Is it time to start rethinking endings in global health emergencies?

(Pictured: LJMU's Professor Ruth Ogden, third from right, at the 'After the End' research project launch)

LJMU is part of an innovative £9 million Wellcome Trust funded project which has launched this month

The ‘After the End’ project aims to improve the way in which we end global health emergencies by critically examining how endings are determined and what happens after the end is declared.

Professor Ruth Ogden leads LJMU’s role on the project alongside academics from around the world including the University of Oxford. Ruth and the project team will be conducting research in countries including the UK, Sierra Leone, Brazil and China to analyse lived experiences of life after the end of global health emergencies to establish how endings can be better determined.

"Declarations of endings are often mis-timed"

Research by the team has determined that during global health emergencies, governments, scientists and aid organisations mobilise to ‘end’ the crisis. For governments, declaring a crisis as ‘over’ carries significant political capital and for citizens, a return to normality is often eagerly anticipated. The desire for clearly discernible and singular ending means that declarations of ending are often mis-timed, coming too early or too late for many of those affected.

Historical analysis shows that 'the end' is often arbitrary, and rarely experienced in unison by everyone affected. Ebola, for example, was declared 'over' 14 times between 2018 and 2020. Similarly, despite the WHO 'ending' COVID-19’s status as a ‘public health emergency of international concern’ in May 2023, COVID-19 still circulates widely, and for those with long-covid, the impact may never be over. The desire to rapidly end crises also suppresses counter-narratives and undermines social, environmental, political and epistemic justice when those ‘left behind’ are excluded from discussions of whether the end has been achieved, or is achievable, and if so when and how.

Specifically, Professor Ogden will examine how we better understand 'when' is the right to start and stop global health interventions. By examining the legal, social, psychological, ethical and historical determinants of endings, the project will develop new frameworks for endings which produce fairer more equitable futures for all affected.

Professor Ruth Ogden said:

“This eight-year project offers a unique opportunity for radical interdisciplinary work to explore how the framing and experience of 'endings' shapes outcomes for individuals and societies following crises. By exploring alternative narratives of endings and what happens afterwards, we hope to bring time and timing to the forefront of decision-making and global health policy.”

Find out more about the ‘After the End’ research project.