jueves, 24 de marzo de 2011

The end of medical anthropology in Canada? A manifesto.

Many people I know, all great medical anthropologists, wrote this manifesto in order to SSHRC rethink its decision on funding application and allocation in Canada for Medical Anthropologists, Medical Sociologists and other scholar doing qualitative research on health within and outside Canada.
by Janice Graham, Naomi Adelson, Sylvie Fortin, Gilles Bibeau, Margaret Lock, Sandra Hyde, Mary Ellen Macdonald, Ignace Olazabal, Peter Stephenson, and James Waldram


Social science and humanities health researchers have long considered the Social Sciences and Humanities Research Council their primary funding agency. In 2009, however, a strategic financial review of SSHRC highlighted a perceived overlap in funding from SSHRC and the Canadian Institutes of Health Research. To meet its own budget constraints, SSHRC imposed an absolute reduction in its funding for health-related research, independent of any discussions with CIHR. Social science and humanities health researchers were told that SSHRC would no longer fund their research and “to explore eligibility” with CIHR.

While CIHR has supported some medical anthropology, our researchers have had less success with CIHR for critically engaged, qualitative research, particularly in internation-al settings. CIHR had envisioned “population research” to include the social, cultural and environmental aspects of health and disease as one of the “four pillars” of research (biomedical, clinical, health systems and services, and population research) that it funds. Yet, despite this, CIHR has acknowledged “barriers to Pillar Four researchers fully participating in CIHR research.”

Many anthropologists are concerned. Even though some have had success with CIHR, this has often been accomplished only by downplaying the anthropological aspects of their work. There remain considerable impediments to supporting social sciences and humanities health research at CIHR. We note, in particular, fundamental epistemological and practical challenges with CIHR’s targeted funding priorities favouring commercial research with industry partnerships and research that addresses the needs of decision makers. Despite talk of a global health initiative, CIHR acknowledges that opportunities for the types of international research in local communities commonly conducted by anthropologists remain largely beyond CIHR’s priorities.

We are deeply concerned that what is currently understood as “qualitative health research” at CIHR does not include the critical social sciences; rather, it is evaluative and positivist in orientation. It does not derive from ethnographically based, theoretically engaged empirical studies conducted by anthropologists trained to work intensively to elicit and contextualize values and perceived health care needs at the local level. Even as CIHR is mandated to fund social sciences health research, we face a decade-long history of inattention by CIHR to the fundamental epistemological research modalities, objectives and outcomes common in the social sciences. To date, no CIHR peer-review committee is composed substantially of social scientists.

It is still unclear whether anthropological research designed to be carried out by single investigators in international settings is eligible for CIHR funding. Researchers must second-guess whether they're expected to design their research as short-term, hypothesis-driven evaluative studies, eligible for funding only if relevant to policymakers and, ultimately, to the health of Canadians, as the CIHR mandate suggests. Also unclear is whether research designed to analyze historical, social, cultural and political dimensions of the production of biomedical knowledge and related technologies and practices is acceptable. Importantly, can medical anthropology research survive in Canada if graduate students in these fields cannot get funding?

Here are a few examples of the kinds of research done by medical anthro-pologists that likely won’t be funded by SSHRC or CIHR: health impacts of Canadian aid funding to Haiti; the role of indigenous healers in primary healthcare around the world; impacts of medical tourism on Cuba; international trade in body organs. Medical an--thro-pologists and some medical sociologists are falling through the cracks in this new funding arrangement.

Health is inherently social and cultural. SSHRC has always understood this; CIHR, we fear, does not. We face the possible extermination of one of the most vibrant, high-demand and policy-relevant health disciplines, the only scholarly field that places culture at the centre of the analysis of health and that characteristically does so in both national and international contexts. In a multicultural, settler society with a substantial aboriginal population, and in a world where health is at the core of developmental, political and social issues in so many countries, where Canada otherwise wishes to have an impact, does this make any sense?

We call for a constructive consultation process with SSHRC and CIHR and invite all social science and humanities health researchers to engage in these critical discussions.

Janice Graham, who holds the Canada Research Chair in Bioethics at Dalhousie University, is president of the Canadian Anthropology Society. The nine other authors are internationally recognized scholars from universities across Canada. Their full report appears at www.cas-sca.ca.

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