Governing Ebola: between global health and medical humanitarianism

ABSTRACT

Medical humanitarianism and global health are two distinct but co-dependent spheres of global health security. Their actors differ in their units of analysis, understanding of neutrality, and organizational capacities. While health underpins the normative principles of humanitarian action, humanitarian ideas, and notably medical humanitarian organizations, are absent from global health security planning. This article develops the work of Lakoff [‘Two regimes of global health’, Humanity, 1(1), 59–79 (2010)], distinguishing between these two governance spheres and how this had stark consequences in the 2014/15 Ebola outbreak in Liberia and Sierra Leone, framed as a problem of global health but which rapidly became a humanitarian crisis. Such a frame excluded medical humanitarian organizations from the initial global strategy and resulted in the creation of a new organization (UMMEER – United Nations Mission for Ebola Emergency Response) and the involvement of militaries to bridge the health-humanitarian divide. Reconciling the distinct but co-dependent relationship between medical humanitarianism and global health is fundamental to effective delivery of global health security.

KEYWORDS:

• Global health
• Ebola
• humanitarianism
• medical humanitarian
• global health security

Acknowledgements

Many thanks to the anonymous reviewers, as well as Kimberley Hutchings, Adam Kamradt-Scott, Roisin Read, Anthony Redmond, and Jeremy Youde for feedback and comments on earlier drafts.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Sophie Harman http://orcid.org/0000-0001-5708-280X

Clare Wenham http://orcid.org/0000-0001-5378-3203

Additional information

Funding

Marie Bashir Institute provided the funding the fieldwork that this paper draws on.

Notes on contributors

Sophie Harman

Sophie Harman is a Reader in International Politics at Queen Mary University of London where she teaches and conducts research into global health, African international politics, and feminist methods. She has published six books in these areas, most notably Global health governance and The World Bank and HIV/AIDS. She is the co-editor of the Review of International Studies, co-founder of the British International Studies Association Global Health working group, and is the Chair of the International Studies Association Global Health book prize. She is Visiting Professor at HEARD, University of Kwa-Zulu Natal and founding trustee of the Tanzanian-based NGO Trans Tanz. Her first feature film – Pili – premiered in competition at the Dinard British Film Festival in 2017 where it was awarded the Hitchcock Public Award. Sophie's previous work on Ebola has focused on gender and women, and civil–military relations.

Clare Wenham

Clare Wenham is an Assistant Professor in Global Health Policy at LSE. Her work for the most part falls in the cross-over between global health and international relations, focusing on global health governance, health security, surveillance, and infectious disease control. Her recent work has focused on Zika, Ebola, pandemic influenza, and more broadly on the governance structures of the global health landscape and global disease control. Her work has appeared in The Lancet, BMJ, Third World Quarterly, Phil Trans B, and Global Health Governance. She previously worked in the Department of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine, working on projects relating to surveillance and transmission of infectious disease. Prior to this, she undertook PhD at the Centre for Health and International Relations at the Centre for Health and International Relations, Aberystwyth University examining the tensions between global disease governance and individual state sovereignty. During this, she did a fellowship at the Parliamentary Office of Science and Technology and consulted for the Asian Development Bank. Before her academic career, Clare worked in public health policy roles at the Faculty of Public Health and for an NHS trust.