GHIC 2019: Global Health & Innovation Conference
April 13-14, 2019
Yale University, New Haven, CT

Unite For Sight's 2011 Global Health & Innovation Conference

Blog Report by Daniel Ting, Unite For Sight Global Health Leadership Intern Alumnus

"A View From a Death in the Morning,'" Rebecca Hardin, PhD, Associate Professor, Department of Anthropology and School of Natural Resources and Environment, University of Michigan

At the 2009 Global Health & Innovation Conference, Rebecca Hardin, an anthropologist at the University of Michigan (and former lecturer at my alum mater, McGill University), gave a memorable talk on the socioemergence of HIV in Africa(1). This year in 2011, Hardin brought her focus to a similar emergence of Q fever in Kenya. Much like the rise of HIV in the mid 20th century, Q fever has been influenced by social and political forces.   

Q fever is a highly infectious respiratory disease characterized by fevers, pneumonia and liver damage. First described in 1937, the disease is relatively new to the biomedical world and is caused by the bacterium Coxiella burnetii. Q fever can present either as an acute disease, which is self-limiting, or as a rare chronic form, whereupon greater than 60% of patients die. In pregnant women, Q fever can cause spontaneous abortion. Q fever is insidious. C. burnetti is usually transmitted from animals to humans, harboring in asymptomatic livestock such as sheep, cattle, and goats, unnoticed by cattle farmers. Fortunately, an effective vaccine against Q fever exists.

In 2007, Kenya held presidential elections, which were marred by violence and corruption (for a timeline of the surrounding events, click here). In the fallout, Kenya introduced a new constitution in 2010. In addition to anti-corruption legislation, the new constitution divides Kenyan land ownership into public, private and community land.

According to Hardin, global health is not just human health; it is ecosystem health, and the two are inseparably linked. The Kenyan land re-distribution means that herds of livestock are migrating between territories, creating new areas of contact between animals and animals, and animals and humans. Because Q fever is highly infectious and often travels imperceptibly in animals, the emergence of the disease may become a future public health issue. Furthermore, Hardin is concerned that the Kenyan government has decided not to vaccinate the migrating livestock to prevent the spread of the disease. Instead, government policy concentrates solely on the vaccination of humans, which has hitherto fallen incomplete. More specifically, a concern would be that the uptake of Q fever vaccination would follow a socioeconomic gradient from rich to poor.  

Take-Home Messages

(1) Hardin, R., 2009. “Socioemergence: Cultural and Political Dimensions of Emergent Viral Disease in Equatorial Africa's Forests." Unite For Sight Global Health and Innovation Conference. New Haven, CT.