Kyle Poplin

Weekly Roundup – Taking Issue with the Meaning (and Quantity) of Global Health Verbiage

Words have meaning. Very specific meaning, as I learned this week in the world of global health.

Writing about tuberculosis in BMJ, the peer-reviewed medical journal, Mike Frick, Dalene von Delft and Blessina Kumar triple-teamed the “stigmatizing language still commonplace in research and practice” surrounding the disease. They say the use of certain terms, which “remain rife in journal articles, conference abstracts, and even some treatment guidelines, as well as in technical expert meetings,” tend to imply the victim is at fault.

Examples of words that “invoke metaphors of transgression and punishment” are: “treatment default,” “tuberculosis suspect,” “compliance” and “research subjects.” Better to use words, they say, that imply “dignity and cure,” such as: “treatment non-completion,” “person to be evaluated for tuberculosis,” “adherence” and “research participants.”

Hurtful language has no place in global health care (or anywhere else, these days), as the authors rigorously point out. But, in the spirit of healthy debate, I’d argue that parsing English words in an effort to weigh their potential to victimize tuberculosis patients who, in many cases, don’t speak English and have much bigger concerns, seems … distracting. Aren’t there already enough concrete failings to worry about when it comes to a disease that could kill 75 million over the next 35 years?

That’s a new debate. But an old one popped back up this week, too. Muhammad Yunus, who won a Nobel peace prize as the founder of the “microcredit revolution,” took issue with a question from Business Today which included “BoP.”

“We do not use the term ’Bottom of the Pyramid,’ or BoP, as it is being used by other groups who see it as a market opportunity,” Yunus said. “I feel their approach gives a wrong impression about microcredit.”

There’s long been discussion of how to segment the “BoP” and who to include, but it’s not time to give up on the term completely, is it? Doesn’t it still represent a concise way to describe the planet’s poorest socioeconomic group?

In yet another word debate, there was a backlash about the updated version of the documentary television show “The Vaccine War” that aired this week on public television in the U.S. Many felt the show’s use of certain words legitimized anti-vaxxers and gave false balance to a debate long-since settled in the scientific community.

Specifically, authors like Tara Haelle took issue with the title “vaccine war,” the Twitter hashtag #VaccineWars (which Haelle storified) and references to an anti-vaxxer as a “vaccine watchdog.” In my mind, the war is settled and the term “watchdog” should be reserved for those helping, not hurting, worthy pursuits – like saving millions of lives through vaccinations.

What’s your take on word microfocus? Have you seen any examples lately that gave you pause? If so, tell us about them in the comments section below.

What do you really think?

Continuing the precise words theme, many have shared The Economist’s unsparing take on the UN’s proposed list of Sustainable Development Goals (SDGs). The editorial makes its point crystal clear, at various points referring to the goals as “a mess,” “a distraction,” “pure fantasy” and “so sprawling and misconceived that the entire enterprise is being set up to fail.”

The SDGs are meant to build on the Millennium Development Goals (MDGs), which have a “decent record,” according to The Economist. But where there were eight MDGs with 21 sub-targets, the SDGs include 169 proposed targets grouped into 17 goals. “These are ambitions on a Biblical scale, and not in a good way,” the editorial says.

“The backers of the SDGs concede from the outset that not all countries will meet all the targets – an admission that robs the goals of the power to shame. The MDGs at least identified priorities and chivvied along countries that failed to live up to their promises; a set of 169 commandments means, in practice, no priorities at all.”

And, while “the MDGs were broad enough to allow local variation,” the SDGs are so narrow “that they will lead to cookie-cutter development policies, which will almost certainly work less well.”

But all is not lost, according to The Economist. With approval of the SDGs set for September, there’s still time to prune the list to 10 goals aimed at poverty reduction, education and health.

This is a debate that could, and should, continue for months.

Dusting diarrhea

There’s no such thing as magic dust. Or is there?

We’ve been reading about the “affordable” toilet powder under development by multinational company RB India (formerly Reckitt Benckiser), and it sure sounds magical.

According to stories and press releases, this “poo powder” is designed to be sprinkled in latrines, where it breaks down feces into water and biogas and keeps flies away, limiting the spread of disease and diarrhea. It’s even organic and smells “like a combination of lemongrass, lemons and grapefruit.”

It’s part of a partnership between RB and Save the Children’s Stop Diarrhoea program and is designed for use in India, where most of the 1.2 billion people relieve themselves outside – and where almost 600,000 children younger than 5 die from diarrhea each year. The program also includes an antibacterial soap bar.

In Case You Missed It … This Week on NextBillion

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Kyle Poplin is the editor of NextBillion Health Care.

Health Care, Impact Assessment
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