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About Alex Broadbent

Director of the Institute for the Future of Knowledge and Professor of Philosophy, University of Johannesburg

Announcing ‘The Philosophy of Public Health’ by Benjamin Smart

It is a delight to share the publication of The Philosophy of Public Health by CPEMPH co-Director, Professor Benjamin Smart of the University of Johannesburg. This is an important and timely book which exemplifies the best of applied philosophical thinking: it identifies deep conceptual problems that arise in real-world contexts, and uses rigorous philosophical tools to reach conclusions that can guide public health practice.

At its core, the book develops a powerful account of health as a property of complex systems. Rather than treating health as a feature of isolated organs or discrete individuals, Ben argues that health is an emergent, capacities-dependent property instantiated at multiple biological and social levels: cells, organs, organisms, and—crucially—populations. This move allows him to dissolve familiar puzzles about “population health” and to provide a framework that aligns far more closely with what public health professionals actually confront.

A second major contribution concerns the goal of public health. Ben rejects the simplistic idea that public health should merely raise aggregated individual health scores, noting that such metrics neglect inequality, autonomy, and the broader social determinants of health. Instead, he argues that public health should aim to increase the capacities that matter for individuals’ ability to realise the goods of life—capacities that range from access to clean water and functioning healthcare systems, to education, mobility, and the structural conditions required for dignified living.

The book also provides a philosophically grounded defence of Evidence-Based Public Health that is sensitive to context, values, and the limitations of traditional hierarchies of evidence. Ben engages seriously with recent failures in global pandemic response, arguing for a more nuanced and context-aware understanding of what it means to “follow the science”.

In the final chapters, he turns to ethics and the question of decolonising public health, offering a principled but pragmatic framework for navigating public health decision-making across profoundly unequal societies. Throughout, the book is shaped by his decade of experience living and working in South Africa, but its arguments travel far beyond this context.

The result is a work that will influence both philosophers and practitioners. It is a rare example of philosophy that is simultaneously conceptually rigorous, policy-relevant, and deeply humane. I could not be more pleased to see it in print, and I recommend it warmly to anyone working in public health, philosophy of medicine, or the conceptual foundations of health policy.

Congratulations, Ben. 

The Oxford Handbook of Philosophy of Medicine

We’re delighted that the Oxford Handbook of Philosophy of Medicine has been published, the result of the efforts of over 30 philosophers from all over the world. The Handbook brings together leading thinkers to chart the evolving relationship between philosophy and medicine. Edited by Alex Broadbent, the volume examines core philosophical questions about health, truth, and evidence, alongside contemporary challenges including social justice, gender, race, and the ethics of artificial intelligence.

The handbook highlights the cultural diversity of medical traditions and the opportunities this creates for a richer philosophy of medicine. Many contributors advocate reform within both philosophy and medicine, seeking to make each more responsive, humane, and self-aware. In doing so, the collection exemplifies one of CPEMPH’s guiding ideas: that reflection on medicine can and should change both medicine and philosophy for the better.

Thinking About Drinking: Rethinking Alcohol, Addiction, and Recovery

On 11 April 2025, the Centre for Philosophy of Epidemiology, Medicine, and Public Health (CPEMPH) hosted an interdisciplinary workshop at Durham University titled Thinking About Drinking. Supported by the Wellcome Discovery Research Platform for Medical Humanities, the event brought together scholars, practitioners, and those with lived experience to critically re-examine assumptions about alcohol use, addiction, and recovery.

Key themes included:

  • The limitations of dominant epistemological and methodological approaches in alcohol research, and the case for methodological pluralism.
  • Revisiting the concept of addiction, including challenges to the disease model.
  • Embracing plural and inclusive understandings of recovery.
  • Exploring the positive and pleasurable dimensions of drinking in ethical and policy contexts.
  • Understanding alcohol use as culturally and locally situated.

The workshop exposed profound differences in how alcohol is understood across sectors, raising pressing philosophical and ethical questions: Who defines harm, recovery, or misuse? What does it mean to live well with or without alcohol? And whose vision of the good life shapes public discourse and policy?

Future directions include collaborative research bridging philosophy, public health, and lived experience.

Read the full report here

New Grant Awarded: Strengthening Contextualised Evidence Use in Public Health

We are thrilled to announce that the Centre for Philosophy of Epidemiology, Medicine and Public Health (CPEMPH) has been awarded a prestigious British Academy grant under the Evidence-Informed Policymaking Programme, funded by the UK’s International Science Partnerships Fund.

The project, “Integrating Evidence for Contextualised Public Health Policy: Lessons from South Africa”, will run from April 2025 to March 2026. Led by Professor Alex Broadbent, Nancy Cartwright, Herkulaas Combrink, Benjamin Smart, and Sarah Wieten, the project is a partnership between CPEMPH at Durham and UJ, Durham University’s CHESS, and the University of the Free State. The project aims to improve the integration of two increasingly important types of evidence in public health policymaking:

  • Model-based projections, which forecast intervention outcomes.
  • Social listening reports, which track public sentiment and identify misinformation.

Using the South African COVID-19 response as a focal case, the project will test and refine the Evidence Mapping Framework (developed by Cartwright, Munro and Kelters) to assess how these evidence types can be better contextualised and used to support effective policy design, implementation, and evaluation.

The research responds to key challenges identified during the pandemic—particularly the difficulties in combining technical modelling outputs with real-time information about community attitudes, needs, and values. By developing practical tools and refining existing methodologies, the project aims to offer transferable lessons for other countries and contexts grappling with similar challenges.

What This Means for CPEMPH

This award supports our mission to advance philosophical engagement with real-world challenges in public health, evidence use, and justice. It reinforces our role as a key international player in the field of evidence-based policy and showcases our ongoing commitment to equitable collaboration—especially through our strong partnerships with South African institutions.

What Comes Next?

Over the coming year, the project will deliver:

  • Case study analyses of modelling and social listening in South Africa
  • An extended Evidence Mapping Framework adapted to diverse evidence types
  • Policy briefs and practical guidance for public health stakeholders
  • A hybrid workshop in late 2025 bringing together researchers, policymakers, and practitioners to test and refine the tools developed

Stay tuned for updates, workshop invitations, and outputs. We’re excited to contribute to better public health policymaking—not only in South Africa, but globally.

For more information please get in touch

Philosophy of Medicine Reading Group (online)

This term we will be tackling a variety of articles rather than a monograph. I hope this added flexibility can encourage new people to join, even if they cannot make the meeting every week.

Each week there will be two online meetings of the group to discuss the same section of text, one on Wednesday night at 5pm UK time, one on Thursday morning at 9 am UK time, in hopes of accommodating group members in a variety of time zones. There is no need to attend all meetings-please come when you can.

Schedule

May 21 and 22

Pappalardo F, Russo G, Tshinanu FM, Viceconti M. In silico clinical trials: concepts and early adoptions. Brief Bioinform. 2019 Sep 27;20(5):1699-1708. doi: 10.1093/bib/bby043. PMID: 29868882

May 28 and 29 

Serrahima, C., Martínez, M. The experience of dysmenorrhea. Synthese 201, 173 (2023). https://doi.org/10.1007/s11229-023-04148-9

June 4 and 5 

Dings R, Strijbos DW. Being in a position to know: attuned responsiveness as the hallmark of experiential knowledge and expertise in mental healthcare. Front Psychiatry. 2025 Jan 13;15:1490489. doi: 10.3389/fpsyt.2024.1490489. PMID: 39872434; PMCID: PMC11770679.

June 11 and 12

Zhou, J. (2025). Pregnancy Is a Survival Pathology: A Biostatistical Approach. Philosophy of Medicine6(1). https://doi.org/10.5195/pom.2025.214

June 18 and 19

Allen, H. (2024). Forsaking Fortune: Luck and Its Limited Utility to Cancer Diagnosis. Philosophy of Medicine5(1). https://doi.org/10.5195/pom.2024.188

June 25 and 26

Woodward, J., & Kendler, K. (2023). Polygene Risk Scores: A Philosophical Exploration. Philosophy of Medicine4(1). https://doi.org/10.5195/pom.2023.156

If you would like to join the group please go to https://groups.google.com/g/philmed-rg/

Negligent Racism in COVID-19 Lockdowns

We are pleased to announce the publication of a new article by CPEMPH members Alex Broadbent (Durham University) and Pieter Streicher (University of Johannesburg), titled Was Lockdown Racist?”, in Ergo: An Open Access Journal of Philosophy.

In this paper, the authors introduce the concept of negligent racism—a form of racism that does not require intent but arises when policy choices foreseeably cause disproportionate harm to certain racial groups, and alternatives are available but ignored.

Focusing on the impact of COVID-19 lockdowns in sub-Saharan Africa, the article argues that these measures, regardless of intention, were ill-suited to the region’s socio-economic realities. The authors contend that the adoption of lockdown policies, modeled after responses in wealthier nations, led to significant harm in African contexts, where factors such as overcrowded housing, reliance on informal economies, and limited access to essential services made strict lockdowns particularly detrimental.

The paper challenges the notion that the adverse effects of lockdowns were merely consequences of existing inequalities. Instead, it posits that the global implementation of such policies, without adequate consideration of their suitability for diverse contexts, exemplifies negligent racism.

This publication contributes to ongoing discussions about equity in global health policymaking and underscores the importance of context-sensitive approaches.

📄 Read the full article here

Or listen to an AI-generated podcast about the article here…

Methodological Pluralism in Epidemiology: Lessons from Covid-19

We are pleased to share a commentary published in Global Epidemiology by CPEMPH members Pieter Streicher and Alex Broadbent, with co-author Joel Hellewell (EMBL-EBI), titled The need for methodological pluralism in epidemiological modelling.”

This paper examines two high-profile failures in Covid-19 forecasting by the UK’s Scientific Advisory Group for Emergencies (SAGE), during the Delta and Omicron waves of 2021. In both instances, projections proved not only inaccurate but too vague to be practically useful—hospitalisations were overestimated by an order of magnitude, and deaths by even more.

The authors argue that a key contributor to these failures was SAGE’s reliance on a single modelling approach: mechanistic simulation. By contrast, the South African Covid-19 Modelling Consortium adopted a pluralistic strategy—combining mechanistic and descriptive methods, learning iteratively from outcomes, and achieving far greater predictive accuracy despite far fewer resources.

The commentary makes a strong case for adopting methodological pluralism in epidemic modelling, highlighting the value of multiple, complementary perspectives when dealing with uncertainty in high-stakes contexts. The paper calls for diverse methodological inputs, critical evaluation of past performance, and more open-minded engagement with data from a variety of global contexts.

📄 Read the full article here

Reading Group Schedule: Feb-Mar 2025

This is an open international reading group, hosted by the Centre but open to all, for bringing together people with interests in philosophy of medicine construed broadly to include epidemiology, public health, biomedical science, and so on. If you would like to join, please request membership of the google group and you’ll be able to access the meeting link there: https://groups.google.com/g/philmed-rg/

Each week there will be two online meetings of the group to discuss the same text, one on Wednesday night at 5pm UK time (BST), one on Thursday morning at 9 am UK time (BST), in hopes of accommodating group members in a variety of time zones. There is no need to attend all meetings – please come when you can.

This term we will be tackling an exciting new text: Leah M. McClimans’ “Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine” published by OUP last year: https://academic.oup.com/book/56467

Weds 5 Feb and Thurs 6 Feb: McClimans, Leah M. Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine. Oxford University Press, 2024. Introduction and Chapter 1 (48 pages)

Weds 12 Feb and Thurs 13 Feb: McClimans, Leah M. Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine. Oxford University Press, 2024. Chapter 2 (26 pages)

Weds 19 Feb and Thurs 20 Feb: McClimans, Leah M. Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine. Oxford University Press, 2024. Chapter 3 (34 pages)

Weds 26 Feb and Thurs 27 Feb: McClimans, Leah M. Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine. Oxford University Press, 2024. Chapter 4 (36 pages)

Weds 5 March and Thurs 6 March: McClimans, Leah M. Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine. Oxford University Press, 2024. Chapter 5 (33 pages)

Weds 12 March  and Thurs 13 March: McClimans, Leah M. Patient-centered measurement: Ethics, Epistemology, and Dialogue in Contemporary Medicine. Oxford University Press, 2024. Chapter 6 and Conclusion (37 pages)

Weds 19 March and Thurs 20 March: TBD

If you have any difficulty accessing the text, please email cpemph@durham.ac.uk for assistance.

Any enquiries, please get in touch. And to join, it’s https://groups.google.com/g/philmed-rg/

Workshop: Thinking About Drinking – Philosophical Contributions to Human-Alcohol Interaction

11 April 2025, 9am-5pm | Register Interest

We are delighted to be hosting this workshop on Thinking About Drinking on 11 April 2025. This is not a series of stand-and-deliver talks, but a world café inspired approach to developing interdisciplinary projects on philosophical aspects of drink, drinking, and alcohol use, misuse, and harms, arising in health, social, personal, and commercial contexts. Despite recent work in other disciplines on alcohol, we believe that philosophical work in this area remains underdeveloped. At the same time, conceptual frameworks in public health, psychology, and other areas are sometimes underdeveloped or partial. An opportunity exists to connect philosophical approaches to these conceptual needs for a project that is at once intellectually novel and impactful, and this workshop supports the development of such a project. Participants are drawn from academia (including philosophy, psychology, sociology, and pharmacology), public health, clinical practice, and industry in the UK, continental Europe, and sub-Sarahan Africa.

Background

Ever since humans began to consume alcohol, they have had a difficult relationship with it. Alcohol is a colorless liquid that has, in itself, no material, cultural, or moral value. But like many other commodities, it has been ascribed complicated and often contradictory sets of values that have varied over time and place, and that are interwoven with the complexities of power, gender, class, ethnicity, and age in the societies in which it is consumed. (Phillips 2014, 1)

So Rod Phillips begins his history of alcohol. Drinking is a well-established subject of study in the social sciences. Yet philosophical literature on alcohol and alcohol use is remarkably sparse across the spectrum of traditions. A small number of books have been written about alcohol and philosophy, often with jocular titles like “The Unexamined Beer is Not Worth Drinking” (Hales 2007) or “I Drink Therefore I Am” (Scruton 2009). There is a notable vein of work on the aesthetics of wine. Elsewhere, medical and public health ethicists have discussed issues related to, for instance, liver transplants for alcohol dependent individuals or justification of alcohol policies (e.g., Gavanagh 2009; John 2018). Addiction has been a topic for philosophers of science (e.g., Burdman 2021); yet the relationship between alcohol and the – relatively recent – concept of addiction may itself be scrutinised. Philosophical interest in drinking remains niche, and there is no defined philosophical literature on alcohol, drinking, or drink.

Yet philosophical questions about alcohol are central to contemporary developments in thinking about alcohol, although commonly left implicit. Here is a selection of such questions.:

  • Is alcoholism a disease? What does/would this mean?
  • Is “alcohol” the right or only conceptual framework within which to think about drinking, given the variety of alcoholic drinks, and their different functions for individuals and in different drinking cultures, past and present?
  • Is “Alcohol Use Disorder” a medically valid category? Is it a spectrum? Is it value-laden? If so, with what values? How does it relate to alcoholism – a replacement, or a different concept?
  • Is all alcohol consumption harmful (“no safe limit”)? In what sense – health, socially, morally?
  • How should alcohol-related “harm” be conceptualized?
  • What is an acceptable limit for alcohol consumption? What does “acceptable” mean – health, social consequences, morality? Or something else?
  • How, if at all, should the longstanding spiritual significance of alcohol be accommodated in contemporary understanding? (Alcoholics Anonymous, the largest recovery programme, is a spiritual programme; alcohol has been regarded as connected to the divine, to truth, to the Devil; etc.)
  • What are the connections between humour and alcohol? Why is it so common to joke about drinking, and behaviour related to drinking? What function does humour perform and what function does alcohol perform in provoking a humorous response even in its absence?

Sometimes, these questions are explicitly discussed, as in the psychology and self-help debate about whether alcoholism is a disease. At other times, answers are assumed, for instance in leaflets by the UK’s National Health Service stating “Like tobacco, alcohol is harmful” and urging everyone to drink less.

Questions such as the nature of health and disease, the role of values in concepts of health and in medicine, the significance and proper extent of medicalisation, the scope of mental health, and the conceptual implications and foundations of measurement in medical contexts are topics of lively philosophical discussion in philosophy of medicine, epidemiology, and public health.

Workshop Rationale

With a view to discussing the possibilities for collaboration on a funded project, the purpose of this workshop is to identify philosophical issues around drinking, by bringing together those thinking about drinking in academic, professional, health, and commercial contexts.

We hope the conversation will enrich all parties, and is the beginning of a lively, fruitful, and impactful philosophical tradition that combines academic and practical interests.

Organisers

The event will be hosted by the Centre for Philosophy of Epidemiology, Medicine, and Public Health (CPEMPH), part of the Institute for Medical Humanities (IMH).

Alex Broadbent      Director of CPEMPH, and Professor of Philosophy of Science at Durham University

Saana Jukola          Assistant Professor of Philosophy at University of Twente, Netherlands

Interested?

Register your interest in attending or following the outcomes of the workshop