Circle U. Chair Programme: The Politics of Sustainability in Global Health

Eivind Engebretsen is appointed as Chair of Global Health at the European University Alliance Circle U, with the mission to explore the interface between global health and democracy. Here you can read his mission statement.

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My chair covers two thematic areas, global health and democracy, and explores the interface between them. More specifically, I interrogate the global ambition that underpins the sustainable development paradigm in global health by exploring some of the core concepts on which the agenda is based, such as sustainability, well-being, equity, partnership and empowerment.

My overall mission is to design and test a corpus-assisted datathon model for student-led, empirically informed debate of key concepts in the sustainability agenda.

Paradoxes of Sustainability

Key global health concepts have come to accommodate various and sometimes conflicting ideological messages, such as an urge for global solidarity and a requirement for self-management and improvement (Engebretsen, Heggen, Das, Farmer and Ottersen 2016).

My argument is that the inherent paradoxes of such key concepts and the instability of their meaning allow them to be co-opted and made to serve goals that mask certain vulnerabilities and are at odds with the SDG vision of leaving no-one behind.

The promise of global solidarity offered by the SDGs, for instance, is transformed into a mechanism of exclusion when medical treatments that we take for granted are deemed ‘unsustainable’ in those communities where the demand for treatment is greatest. As Paul Farmer has noted, “The kind of care that ‘we’ receive isn’t ‘affordable’ or ‘sustainable’ for ‘them’ – the poorer inhabitants of indebted countries under pressure to shrink their public budget and healthcare payroll” (Farmer 2015). Sustainability has become a container for conflictual ideologies and logics: it functions both as a promise and an obligation, as a gift and as a weapon. 

An important obstacle hampering the successful uptake of the sustainability agenda, moreover, is that key concepts underpinning the SDGs are regarded as one size fits all, allowing the implementation process to be reduced to a delivery pipeline, and hence leading to a democratic deficit (Engebretsen and Heggen 2015). Concepts such as sustainability, empowerment, partnership and resilience tend to gloss over conceptual differences, conflicts and paradoxes based on the false assumption of a neutral and superior rationality situated outside and above the world (a Cosmotheros) from which the concept can be universally defined (Nancy 2002).

While this is true even within the same social and linguistic sphere, it becomes more evident when we examine the counterparts of such concepts in other languages – for example, solidaritet (solidarity), samarbeid (partnership/collaboration) and likestilling (equality) in Norwegian, or musawaa (equality) and tamkeen (empowerment) in Arabic.

At the same time, if acknowledged and carefully analysed, conceptual paradoxes and ambivalences, together with divergent cultural understandings of key concepts relating to the sustainability agenda, can be deployed critically as a lever for democratic debate and radical change, a means of sensitizing students to cultural differences, and a robust basis on which to conduct fruitful cross-cultural dialogue.

A cornerstone of my Circle U research and educational agenda will therefore be to create the resources, tools, training opportunities and conditions that can allow a new generation of students to address such paradoxes through productive (rather than antagonistic) disagreement, and hence contribute to strengthening democratic governance and debate in and beyond their respective societies.

Grassroot Discourses

Through socially engaged education and research, moreover, I aim to give voice to and learn from the extensive, on the ground experience of global health organisations and activist collectives situated outside (and at times in tension with) the mainstream institutions that set the sustainability agenda globally.

These organisations and collectives question some of the principles and approaches of institutional governance in the area of global health on the basis of how they see these principles deployed in practice and how their implementation impacts their communities. They question what they see as the cosmetic use of buzz words such as empowerment, partnership, equality and diversity, among others, and campaign to change policy on various issues.

Their experience and alternative views on issues such as equity and well being can, if analysed and acknowledged, enrich and encourage a more democratic and bottom-up realization of the sustainability agenda in global health.

Giving voice to such groups and learning from their experience means creating various forums through which they can be heard: not once, or twice, but repeatedly, in many venues, by different constituencies, and in different types of context.

A preliminary step towards achieving this goal involves identifying the venues (be they blogs, magazine articles or campaigning leaflets) through which the groups in question articulate their alternative views on the nexus between global health, sustainability and governance.

This will be followed by a carefully thought out plan for documenting, understanding and disseminating these discourses among various constituencies – starting, importantly, with educational contexts.

Oslo Medical Corpus

My method for capturing and analysing these discourses in the first stage of this multi-pronged research and educational agenda involves creating the Oslo Medical Corpus, currently under construction at the Centre for Sustainable Healthcare Education (SHE), in collaboration with the Genealogies of Knowledge Research Network (GoK), and ensuring that they are well represented in it.

This is a unique, large suite of freely accessible electronic corpora running into tens of millions of words, accompanied by a novel, open-source corpus analysis and visualization interface to support a wide range of empirical studies into various discourses on global health, both mainstream and non-mainstream.

The corpora, together with sophisticated software and visualization tools, will be readily accessible to students and researchers to conduct studies on both official and grassroots discourses. These resources will feature prominently – though not exclusively – in the datathons described below.

Plan of Action

My plan will be realised through seven tasks that will involve students, colleagues and collaborators from Circle U partner universities:

  1. I and my team, including MA and PhD students, will draw on the Oslo Medical Corpus and harness the power of technology to demonstrate – through a series of empirical studies – the historical and contingent nature of the core concepts underpinning various mainstream discourses on sustainability and sustainable development in global health across several languages, their co-optation in industry and politics, and failure to accommodate certain vulnerabilities and world views beyond the Global North. Apart from English, these languages will provisionally include Norwegian, French, and at a later stage Arabic and Spanish, all of which are important languages into which most mainstream discourses on sustainability and global health are regularly translated.
  2. We will use the same resources in a further series of empirical studies that will analyse alternative visions of sustainability and related concepts in the discourses of grassroots organisations and activist collectives across the same set of languages, and will ensure that the findings of these studies are widely disseminated among a range of different stakeholders, including Circle U Associated Partners.
  3. Focusing on the educational dimension of my mission, I will implement a three-stage plan, the first stage of which I will initiate by organising a series of workshops to introduce interested students from Circle U partner universities to the methodology of corpus analysis, and train them in the use of the Oslo Medical Corpus and associated software. This is an important preliminary step to prepare the ground for the datathon events mentioned earlier and outlined in 4 below.
  4. The second stage of this educational plan will involve organising datathons during which students will be able to put what they learned about corpus analysis into practice. Inspired by Aboab and colleagues, I propose to adapt the computer industry’s hackathon model – a hackathon being an event in which diverse professionals work together on software development – to accommodate the collective analysis of textual data (in this case corpora). In hackathons, participants are typically brought together over a short period of time to form interdisciplinary teams and answer research questions related to a specific topic. The aim is to “establish a platform for the real-time, respectful, and effective exchange of ideas among specialists who are usually separated by time, space, methods, attitudes, and terminology” (Aboab et al 2016).  Textual analysis based on a readily accessible corpus such as the one being created by SHE in collaboration with GoK is particularly suited to this model since the data will be openly available to the research community through an electronic interface developed by members of my team in a previous project and further adapted to the needs of my extended agenda for Circle U. My adaptation of the concept of ‘hackathon’ will thus involve organising a range of highly interactive, interdisciplinary fora (conceived as ‘datathons’) in which colleagues and students from partner universities, who will have already received training in corpus analysis, will participate in live, hands on brainstorming sessions that involve looking closely at corpus evidence for claims and counter claims about sustainability and related concepts. Supported by the training outlined in 3 above, students who are new to corpus-based analysis will be able to discuss such paradoxes partly on the basis of the findings of empirical studies undertaken in tasks 1 and 2 above, and partly through live, hands on interrogation of the Oslo Medical Corpus to hone their analytical skills, and to expose them to different and novel interpretations of the data arising from their own analysis or the analysis of other datathon participants. External partners with disparate but potentially synergistic and complementary knowledge and skills will be invited to attend parts of these datathons and to discuss some of the paradoxes and conflicts relating to sustainability and global health identified by students during the datathons.
  5. In the third and final stage of this educational plan, I will arrange a series of student-led follow up workshops involving a variety of stakeholders and grassroots collectives in which participants will be encouraged to work together, and with different stakeholders, to propose strategies for reframing the SDG indicators relevant to global health in a way that takes the paradoxes attested in empirical studies and live corpus interrogation into account. Students will also be encouraged to explore ways in which the SDGs might be revised or extended to accommodate the priorities and world views of grassroots organisations, including those located in the Global South.
  6. My educational mission will extend beyond the datathon-driven, three-stage plan and beyond Global Health to include interdisciplinary PhD-level training in the critical analysis of key concepts in both the Sciences and Humanities. I will co-design with collaborators from other Circle-U Universities a joint PhD course that examines the history and multiple understandings of key concepts such as global, local, evidence, culture, context, nation, gender, rationality, reason and probability.
  7. Finally, together with my colleague and Circle U Chair of Democracy Professor Tobias Bach, I have already launched a seminar series entitled Evidence and Democracy in Times of Crisis, which will serve as a platform for showcasing cutting-edge research and educational innovation related to this theme. These seminars will be hosted by different collaborating institutions in order to ensure equal opportunity for students and staff to shape the content of the series and engage with various topics and speakers in their own institutional settings.

A new European University

By 2025, Circle U. is an inclusive, research-intensive and interdisciplinary European university. Students, academic staff and partners from civil society, businesses and the public sector collaborate to jointly develop competencies and solutions for keeping Europe and our planet healthy, peaceful, democratic and prosperous.

The Academic Chairs will work together in networks (knowledge hubs) to carry out their individual missions. 

Oslo Team

Mona Baker, Affiliate Professor (Leader of the Oslo Medical Corpus), SHE

Kristin Heggen, Professor/Director, SHE

Tony Sandset, Researcher, SHE

Ida Lillehagen, Researcher, SHE

Gina Fraas Henrichsen, Researcher SHE

Hilde Vandeskog, PhD Researcher, SHE

Gabriela Saldanha, Affiliate Researcher, SHE

Circle U Partners

Antoinette Mary Fage-Butler, Associate Professor, University of Aarhus

Loni Kraus Ledderer, Associate Professor, University of Aarhus

Btihaj Ajana, Professor, King’s College

Irena Fiket, Associate Professor, University of Belgrade

Other Partners

Jan Buts, Boğaziçi University, Turkey

Henry Jones, University of Manchester, UK

Kyung Hye Kim, Shanghai International Studies University, China

Saturnino Luz, University of Edinburgh, UK

Maeve Olohan, University of Manchester, UK

Luis Pérez-González, University of Agder, Norway

Shane Sheehan, University of Edinburgh, UK


Centre for Sustainable Healthcare Education (SHE)

Tags: sustainable health care, SDGs, Education
Published Sep. 11, 2021 2:24 PM - Last modified July 1, 2022 10:43 PM