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Amid a global health crisis, the process for declaring a Public Health Emergency of International Concern (PHEIC) is at a crossroads. As a formal declaration by the World Health Organization, a PHEIC is governed by clear legislation as to what is, and what is not, deemed a global health security threat. However, it has become increasingly politicized, and the legal criteria now appear to be secondary to the political motivation or outcome of the announcement. Addressing multiple empirical case studies, including COVID-19, this multidisciplinary book explores the relationship between international law and international relations to interrogate how a PHEIC is declared and its role in how we collectively respond to outbreaks.
When Zika made headlines in 2016, images of women cradling babies affected with microcephaly spread across the media and pulled on heartstrings. But, as this book argues, whilst this outbreak was about women and babies, this outbreak also highlighted the lack of gendered considerations in global health security. The policy response to Zika focused on limiting the spread of the virus through domestic and civic cleaning to remove mosquitoes and by asking women to defer pregnancy. Both of these actions are inherently gendered, placing the burden of responsibility for stemming the spread of disease on women. By taking Zika as its primary case but also touching on COVID-19, Feminist Global Health Security asks what the policy response to disease outbreaks tell us about the role of women in global health security. More broadly, what would global health policy look like if it were to take gender seriously, and how would this impact global disease control? Beyond raising questions of gender equity, Clare Wenham also considers global health security's lack of consideration for sustainability in epidemic preparedness and response. Wenham argues that global health security in general has thus far lacked a substantive feminist engagement, with the result that the very policies created to manage an outbreak of disease disproportionately fail to protect women. We know that women have biological pre-disposition and social vulnerability to contracting a number of infectious diseases, making them more susceptible to infection. Yet, the dominant gender-blind policy narrative of global health security has created pathways which focus on protecting the international spread of disease and state economies, rather than protecting those who are most likely to be affected. As such, the state-based structure of global health security provides the fault line for global health security's failure to engage women. This book highlights the ways in which women are disadvantaged by global health security policy, through engagement with feminist international relations concepts of visibility, social and stratified reproduction, intersectionality, and structural violence. Wenham argues that it was no coincidence that poor, Black women living in low-quality housing were the most affected by the Zika outbreak and will continue to be so amid all epidemics, until meaningful engagement with gender is incorporated into global health security. As many news reports have made clear during COVID, there has been a recent sea change in thinking about the secondary effects of infectious disease control policy on women. However, we have yet to see this reflected in global health policy.
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