Making and Unmaking Public Health in Africa: Ethnographic and Historical Perspectives(Cambridge Centre of African Studies Series)

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

Table of Contents:
* Acknowledgments * Introduction Situating Health and the Public in Africa Historical and Anthropological Perspectives RUTH J. PRINCE * Part I WHOSE PUBLIC HEALTH? * One The Peculiarly Political Problem behind Nigeria's Primary Health Care Provision MURRAY LAST * Two Who Are the "Public" in Public Health? Debating Crowds, Populations, and Publics in Tanzania REBECCA MARSLAND * Three The Qualities of Citizenship Private Pharmacists and the State in Senegal after Independence and Alternance NOEMI TOUSIGNANT * Part II REGIMES AND RELATIONS OF CARE * Four Regimes of Homework in AIDS Care Questions of Responsibility and the Imagination of Lives in Uganda LOTTE MEINERT * Five "Home-Based Care Is Not a New Thing" Legacies of Domestic Governmentality in Western Kenya HANNAH BROWN * Six Technologies of Hope Managing Cancer in a Kenyan Hospital BENSON A. MULEMI * Part III EMERGING LANDSCAPES OF PUBLIC HEALTH * Seven The Publics of the New Public Health Life Conditions and "Lifestyle Diseases" in Uganda SUSAN REYNOLDS WHYTE * Eight Navigating "Global Health" in an East African City RUTH J. PRINCE * Nine The Archipelago of Public Health Comments on the Landscape of Medical Research in Twenty-First-Century Africa P. WENZEL GEISSLER * Bibliography * Contributors * Index

About the Author :
Ruth Prince is a research fellow in the Department of Social Anthropology at the University of Cambridge and the Institute of Anthropology at the University of Oslo. Rebecca Marsland is a lecturer in the Department of Social Anthropology at the University of Edinburgh.

Review :
"The essays are in the very best tradition of medical anthropology: they display intimate political engagement, are genuinely comparative, speak to each other, and…accessibly written. …The volume opens up new vistas on public health, and challenges what we take for granted." (African Affairs) "Public health in Africa—as elsewhere—is no longer strictly public. Public and private providers are involved in national and transnational partnerships that divide responsibility for health and welfare among a number of agencies and actors. These clear and powerful essays set out this new landscape, exploring how medical professionals and patients, government officials and citizens approach questions of health. This text is required reading for anyone interested in contemporary Africa." "[The chapters] provide a fascinating range of ethnographically rich and theoretically subtle accounts of and insights into the diverse and often ambiguous practices of 'public health' across Africa. …One of the most impressive things about this volume is its integration and coherence…The result is a landmark publication that I believe will become a key text of enduring value – particularly to scholars and practitioners in the fields of public health, global health, and medical anthropology – but also to a much wider audience within and beyond anthropology." (Journal of the Royal Anthropological Institute) "A powerful and complex picture of what 'public health' is in Africa today as commitments to national health systems are being reshaped through the dramatic rise of 'global health.' This set of ethnographically rich and historically sensitive essays illustrates the forms of inequality that structure efforts to building health care institutions and that configure debates over who is responsible for the health and care of particular individuals. It is a must read for both Africanists interested in medicine and public health professionals who care about Africa." "This volume contributes significantly to the rapidly developing scholarship of public health and global health in African contexts, considered either as a collection of excellent chapters or taken as the sum of its parts. … [It] is also book-ended with trenchant, provocative commentaries on the operative theories and current practices of public health in Africa.…Making and Unmaking Public Health in Africa is an ideal fit for teaching the history or anthropology of public health at the undergraduate or graduate level." (Social History of Medicine) "Though the historical and anthropological literature on public health in Africa has tended to focus on the 'health' part of the equation, the chapters in this volume interrogate the meaning of the 'public' aspect.…Prince and Marsland argue that in recent years 'widening global and national inequalities and the emptying out of the public as an inclusive terrain' has led to a shift in health care provision to 'the arena of the market and of nongovernmental and transnational organizations' in most African settings. Individual chapters examine how Africans across the continent interpret and negotiate this chaotic, fractured terrain in a variety of contexts… Recommended." (Choice) "Any medical anthropologist who works in Africa will want this book in a nearby library. Those of us who study African biomedicine and biomedical research, whether anthropologists or historians, will find it particularly valuable. …As a whole, this excellent collection enlarges the scope of public health and challenges readers to think deeply about who is responsible for African health—and for the many threats to it." (Medical Anthropology Quarterly) "This superb new edited volume is extraordinarily timely and important." (Journal of the Royal Anthropological Institute)