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Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for “resource-poor” hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science. Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money—as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.
Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for “resource-poor” hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science. Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money—as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.
Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for “resource-poor” hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science. Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money—as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.
This collection is dedicated to the diagnostic moment and its unrivaled influence on encompassment and exclusion in health care. Diagnosis is seen as both an expression and a vehicle of biomedical hegemony, yet it is also a necessary and speculative tool for the identification of and response to suffering in any healing system. Social scientific studies of medicalization and the production of medical knowledge have revealed tremendous controversy within, and factitiousness at the outer parameters of, diagnosable conditions. Yet the ethnographically rich and theoretically complex history of such studies has not yet congealed into a coherent structural critique of the process and broader implications of diagnosis. This volume meets that challenge, directing attention to three distinctive realms of diagnostic conflict: in the role of diagnosis to grant access to care, in processes of medicalization and resistance, and in the transforming and transformative position of diagnosis for 21st-century global health. Smith-Morris’s framework repositions diagnosis as central to critical global health inquiry. The collected authors question specific diagnoses (e.g., Lyme disease, Parkinson's, andropause, psychosis) as well as the structural and epistemological factors behind a disease’s naming and experience.
This is a lively and original book, which treats Western biomedical discourse about illness in Africa as a cultural system that constructed "the African" out of widely varying, and sometimes improbable, materials. Referring mainly to British dependencies in East and Central Africa in the late nineteenth to the mid-twentieth century, it draws on diverse sources ranging from court records and medical journals to fund-raising posters and "jungle doctor" cartoons. Curing Their Ills brings refreshing concreteness and dynamism to the discussion of European attitudes toward their others, as it traces the shifts and variations in medical discourse on African illness. Among the topics the book covers are the differences between missionary medicine, which emphasized individual responsibility for sin and disease, and secular medicine, which tended toward an ethnic model of collective pathology; leprosy and the construction of the social role of "the leper"; and the struggle to define insanity in a context of great ignorance about what the "normal African" was like and a determination to crush indigenous beliefs about bewitchment. The underlying assumption of this discourse was that disease was produced by the disintegration and degeneration of "tribal" cultures, which was seen to be occurring in the process of individualization and modernization. This was a cultural rather than a materialist model, the argument being that Africans were made sick not by the material changes to their lives and environment, but by their cultural "maladaptation" to modern life. The "scientific" discourse about the biological inferiority of "the African," traced by one school of scientists to defects in the frontal lobe, makes painful reading today; it persisted into the 1950s.
This book combines evidence from natural and social sciences to examine the impact on Africa of seven cholera pandemics since 1817, particularly the current impact of cholera on such major countries as Senegal, Angola, Mozambique, Congo, Zimbabwe and South Africa. Myron Echenberg highlights the irony that this once-terrible scourge, having receded from most of the globe, now kills thousands of Africans annually - Africa now accounts for more than 90 percent of the world's cases and deaths - and leaves many more with severe developmental impairment. Responsibility for the suffering caused is shared by Western lending and health institutions and by often venal and incompetent African leadership. If the threat of this old scourge is addressed with more urgency, great progress in the public health of Africans can be achieved.
Africa has emerged as a prime arena of global health interventions that focus on particular diseases and health emergencies. These are framed increasingly in terms of international concerns about security, human rights, and humanitarian crisis. This presents a stark contrast to the 1960s and ‘70s, when many newly independent African governments pursued the vision of public health “for all,” of comprehensive health care services directed by the state with support from foreign donors. These initiatives often failed, undermined by international politics, structural adjustment, and neoliberal policies, and by African states themselves. Yet their traces remain in contemporary expectations of and yearnings for a more robust public health. This volume explores how medical professionals and patients, government officials, and ordinary citizens approach questions of public health as they navigate contemporary landscapes of NGOs and transnational projects, faltering state services, and expanding privatization. Its contributors analyze the relations between the public and the private providers of public health, from the state to new global biopolitical formations of political institutions, markets, human populations, and health. Tensions and ambiguities animate these complex relationships, suggesting that the question of what public health actually is in Africa cannot be taken for granted. Offering historical and ethnographic analyses, the volume develops an anthropology of public health in Africa. Contributors:Hannah Brown, P. Wenzel Geissler, Murray Last, Rebecca Marsland, Lotte Meinert, Benson A. Mulemi, Ruth J. Prince, Noémi Tousignant, and Susan Reynolds Whyte

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