In this article, I argue that in portending potentially fatal harm to immunocompromised others, certain vaccine-hesitant views create a paradox for democratic deliberation on public health matters. In this paradox, either vaccine-hesitant views entailing potential harm to others are entertained as legitimate public health policy, or these views are disallowed, excluding discussion of competing harms from the deliberative process. In either case, the result is a deliberative process in which some group is not treated with the consideration owed to free (...) and equal persons as required by the terms of democratic membership. I argue for capitalizing on and refining certain epistemic traits exhibited by anti-vaxxers to address vaccine-hesitant views and minimize this paradox. However, I make the case that this paradox cannot be completely resolved, so we should focus on certain demands of justice to protect the most vulnerable. (shrink)

Volume 20, Issue 7, July 2020, Page 169-172.

This chapter provides an overview of public health in AfricaAfrica in four main sections. One section explores challenges and promises to public health posed by the size and diversity of Africa. The second section explores the challenges and promises of Africa’s infrastructure. The third section explores existing crises like the HIVHIV/AIDSAIDS pandemic and emerging crises like food insecurity. However, in the fourth section, I suggest that Africa’s biggest public health challenges are rooted in stigma and fear.

Africa has a colonial past that renders it a linguistic melting pot, where language is not only important for communication but is inextricably related to cultural identity. In Africa, there are over 2000 languages that are still being used and spoken. Language diversity coupled with cultural diversity may affect the process of obtaining informed consent in data-intensive research. We explore some of the challenges and opportunities of multilingualism in handling informed consent in the context of data-intensive research. In multilingual contexts, (...) as in most African countries, language is exceptionally central, and translation has potential cultural, social, historical, functional and scientific importance. However, it is recognised that terminological and translation activities may not always be cost-effective or feasible. We consider alternative mechanisms of harmonisation of data-related terminology and concepts in multilingual contexts, such as iconography, graphic elicitation and other multimedia formats of information sharing. The inclusion of visual or multimedia explanations in informed consent forms can improve comprehension, enhance information transfer and learning, reduce potential vulnerabilities associated with low literacy levels or the inability to interpret technical language associated with data-intensive research, build trust with participants and their communities, and promote autonomy of potential participants. We recognise that the inclusion of visual or multimedia content to facilitate information transfer is only one component of the informed consent process for data-intensive research. Research ethics committees (RECs) should be mindful of other key considerations and challenges of informed consent for data-intensive research in sub-Saharan Africa (SSA), and to explore whether these alternative forms of consent are ethical and effective in multilingual contexts. (shrink)