Mind your Language: Discursive Practices Produce Unequal Power and Control Over Infectious Disease: A Critical Discourse Analysis

Mzwandile A. Mabhala, Asmait Yohannes, Alan Massey, John A. Reid


Background: Power, socioeconomic inequalities, and poverty are recognized as some of the fundamental determinants of differences in vulnerability of societies to infectious disease threats. The economic south is carrying a higher burden than those in the economic north. This raises questions about whether social preventions and biomedical preventions for infectious disease are given equal consideration, and about social institutions and structures that frame the debate about infectious disease. This article examines how institutionalized ways of talking about infectious disease reinforces, creates, and sustains health inequalities.

Methods: Critical discourse analysis was considered to be epistemologically and ontologically consistent with the aims and context of this study.

Results: The study examined three types of infectious disease: • Emerging infectious diseases/pathogens • Neglected tropical diseases • Vector‑borne infections. Examination revealed that poverty is the most common determinant of all three.

Conclusions: A sustainable reduction in infectious disease in the southern countries is most likely to be achieved through tackling socioeconomic determinants. There is a need for a change in the discourse on infectious disease, and adopt a discourse that promotes self‑determination, rather than one that reinforces the hero‑victim
scenario and power inequalities.

Keyword: Critical discourse, inequalities, infectious disease, poverty, power

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