Bulled, PhD is a medical anthropologist and public health practitioner, whose work lies at the intersections of global health, health communication, and anthropology. Her work focuses on the social and structural determinants of infectious diseases among marginalized populations in South Africa, Lesotho, the US, and Greece. She is primarily concerned with the interplay of personal and health system barriers, and on economic and structural factors that shape risk engagement, prevention product use, and health outcomes. She holds an appointment as an Assistant Research Professor at the Institute for Collaboration on Health, Intervention, and Policy (InCHIP) at the University of Connecticut. In addition, she is affiliated with Brown University, Tufts University’s Cummings School of Veterinary Medicine, Purdue Global, and the University of the People. She has authored numerous peer-reviewed articles in anthropology and public health journals. Her monograph, Prescribing HIV Prevention (Routledge), examines responses to externally imposed HIV prevention strategies in Lesotho. Her edited collection, Thinking Through Resistance (Routledge) examines hesitancy towards and rejection of global health interventions.