Intro to theories of power_2022_UCL_pptx

This is an intro to the theories of power.

1. Theories of power: an introduction to power Dr. Rochelle Burgess, PhD, FRSPH Associate Professor in Global Health Deputy Director, UCL Centre for Global Non-Communicable Diseases

2. Session Outline Part 1 : Power in Global Health Global health as a field of power relations ( Shiffman ) Part 2: An introduction to power frameworks A) Three faces of power: Stephen Lukes B) Diffuse & hegemonic nature of power: Foucault, power/knowledge and discourse C) Making power visible: Power cube: Gaventa D) Remembering the person: Matrix of domination in global health (Burgess) 2

3. Power in global health Understand power to be the production of effects that shape the capacity of others to determine their own circumstances or fates …. W hy do some individuals become recognised as experts in global health ? (Shiffman, 2014)

4. Where to start… ( Power is contested ! Many categories blur into one another Power is not always visible Stephen Lukes : If someone needs to uses force, that is a failure of power – not the act of power 4 This Photo by Unknown Author is licensed under CC BY-SA-NC

5. Type of power Actors Theoretical foundations Level/spaces of action (Gaventa, 2000) Examples Physical power Militaries, police; peace keeping missions Dahl National; Global UN Peacekeeping missions Economic power States; Philanthropic entities; Corporations; transnational organisations Marxism; Gramsci Global, National International monetary fund structural adjustment policies that demand low investment in social welfare sector (health) Structural power Governments Barnett & Duval Lukes Global, National, Local Legislation on drinking age; abortion rights Institutional Organisations, government apparatuses Lukes; Foucault (bio-power) Global, National, Local Governance and management systems; policy frameworks Moral Public figures; traditional leaders; Bourdieu, Shiffman Global, National, Local Bill Gates and similar actors who gain authority Expertise (knowledge) Academics, professionals, scientists Foucault, Shiffman Boaventura de Santos Global, National Academic publications Discursive power Media, academics; think tanks; journals; local leaders Foucault, Shiffman, Global, National, Local Lancet Commissions Networks Individuals and collectives Foucault; Bourdieu; Scott Global, National, Local Treatment Action Campaign

6. Power in global health: knowledge and moral claims ( Shiffman , 2014)   structural  power : how we define ourselves in relationship to one another, in ways that enhance the capacities of some and limit those of others.  cadre of individuals medical professionals, development economists, advocacy experts who offer advice to governments of low-income countries productive  power : how we create meaning, through the use of categories that lead us to think about the world in some ways but not others. create concepts for thinking about health priority-setting, such as burden of disease, treatment cost-effectiveness and the right to receive care. Epistemic and Normative power 6

7. Epistemic and Normative power Epistemic power : expertise linked to issues in global health – namely knowledge about conditions and perspectives on interventions to alleviate distress (Knowledge) Officials in universities; academics; policy makers Normative power : expertise and insight linked to ethics and moral principles about what pathways we should take to respond to global health challenges Human rights lawyers; activists; humanitarian actors 7

8. What can we see? Faces of power (Stephen Lukes ) Stephen Lukes : If someone needs to uses force, that is a failure of power – not the act of power How do we make sense of this concept of power? Looking explicitly at how power acts or exists in particular contexts Serves particular purposes Is present or absence in relationships 8

9. Three faces of power: Stephen Lukes (2005) Many power theorists remain locked in a view of two dimensions (power over/power to) Lukes (2005) demands attention to a third dimension where positive notions of power agency and resistance are more recognised Actor focused – looking at individuals and groups

10. First face: Decision making First face of power: Power that shapes decision making Power works in ways that shape the decisions others make This can be through tangible means or intangible forms Economic power (tangible) Positional power (intangible) State structures (tangible) 10

11. Decision making: 11

12. Lukes : Three faces of power Second face of power: Agenda setting Who gets to decide what is decided? Demands for change can be muted before they are even voiced They can achieve this power through the exercise of additional power: Structural power Productive power ( Shiffman , 2014) 14

13. (c) BBC News, 2021 Agenda setting: Who defines what’s possible for climate action? 15

14. Lukes : Three faces of power Third face of power: Thought control Averting conflict through consent This is the most ‘invisible’ form of power - mind control BUT…. Gives more agency to individuals who ‘resit’ Resistance doesn't need to be overt – can also be subtle 16

15. Thought control 17

16. In summary Faces of power enables us to do particular actions with a power analysis. Platform to consider more hidden forms of power, but also….

17. Power revisited Foucault: the pervasive nature of power Part II

18. Foucault: Fourth face of power: Worked to ‘de-theorize’ power Dismantle presumptions about the nature and functioning of power

19. Foucalidan approaches to power: complexity What makes power good, what makes it accepted, is simply the fact that it doesn’t only weigh on us as a force that says ‘no’ but that it traverses and produces things, it induces pleasure, forms of knowledge….It needs be considered as a productive network… more than as a negative instance whose function is repression (Foucault, 1980)

20. Fourth face of power-over: Systems of discourse Focus on structures that shape acts or actors, or determine human behavior Fourth face of power (Foucault) Power works through discourse to shape our attitudes and thus our very “selves” Discourse: sum of what is thinkable and sayable on a topic (e.g. The west; Sustianable development goals ) Linked to the idea of the power of knowledge and disciplinarily 22

21. Example of Discourse: The ‘west’ and the rest (Hall, 1994) Hall’s work highlights the process of how the notion of the west emerges and gains power. In each of its functions we see the power of discourse – how it works to create people, ideas, actions and thoughts. The ‘totality’ of power Allows classification: creation of categories; what is and isn’t the ‘west’ Represents an idea: links to certain images and language Standard for comparison Standard for measurement and evaluation – what is good (west) what is bad (the non-west) 23 Function of the notion of the ‘west’ (discourse)

22. Foucault: Power as Knowledge and Resistance Knowledge Knowledge-power construct – they cannot be separated Linked to the way that we come to be ‘known’ and understood by others Exercising of knowledge and creation of knowledge is the exercising of power Resistance Part of the perspective that power is relational There can be no power without resistance

23. Contemporary applications of power in Health and Development: John Gaventa Gaventa (2006) interest in power in international development linked to interest in participation Draws on the works of Lukes to build a larger framework for engaging with power to make it more ‘explicit’ in the operations of development Also recognises the contributions of Foucault – in thinking about the spaces where power acts

24. Gaventa’s three faces of power Visible power : observable decision making mechanisms, winners and losers Hidden power : setting the agenda behind the scene Invisible power: social conditioning, ideology and knowledge that influence practices of others

25. Gaventa’s Power cube: Spaces Spaces explore the ways in which power is available to particular actors within your phenomenon. Closed space: only available to specific actors Invited: selected people are invited into a space Claimed/created: actors take over a space, or create new spaces for the redistribution of power to shape action

26. Challenge question: Can we use the power cube to do a power analysis?

27. Transnational surrogacy (Pande, 2013) The phenomenon of surrogacy is the intersection of two notions of labour in feminist tradition that have been historically separate Reproductive labour and formal labour participation Highlights a case/instance where reproductive labour is grounds for remuneration

28. Commercial transnational surrogacy (Davies, 2017) What are the human implications of the expansion of new reproductive technologies across borders, to become part of a billion-dollar industry that places financial interests above the health and welfare of people? Donors of genetic material doctors Recruiters agents

29. Transnational surrogacy in India Pande, 2017 I told her [the intended mother] that I want to rest for six months because of the operation. I also told her that I don’t want to go home, but rest at the clinic. And since we don’t have extra money, I want them to pay for the extra months. They are very nice people, they agreed. With my own children I had to go back to backbreaking work almost the day they [were born]. This time I can make it different (emphasis added).

30. Transnational surrogacy in India, Pande , 2014 Banning surrogacy in India will just push it underground, further stigmatizing the profession and the women involved and undermining their rights as workers… Given that countries like India will most likely lack the political will to implement effectively a ban on surrogacy, the more probable outcome.. Would be to make surrogates even more vulnerable and without protection from borkers and clients.

31. Surrogacy as an issue of power: “This vilma (broker) she takes rs 10,000 ($200) from us for getting us to the clinic. We take all the pain and she earns so much money. See we come here because we are desperate but she has made a business out of this. This shouldn’t be allowed to happen…. The couple hiring us should pay extra for people like vilma . This money means a lot to us, our children. Why should we give it to someone who is not even our relation?” ( Pande , 2013 pg. 162)

32. A field of power relations ( Shiffman , 2015) but… where is the interest in local power? 36 Normative power Epistemic power Normative power

33. What is the value of bringing this back to ‘people’ ?

34. Bringing us back to the person: Notes on resistance The roots of ’quiet’ resistance: understanding power must be taken within the context of what is possible in contexts of survival. “To conclude that slaves, serfs, peasants, untouchables and other subordinate groups are submissive because their protests and claim confirm to the dominant class they are challenging would be a serious analytical error.”, Scott, 1990 38

35. Bringing us back to the person: Black (feminist) empowerment Black scholarship on power and resistance globally is under utilized within scholarship on power in global health ( Gumbonzvanda , Gumbonzvanda & Burgess, 2021) The irony: global health is directly related to responding to the health needs of black and other racialized groups (Hirsch, 2019) but we don’t use frameworks that understand or explain their oppression as part of our analysis Patricia Hill Collins r eflections on agency, oppression and the working of power on black women in the US has much to teach us on how to create a field of power relations that doesn’t erase the power held by communities 39

36. Dialectic and subjective power relations (Collins, 2000) Dialectic power relations : think about power and agency relationships – the actions of the oppressor vs. the oppressed Subjective power relationships : Think about the power and systems that act on people, to oppress them

37. Rethinking the field of power relations: Matrix of domination in Global Health (Burgess, Forthcoming)

38. Structural Domain: Organising oppression through macro-level social structures

39. Disciplinary domain: managing the operation of power

40. Hegemonic domain: maintains oppression through shaping consciousness

41. Interpersonal domain: everyday micro-practices that maintain oppression; or enable survival

42. Concluding thoughts: The simple way, is not the best way “Oppression is filled with such contradictions because these approaches fail to recognize that a matrix of dominations contains few pure victims or oppressors…. Each individual derives varying amounts of penalty and privilege from the multiples systems that frame everyone’s lives” Collins, p.306

43. Further References Scott, J.C. (1990) Chapter four: False Consciousness: Laying it on Thick or Thin? In: Domination and the arts of resistance. Yale University Press, New York. Music credits Draw Bad Card – Bob Marley Steve Biko, Tribe called quest