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Global public health policy transfer and dengue fever in Putrajaya, Malaysia: a critical discourse analysis

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This study critically analyzed the operationalization and materialization of globally hegemonic dengue fever discourse at the local level in the city of Putrajaya, Malaysia. Textual analysis of the World Health Organization's First report on neglected tropical diseases (NTDs) (2010) identified three discursive strategies in the WHO's effort to set the agenda for research and action on neglected diseases: the nomination of dengue fever as a disease of the impoverished and voiceless other; the predication of neglected disease status on environmental and behavioural uncleanliness; and the framing of so-called ‘pro-poor’ neglected tropical disease discourse as a new paradigm under which targeting these othered people, behaviours and environments is a key strategy for NTD management and control. Further analysis of the transcripts of 14 key informant interviews conducted with experts in public health, governance and urban development in Putrajaya found that discursive links between dengue and poverty contributed to the inappropriate transfer of globally dominant dengue control strategies to Putrajaya's non-poor local environment. These findings indicate that endemic dengue emerged in Putrajaya in part because planners, health officials and residents reproduced in their plans, policies and behaviours the construction of the disease as one of the other. The findings call into question the characterization of dengue fever as a disease of poor people, unclean spaces and unsanitary behaviours, and raise new questions about the appropriateness of targeting NTD initiatives to the poor. The findings also highlight the need for locally appropriate public health policies for infectious disease control in non-poor environments.
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Keywords: critique; healthy public policy; illness

Document Type: Research Article

Affiliations: 1: School of Geography and Earth Sciences, General Science Building Room 206, McMaster University, Hamilton, ON L8S 4K1, Canada 2: Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada 3: United Nations University Institute on Water, Environment & Health (UNU-INWEH), Hamilton, ON L8P 0A1, Canada

Publication date: December 1, 2012

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