Emergency, preparedness, and UK global health policy following the 2014 West African Ebola epidemic

ABSTRACT

In this article, we analyze UK global health policy in the light of the 2014 Ebola epidemic. Specifically, we focus on the UK government’s intervention in the epidemic, reflections on the UK’s response in parliamentary committees and government-sponsored forums, and subsequent UK global health policy changes. Post-Ebola, we argue, UK global health policy turned into a pursuit of global health emergency-preparedness through development. This, we further suggest, resulted from what we identify as the specific structure of the UK’s emergency-preparedness configuration that creates a ‘spill-over’ between the immediate event (of emergency) and future preparedness. This configuration transmits problems between different temporalities – allowing immediate, urgent problems to become problems of future uncertainty (and future uncertainties to be enacted as urgent problems). In activating emergency-preparedness, furthermore, self-scrutiny is triggered – prompting the UK to assume responsibility for problems identified as threats regardless of their point of origin, thus internalizing external problems.

KEYWORDS:

• Emergency
• preparedness
• global health policy
• Ebola

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. ‘Global health’ means different things to scholars from different disciplines (see Brown, Craddock, and Ingram 2012; Janes and Corbett 2009). Here, however, we use the term narrowly to frame the relevant UK policy for the 2014 Ebola epidemic.

2. Our analysis focuses on documents, a highly important and central tool of bureaucracy, as shaping mediators rather than neutral representations of discourse (Hull 2012). Thus, we are less interested in whether a given document actually represents ‘reality’ or implemented in practice, and more in the perspective it communicates and the structures of power it implies.

3. Throughout the article, we refer to several different committees. For more information on their different capacities, responsibilities, and functions, see the website of the UK Parliament at: https://www.parliament.uk/business/committees/.

4. Scholars have also discussed anticipatory governmental solutions such as precaution (Amoore and de Goede 2008; Aradau and van Munster 2007), pre-emption (Cooper 2006; De Goede 2008), and resilience (Brassett and Vaughan-Williams 2015). These terms can generally be seen as part of the broader governmental rationality of preparedness (Lakoff and Collier 2008; Samimian-Darash 2009), but this is a discussion that remains outside the scope of the current article.

5. UK emergency management is built on three phases: preparation, response, and recovery. Within response, crisis management and consequence management are used as two (often overlapping) management tools deployed ‘to control and minimise the immediate challenges arising from an incident’ (Cabinet Office 2013, 6). Crisis management ‘attempts to prevent or avert an imminent emergency … prevent further damage or disruption and secure the scene. It also includes actions taken to address the immediate effects of an incident.’

Additional information

Notes on contributors

Michael Rabi

Michael Rabi is a PhD Candidate at the Federmann School of Public Policy and Government at the Hebrew University of Jerusalem, Israel.

Limor Samimian-Darash

Dr. Limor Samimian-Darash is a Senior Lecturer at the Federmann School of Public Policy and Government at the Hebrew University of Jerusalem, Israel.