Dengue and development: a critical political ecology
Date
2012
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Abstract
Policies for the control of dengue fever often construct the mosquito-borne virus
as a disease of poverty, and call for disease control through “development” to
meet the needs of poor populations and impoverished or unsanitary spaces.
However, exceptions to the narrative of a rich/poor dengue divide persist in nonpoor
urban environments across the world. One example is Malaysia's new
administrative capital city of Putrajaya – a wealthy and centrally planned new city
with among the highest rates of dengue in the country.
This dissertation drew on theories of ecosocial epidemiology and urban
political ecology to investigate and contextualize the geography of dengue and
development in Putrajaya. Key informant interviews and critical discourse
analysis found that infectious disease control fell well below other urban priorities
for the city, and that globally dominant dengue control strategies targeted toward
poor populations were inappropriately transferred to Putrajaya's non-poor local
environment. A systematic review of the research literature found no clear
evidence showing an association between dengue and conditions of poverty.
These findings challenge conventional thinking by policy makers about
epidemiological transition and the social determinants of health.
The dissertation addresses the dearth of research into the world's neglected
tropical diseases (NTDs); in particular, gaps in our understanding of the biopolitical and socioecological contexts (sites of urban governance, sites of
health policy development and implementation, and sites of academic research) in
which policies for NTDs like dengue are determined, enacted and justified. The
dissertation further identifies non-poor urban environments – in particular those
undergoing rapid development, such as Putrajaya – as key spaces for future
geographic and political ecological research related to epidemiological transition,
economic development and the social and environmental determinants of health.
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Keywords
MALAYSIA--PUTRAJAYA, DENGUE, DISEASE CONTROL, EPIDEMIOLOGY, POLICY MAKING, URBAN ENVIRONMENT, ENVIRONMENTAL HEALTH, NEGLECTED TROPICAL DISEASES, ECO-SOCIAL EPIDEMIOLOGY, MOSQUITO BORNE DISEASES, HEALTH POLICY, BUREAUCRACY, URBAN PLANNING