Climate change: How scientism has neutralised health policy effectiveness for rural communities

Many countries have developed, or are in the process of developing, climate change adaptation policy statements, including for health. What knowledge do these policy statements value? How are rural community and Indigenous knowledges included? What are the implications of the answers to these questions for effective adaptation policy for health, particularly for rural communities? These potentially influential government policy statements have not yet been collectively analysed for the ways they reproduce particular discourses in the operation of their meaning-making for health adaptation. This international study investigates and maps health adaptation policy via a discourse analysis of an exhaustive set of twenty-one national adaptation policy documents from twelve Annex 1 countries in the United Nations Framework Convention on Climate Change. The study uses the techniques of critical discourse analysis to reveal that the national policy texts operate within an ordered universe of discourses that most values climate science and epidemiology and least values local community knowledge, needs and adaptive assets. This is true even for the discourse that emphasises particular forms of translational knowledge and methods for health services development critical to adaptation in these communities. In this respect, national adaptation policy, including for health, does not appear consistent with the prescriptions of global policy frameworks provided by the UN and WHO which emphasise local knowledges. The study’s findings are explored with reference to critiques of scientism and Foucault’s metaphor of the panopticon to suggest how national policy has worked as a mechanism for the appropriation, governance and regulation of rural communities, limiting its effectiveness.