‘Great Leveler’? Covid-19’s Impact on Migration and Health Research

Thea de Gruchy et. al. discuss the implications of Covid-19 for migration and health research

As the Covid-19 pandemic developed, it was framed by many as a ‘great leveler (Milanovic 2020; Hiam and Yates 2021), a shared global challenge that would highlight existing, entrenched inequities, but – more importantly – create strategic opportunities for health system strengthening and progress towards Universal Healthcare Coverage (UHC). Similarly, it was hoped that the covidisation’ of research (Pai 2020) would offer opportunities to level the academic playing field, encouraging researchers to work in more inclusive, collaborative, and equitable ways to address this shared challenge. Drawing on the experiences of previous global health crises, most notably HIV (Wheaton 2021), activists and researchers warned against this optimism, highlighting how the pandemic would only exacerbate the inequalities long associated with the geopolitics of disease (Bashford 2007) and research (Cash-Gibson et al. 2018).

Some research fields, particularly where colleagues are sequencing variants and sharing vaccine technologies, have experienced improved collaboration. However, the impact and benefits of such research remains unequal. The global south – or as it is increasingly recognized, the Majority World (Alam 2008) – has consistently contributed to research on and responses to Covid-19, but remains excluded from reaping the benefits. Many African countries, for example, participated in vaccine trials but have not benefitted from the trials’ success (Makoni 2020) as a minority of wealthy countries – the Minority World – stockpile vaccines (Harman et al. 2021).

Kenneth Kamanga, 48, lost his eyesight after contracting measles as a child. “Having a disability doesn’t mean we don’t have ability. We are very capable people,” Kenneth said. Kenneth and his wife survive by selling vegetables and other snacks to the other residents of the building they live in in the Johannesburg inner-city. Picture: James Oatway, 2021, The Endless Journey. Used with permission

As forewarned, evidence emerging from the last 18 months also suggests that the ‘covidisation’ of research has further exacerbated inequities within academia, including within the field of migration and health (Pernitez-Agan et al., n.d.). To take stock of this ‘pandemic effect’ on the field of migration and health research globally, we organised a series of virtual consultations to gather perspectives on the impact of the pandemic on research, and researchers, in the field. Two of the consultations were global in nature, whilst the third focused on Southern Africa. The findings, briefly summarised below, also informed the development of a Covid-19 addendum to the Guidelines for Ethical and Equitable International Partnerships in Migration Research (Johannesburg Principles) (Migration Leadership Team 2020).

We found that, at an individual level, the lack of financial and collegial support, particularly for PhD students and early career researchers (ECRs), and the associated stress and anxiety this caused, was a key issue. Participants indicated that employers, funders, and collaborators expected researchers at all career levels and in all contexts to simply pivot to online, digital methods and Covid-19-related lines of enquiry. This has created some opportunities for novel forms of research in certain contexts. However, participants indicated that these expectations undermined existing research projects and put researchers in the uncomfortable position of having to conduct research outside of their area of expertise without the necessary methodological skills or support. Concerns were raised about what the longer-term impact of this would be on students and ECRs and, consequently, what it would mean for the future of migration and health research.

In addition, participants felt that Research Ethics Committees (RECs) were making decisions about what kind of research to approve in response to institutional concerns about risk, rather than in line with what is best for researchers and research participants. Much research has simply not been permitted. While often justifiable, this means that, in addition to impacting researchers and students, there are gaps in our understanding about the implications of the pandemic in contexts of migration. This is particularly true amongst hard-to-reach populations, and amongst those disadvantaged due to the digital divide.

The inability of researchers, specifically those based in the Minority World, to interact with research participants in person has reaffirmed the central role of interlocutors, fieldworkers, and researchers based in the Majority World. Yet contracting delays and funding cuts have most affected these individuals. The limited interest expressed by some funders and international partners in what is possible or ethical in local contexts, particularly in light of inequities in access to vaccines, is a key concern. Solidarity is needed among collaborators; until colleagues and research participants in the Majority World are vaccinated and feel it appropriate to return to face-to-face research, those in more secure positions must push back against unrealistic expectations from funders.

Due to the pandemic, many international research partnerships have struggled to conduct the research originally planned. Nonetheless, participants indicated that collaborations that were structured in a more equitable manner at their inception – including the fair sharing of risk, responsibility, and opportunity – were reported to be more resilient and flexible. This reinforces the fact that equitable and ethical international partnerships and project structures are a prerequisite for effective research.

Finally, the ‘move online’ is often said to provide opportunities for more diverse participation and engagement in collaborative activities and academic events. However, participants felt that the possibilities offered by remote ways of working have not been leveraged and reported that traditional patterns in who is invited to present and participate have persisted. Additionally, the sheer number of online events has further disadvantaged those with poor access to the internet.

Participants were unanimous: the pandemic has not been a ‘great leveler’ within the field of migration and health research. Research communities need to pause and invest time in assessing their current ‘pandemic practice’ to identify opportunities for positive change. The discussions at the consultations suggest that this requires rethinking current ways of working and building more compassionate and respectful approaches. Flexible funding is required to build diverse and responsive online spaces; to invest in improving the state of knowledge about migration and health in the context of Covid-19; and to develop online and digital research tools and methods.

 

Thea de Gruchy is a postdoctoral research fellow at the African Centre for Migration & Society at Wits University, where she works on migration and health. 

Jo Vearey is an Associate Professor & Director of the African Centre for Migration & Society at Wits University. Her research focuses on the intersections between migration and health.

Kavita Datta is a Professor in Development Geography, and Director of the Centre for Migration Studies, at Queen Mary University of London. Her research focuses on migration, food, gender and development.

Elaine Chase is Professor in Education, Wellbeing and Development at UCL Institute of Education.  Her work focuses on the impacts of migration and (im)mobility on people’s wellbeing.

Linda Musariri is a postdoc at the African Centre for Migration and Society, University of Witwatersrand and Coordinator of the African Academy for Migration Research. Her research interests are in migration, gender and development.

Heleen Tummers: Samuel Hall, the Netherlands

 

References

Alam, Shahidul. 2008. ‘Majority World: Challenging the West’s Rhetoric of Democracy’. Amerasia Journal 34 (1): 88–98. https://doi.org/10.17953/amer.34.1.l3176027k4q614v5.

Bashford, Alison. 2007. Medicine at the Border: Disease, Globalization and Security, 1850 to the Present. https://doi.org/10.1057/9780230288904.

Cash-Gibson, Lucinda, Diego F. Rojas-Gualdrón, Juan M. Pericàs, and Joan Benach. 2018. ‘Inequalities in Global Health Inequalities Research: A 50-Year Bibliometric Analysis (1966-2015)’. PLOS ONE 13 (1): e0191901. https://doi.org/10.1371/journal.pone.0191901.

Harman, Sophie, Parsa Erfani, Tinashe Goronga, Jason Hickel, Michelle Morse, and Eugene T Richardson. 2021. ‘Global Vaccine Equity Demands Reparative Justice — Not Charity’. BMJ Global Health 6 (6): e006504. https://doi.org/10.1136/bmjgh-2021-006504.

Hiam, Lucinda, and Robert Yates. 2021. ‘Will the COVID-19 Crisis Catalyse Universal Health Reforms?’ The Lancet 0 (0). https://doi.org/10.1016/S0140-6736(21)01650-0.

Makoni, Munyaradzi. 2020. ‘COVID-19 Vaccine Trials in Africa’. The Lancet Respiratory Medicine 8 (11): e79–80. https://doi.org/10.1016/S2213-2600(20)30401-X.

Migration Leadership Team. 2020. ‘The Johannesburg Principles: Building Equitable and Effective Partnerships for Migration Research’. Queen Mary University of London.

Milanovic, Branko. 2020. ‘A Great Equaliser’. Social Europe. 9 March 2020. https://socialeurope.eu/a-great-equaliser.

Pai, Madhukar. 2020. ‘“Covidisation” of Academic Research: Opportunities and Risks’. Nature Research Microbiology Community (blog). 10 April 2020. http://naturemicrobiologycommunity.nature.com/users/20892-madhukar-pai/posts/65638-covidisation-of-academic-research-opportunities-and-risks.

Pernitez-Agan, Sweetmavourneen, Mary Ann C Bautista, Janice Lopez, and Margaret Sampson. n.d. ‘Bibliometric Analysis on Covid-19 in the Context of Migration Health’, 39.

Wheaton, Sarah. 2021. ‘Why AIDS History Is Repeating in COVID-19’. POLITICO. 15 June 2021. https://www.politico.eu/article/aids-hiv-history-covid-19-coronavirus-access-inequality-antiretrovirals-drugs/.

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