Clinical assistant professor of Health Systems and Population Health (HSPop) and World Health Organization (WHO) consultant Akhenaten S. Tankwanchi expounds upon his varied research interests, including vaccine hesitancy and skilled migration. His latest publication is a chapter in the textbook Race and Research.
The question of how to treat human subjects in medical trials is fraught. History is littered with examples of medical malpractice, including the infamous Tuskegee Syphilis Study. As scholars have often noted, people of color have disproportionately been subjected to unethical experiments.
A new textbook, Race and Research: Perspectives on Minority Participation in Health Studies, grapples with how to ensure racial equity for both researchers and subjects. Clinical assistant professor Akhenaten Siankam Tankwanchi co-authored a chapter, “International Perspectives on Race in Research,” which he also expanded into a separate journal article.
“The historical issues we reviewed include research neocolonialism or the treatment of indigenous populations as mere disease reservoirs suitable for extraction, and the marginalization of local investigators,” Tankwanchi explained.
They also assessed proposed reforms in global research ethics, including efforts to recruit Indigenous researchers studying HIV/AIDs. Tankwanchi has a personal connection to the material stemming from his upbringing in Cameroon.
“As the scientific study of human behavior, psychology enables the exploration of concepts like motivation, intention, place attachment, well-being, acculturation and relational process, many of which are intangible but important for understanding micro-level determinants of skilled migration.”
–Akhenaten S. Tankwanchi
“I cumulate in one Black body the burden of three Western colonial experiences—Cameroon was a German colony before being split between France and Great Britain after World War 1,” he reflected.
Applying a Psychological Lens to Global Health
Tankwanchi’s background in clinical psychology informs his public health work. After he moved to the US to complete his MS in clinical psychology in 2003, he became “disenchanted” with the biomedical model of mental illness. He sought to understand sociocultural factors for mental illness such as social determinants of health. This led to pursuing his PhD in community psychology in an interdisciplinary program at Vanderbilt University. When he took a course at the Vanderbilt Institute for Global Health focusing on resource-limited countries like Cameroon, he was hooked.
One of Tankwanchi’s chief research interests, vaccine hesitancy, lies at the nexus of public health and psychology. He has examined vaccine hesitancy (either the delay or the outright refusal to get recommended vaccinations) among migrant communities, both before and after the COVID-19 pandemic.
“Among minoritized groups in Western societies, the reluctance to vaccinate despite access to health services and availability of vaccines may be driven largely by issues of trust, a concept which is best studied by psychology,” he explained.
Tankwanchi has pushed the field to consider deeper cultural explanations for vaccine hesitancy. His review papers have found that concerns about vaccines, including the fear that HPV vaccines encourage promiscuity, can be passed down through multiple generations after migration.
The Psychological Dimension of Skilled Migration
“As the scientific study of human behavior, psychology enables the exploration of concepts like motivation, intention, place attachment, well-being, acculturation and relational process, many of which are intangible but important for understanding micro-level determinants of skilled migration,” he explained.
As a postdoctoral researcher at the University of Witwatersrand in South Africa, Tankwanchi became fascinated by the phenomenon of African physicians migrating en masse, which has led to brain drain and workforce shortages. In the context of ongoing HIV, tuberculosis, and other infectious disease epidemics, such brain drain can exacerbate poor health outcomes.
After reading his paper on the topic, the WHO enlisted Tankwanchi to contribute to their pilot policy research project on the ethical management of physician migration from five African countries to Europe. A few years later, the WHO again enlisted Tankwanchi to “develop a policy brief that documented evidence of health worker unemployment in lower-middle-income countries experiencing health workforce shortage,” he explained. When the COVID pandemic erupted, he co-authored several rapid policy briefs for the WHO geared towards African leaders.
Tankwanchi’s career has taken him all over the world, from Johannesburg to Seattle, but he often returns, at least in spirit, to the countries where he grew up.
“I do not consider my interest in global health as the outcome of some inspiration or epiphany. Rather it is the expression of a yearning to stay connected and informed about the needs of the resource-limited countries that shaped my upbringing and early adulthood,” he reflected.