Promoção da Saúde e Medicalização: Notas Inquietantes em Conversas de Foucault com Canguilhem

Este artigo visa problematizar práticas de promoção de saúde no Brasil, a partir da história da saúde pública no país, em uma analítica da medicalização e da gestão higienista do hospital, da cidade, dos pobres e do Estado. Busca-se pensar como emerge junto com a saúde na atenção básica um modo de gerir a política pública de saúde como tática medicalizante dos corpos, do espaço, do hospital, da comunidade e das relações sociais. Interroga-se no seguinte ensaio temático um conjunto de práticas que operam um mecanismo biopolítico e de governo da vida e das existências por meio de intensa medicalização na atuação preventivista da saúde. Portanto, questiona-se o estilo de vida saudável na sociedade contemporânea a partir de uma estratégia medicalizadora do direito à saúde com Michel Foucault e Georges Canguilhem.Palavras-chave: Saúde. Medicalização. Práticas. Biopolítica. Prevenção. Health Promotion And Medicalization: Disturbing Notes In Talk Of Foucault With CanguilhemABSTRACTThis article aims to problematize health promotion practices in Brazil, based on the history of public health in the country, in an analysis of medicalization and hygienist management of the hospital, the city, the poor and the State. It seeks to think about how a way to manage public health policy emerges together with health in primary care as a medicalizing tactic of bodies, space, hospital, community and social relations. in the following thematic essay a set of practices that operate a biopolitical and government mechanism of life and existences through intense medicalization in preventative health action. Therefore, the healthy lifestyle in contemporary society is questioned based on a medicalizing strategy of the right to health.Keywords: Health. Medicalization. Practices. Biopolitics. Prevention.

The Cost of Trust: The World Health Organizations and Vaccination's Contested Economization in France

This article explores the role of the World Health Organization (WHO) within the tumultuous history of the hepatitis B vaccine in France, including a controversy that erupted in 1996 and lasted several years. When the first hepatitis B vaccine was commercialized in France in 1981, it inaugurated a new era in the industry characterized by high prices, an unprecedented number of patents and aggressive commercial competition. By inscribing the hepatitis B vaccine controversy into a broader, global history of the economization of immunization – in which the WHO played a central role – this article reframes the causes and implications of a controversy that both actors and scholars have approached through a primarily national lens. The challenge posed to the economic approach to immunization prepared the ground for subsequent critiques of vaccines as commodities. The article discusses a key transformation in the recent transatlantic history of public health by focusing on the perceived association of immunization with a contested economic order.

Health promotion, health education, and the public’s health

Health promotion is a complex, ambiguous concept and set of practices. While many have linked it, primarily, to a revolution in health education, its roots go much deeper into the history of public health. It had its contemporary beginnings in the throes of the backlash against bureaucratic and professional dominance exemplified by the new social movements of the 1970s and 1980s. At its heart, health promotion is centred on the values and principles of equity, participation, and empowerment. These concepts are embedded in health promotion’s founding document, the Ottawa Charter for Health Promotion. However, exactly how these values are articulated is often ambiguous. In this chapter, the authors contend that health promoters must intensify their reflection on these core values and principles; particularly in the light of the tendency to slip back into a comfortable paternalism, which reinforces existing power imbalances. We are specifically concerned with the precise interpretation of health equity in health promotion.

Reverse zoonosis of coronavirus disease-19: Present status and the control by one health approach

The recent coronavirus disease (COVID-19) outbreak is one of its kind in the history of public health that has created a major global threat. The causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a zoonotic source and hence, reverse zoonosis (disease transmission from humans to animals) increases the risk and rate of SARS-CoV-2 infection. Serological and molecular analyses and experimental infection studies have identified SARS-CoV-2 infection in several animal species in various countries. Different domestic and wild animals, including cats, dogs, tigers, lions, puma, snow leopard, minks, and pet ferrets, are infected naturally with SARS-CoV-2, mostly through suspected human to animal transmission. In addition, in vivo experimental inoculation studies have reported the susceptibility of cats, ferrets, hamsters, Egyptian fruit bats, and non-human primates to the virus. These experimentally infected species are found to be capable of virus transmission to co-housed animals of the same species. However, SARS-CoV-2 showed poor replication in livestock species such as pigs, chickens, and ducks with no detection of viral RNA after the animals were deliberately inoculated with the virus or exposed to the infected animals. As the pets/companion animals are more susceptible to COVID-19, the infection in animals needs an in-depth and careful study to avoid any future transmissions. The one health approach is the best inter-disciplinary method to understand the consequences of viral spread and prevention in novel host populations for the betterment of public health. Further in this review, we will explain in detail the different natural and experimentally induced cases of human to animal SARS-CoV-2 infection.

A Systematic Review of the Rationale for Vaccine Hesitancy among American Parents

INTRODUCTION: Vaccines are one of the most successful interventions in the history of public health. They are largely responsible for the near eradication of several diseases. However, some people are vaccination averse which can lead to vaccine hesitancy. Vaccine hesitant parents are those that refuse or delay getting their children vaccinated despite the availability of vaccination services. This phenomenon often occurs despite parent’s belief that vaccines are effective. The purpose of this review was to exam available literature to identify predictors of vaccine hesitancy among parents and parental rationale for vaccine hesitancy. METHODS: This literature review utilized the SCOPUS database to identify articles examining vaccine hesitancy among American parents, published from 1997 to 2020, inclusive. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was utilized to select articles used in the final literature review. RESULTS: Fifty-one articles were included in the final review. Predictors of vaccine hesitancy included demographics (income, education, marital status, race/ethnicity), healthcare practices (provider relationship, use of complementary or alternative medicine), and social-cultural factors. Parental rationale for vaccine hesitancy included concerns about the safety of vaccinations, not fearing diseases covered by vaccinations, and the belief that vaccines were not necessary. The most consistent and prevalent theme of vaccination hesitancy was the strength of the influence that the medical provider has on the parents. CONCLUSION: Balanced communication with a trusted medical provider that addresses both the benefits and risk of vaccinations, along with parents’ concerns about safety are important factors to reduce vaccine hesitancy among parents.

Abandoning the SRO: Public Health Withdrawal from Sanitary Enforcement in Vancouver’s Downtown Eastside

This paper situates a ten-year period of political upheaval in addressing the problem of Single Room Occupancy (SRO) housing in Vancouver, Canada, within an epistemic transformation of public health. Until 1970, the Vancouver Health Department exemplified a colonial history of public health in establishing the city’s skid road as a cordon sanitaire. But the 1970s saw a sudden fading of the Department’s authority just as a more collaborative approach to housing policy was emerging. The sunsetting of sanitary enforcement was driven in part by the arrival of a “new public health” that became primarily concerned with defining public health problems and solutions through the regulation of racialized bodies and behaviors—a cordon thérapeutique. By the 1980s, this shift constituted an epistemic and regulatory abandonment of SRO housing, leading to the accelerated deterioration of the entire housing stock and costing incalculable human suffering and the loss of lives.

Health, Development, and HIV in India

The first HIV (human immunodeficiency virus) case in India was detected in 1986 among female sex workers. The rapid spread in HIV infections subsequently due mainly to high-risk behavior among vulnerable population groups required a sensitive, multisectoral, multipronged response that had to influence risk behavior and alleviate the socioeconomic impact of the epidemic. The journey has been a unique one in many ways in the history of public health in India. The challenges emanated from the economic, social, legal, and cultural contexts in which risk-taking behavior took place, and to be effective, the response required a framework that had to be vastly different from the usual public health approaches adopted in the country. The fairly successful national response was made possible due to the presence and subsequent co-option of a vibrant civil society, which shaped discussions and discourses around sex, sexuality, and gender and could reach out to marginalized and stigmatized groups with messages and interventions. During the course of the thirty years of response to the epidemic, shifts in positions of individuals in the three organs of the government—executive, legislative, and judiciary—on key sensitive issues around sexual behavior and preferences could be discerned to some extent, which was unprecedented and helped strengthen the response. New infections have come down significantly over the years and treatment has scaled up massively. However, the momentum in national HIV programs has slowed down globally and in India, with lower finances and a shift to other national priorities. The sociocultural and economic contexts have yet to change for most of the groups vulnerable to HIV, and they will continue to determine risk behavior, requiring interventions to continue at a fairly high level of intensity.

Rockefeller Foundation and medical research in Korea and Taiwan under Japanese rule

Much historical information is yet to be uncovered, such as how knowledge was formed in certain parts of the world, including in Japan and Korea. Professor Toshihiko Matsuda, International Research Center for Japanese Studies, Japan, is investigating, in a global context, the body of knowledge formed in Japan, and it's outer influence, including on Taiwan, Korea and Manchuria in the modern era and on public health study and education. This needs to be clarified as, in Japan, there is a tendency to believe that Korea's knowledge and high-level education system came about from its colonial era, but South Korean researchers don't believe this to be the case. One line of investigation for Matsuda concerns a famous bacteriologist in prewar Japan called Kiyoshi Shiga who spent his last decade as a researcher in colonial Korea. Through this research, Matsuda is seeking to understand the position occupied by colonial Korea in the course of global medical history. He is using historical records to establish an understanding of how the history of public health as an academic discipline was introduced into colonial Korea, including using the documents of the Rockefeller Archives Center to decipher Shiga's role in introducing public health into Korea. In the process, Matsuda is filling gaps regarding how knowledge was imparted, pooled and shared between Japan and South Korea and emphasising that the information shaped in colonial Korea is closely connected to Western knowledge.

We Must Fix US Health and Public Health Policy

Despite a history of public health progress and the most expensive health care system in the world, the United States failed in its initial response to COVID-19. Much of this failure resulted from a presidential administration that sidelined, undermined, and maligned public health. But the roots of failure are deeper. Recovering from the pandemic and building health and public health back better will require recognizing the roots of failure and working persistently to achieve the progress that the country needs—especially among the most underserved communities. This must begin with recognizing the shortcomings in the US health system response to the pandemic, but the multiple overlapping failures laid bare by this crisis demonstrate the need for a systemic, multifaceted, sustained approach to reform that goes beyond pandemic preparedness. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e5. https://doi.org/10.2105/AJPH.2020.306125 )