Examining the World Health Organization's governance and response to noncommunicable diseases: A Foucauldian analysis
Date
2020-04-29
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Abstract
The World Health Organization (WHO) is a key actor leading international cooperation to address global health problems. This dissertation focuses on how the WHO mobilizes discourse to construct and inform the international response to global health problems in its guideline and technical documents. The theoretical framework of governmentality is used as a lens to examine the WHO as a global institution that governs while unable to impose policies on sovereign Member States; thus, the WHO’s mobilizations of the discourse and evidence in its documents and document review procedures are critical for its governance. This project explores the extent to which the WHO is neoliberal and mobilizes biopolitical techniques of power. Through an in-depth, Foucauldian discourse analysis of 29 WHO guideline and technical documents from 1992-2016 and five WHO key informant interviews, this dissertation more specifically examines the WHO’s approach to noncommunicable diseases (NCDs). The dissertation shows that the WHO depicts NCDs as undermining economic and social development throughout the world, threatening the achievement of internationally agreed-upon development goals, and increasing inequalities between countries and populations. In WHO documents, NCDs are attributed to a few behaviours considered modifiable, such as dietary choices and tobacco use, although many scholars argue that this focus is ineffective in decreasing NCDs. At times, the WHO attributes the economic burden of NCDs to irresponsible individual behaviours, suggesting a neoliberal governmentality. To measure this economic burden, the WHO employs a biopolitical technique in service of neoliberalism in the form of epidemiological statistics of premature deaths. The WHO experiences several tensions in this current, neoliberal political climate as it negotiates how to protect global health and attempts to govern the global population; these tensions involve the tobacco and food industries, evidence review, and political and financial support. Furthermore, in the creation of WHO documents, the WHO’s epistemology is evidence-informed decision-making which results in systematically favouring medical evidence and excluding social science literature. I question the extent to which WHO documents are useful due to their assumptions and limitations in construction – given the need for the WHO as a global partner, and the tensions experienced by the organization.
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World Health Organization, Governmentality, Global Health Governance, Noncommunicable diseases, Modifiable behaviours, Neoliberalism, Biopolitics, Discourse analysis
Citation
Chaisson, K. G. E. (2020). Examining the World Health Organization's governance and response to noncommunicable diseases: A Foucauldian analysis (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.