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When People Come First: Critical Studies in Global Health - Softcover

 
9780691157399: When People Come First: Critical Studies in Global Health
Softcover
ISBN 10: 0691157391 ISBN 13: 9780691157399
Verlag: Princeton University Press, 2013

Inhaltsangabe

A people-centered approach to global health

When People Come First critically assesses the expanding field of global health. It brings together an international and interdisciplinary group of scholars to address the medical, social, political, and economic dimensions of the global health enterprise through vivid case studies and bold conceptual work. The book demonstrates the crucial role of ethnography as an empirical lantern in global health, arguing for a more comprehensive, people-centered approach.

Topics include the limits of technological quick fixes in disease control, the moral economy of global health science, the unexpected effects of massive treatment rollouts in resource-poor contexts, and how right-to-health activism coalesces with the increased influence of the pharmaceutical industry on health care. The contributors explore the altered landscapes left behind after programs scale up, break down, or move on. We learn that disease is really never just one thing, technology delivery does not equate with care, and biology and technology interact in ways we cannot always predict. The most effective solutions may well be found in people themselves, who consistently exceed the projections of experts and the medical-scientific, political, and humanitarian frameworks in which they are cast.

When People Come First sets a new research agenda in global health and social theory and challenges us to rethink the relationships between care, rights, health, and economic futures.

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Über die Autorin bzw. den Autor

João Biehl is the Susan Dod Brown Professor of Anthropology at Princeton University. He is the author of Vita: Life in a Zone of Social Abandonment and Will to Live: AIDS Therapies and the Politics of Survival (Princeton). Adriana Petryna is the Edmund J. and Louise W. Kahn Term Professor in Anthropology at the University of Pennsylvania. She is the author of Life Exposed: Biological Citizens after Chernobyl and When Experiments Travel: Clinical Trials and the Global Search for Human Subjects (both Princeton).

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"Rapid social change is the one constant in this ambitious volume. These pages come to life and are wrenching because they never seek to elide the messiness of experience. With ethnographic evidence from some of the most important theaters of global health, the authors give us a sound understanding of the collision of a crushing burden of disease, emerging audit cultures, and new therapeutic regimes. As case studies rooted in long familiarity but alive to overwhelming transformation, they will stand the test of time."--Paul Farmer, Harvard Medical School and Partners in Health

"Award-winning medical anthropologists João Biehl and Adriana Petryna have produced a stunning and original collection. In an era of market-driven global health interventions, this volume demonstrates anthropology's unique contribution as a critically evaluative and humanizing discipline."--Marcia C. Inhorn, Yale University

"Global health as a field is being redefined, from one based on narrow interventions to a more holistic focus on delivering value to patients. This requires a deep understanding of how to connect care delivery to patients, their families, and the local country context. When People Come First is an indispensable resource in creating the global health delivery systems of the future. Its rich case studies are essential for practitioners and scholars in designing and implementing care processes that really work."--Michael E. Porter, Harvard Business School

"Global health is a big business: the World Bank, the World Health Organization, the United Nations, the Gates Foundation, academia, pharmaceutical companies, and thousands of NGOs are working to improve health around the world. Lost among these powerful groups, the supposed beneficiaries have little to say. When People Come First tells us why and how to make global health better. It is an eye-opener, especially for those of us locked into our comfortable disciplinary silos."--Angus Deaton, Princeton University

"When People Come First is a truly pioneering volume that will change the kind of work that is done in the anthropology of global health in the future."--Richard G. Parker, Columbia University

"When People Come First sets an ambitious agenda that emphasizes ethnography as an important methodological tool for better understanding health services at all levels of analysis, including at the stages of service provision, medicine marketing, and policymaking. There is no doubt that this book will be read and widely cited by scholars of global health."--Nitsan Chorev, Brown University

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WHEN PEOPLE COME FIRST

CRITICAL STUDIES IN GLOBAL HEALTH

By JOÃO BIEHL, ADRIANA PETRYNA

PRINCETON UNIVERSITY PRESS

Copyright © 2013 Princeton University Press
All rights reserved.
ISBN: 978-0-691-15739-9

Contents

Critical Global Health JOÃO BIEHL AND ADRIANA PETRYNA.....................1
I EVIDENCE Overview.......................................................23
1 A Return to the Magic Bullet? Malaria and Global Health in the 
Twenty-First Century MARCOS CUETO.........................................		30
2 Evidence-Based Global Public Health Subjects, Profits, Erasures 
VINCANNE ADAMS.............................................................		54
3 The "Right to Know" or "Know Your Rights"? Human Rights and a 
People-Centered Approach to Health Policy..................................		JOSEPH J. AMON 91
4 Children as Victims The Moral Economy of Childhood in the Times of AIDS 
 DIDIER FASSIN.............................................................		109
II INTERVENTIONS Overview.................................................133
5 Therapeutic Clientship Belonging in Uganda's Projectified Landscape of 
AIDS Care SUSAN REYNOLDS WHYTE, MICHAEL A. WHYTE, LOTTE MEINERT, AND 
JENIPHER TWEBAZE...........................................................		140
6 The Struggle for a Public Sector PEPFAR in Mozambique JAMES PFEIFFER...166
7 The Next Epidemic Pain and the Politics of Relief in Botswana's Cancer 
Ward JULIE LIVINGSTON.....................................................		182
8 A Salvage Ethnography of the Guinea Worm Witchcraft, Oracles and Magic 
in a Disease Eradication Program AMY MORAN-THOMAS.........................		207
III MARKETS Overview......................................................243
9 Public-Private Mixes The Market for Anti-Tuberculosis Drugs in India 
STEFAN ECKS AND IAN HARPER.................................................		252
10 Labor Instability and Community Mental Health The Work of 
Pharmaceuticals in Santiago, Chile CLARA HAN..............................		276
11 The Ascetic Subject of Compliance The Turn to Chronic Diseases in 
Global Health IAN WHITMARSH...............................................		302
12 Legal Remedies Therapeutic Markets and the Judicialization of the 
Right to Health JOÃO BIEHL AND ADRIANA PETRYNA............................		325
Afterword The Peopling of Technologies MICHAEL M. J. FISCHER.............347
Contributors...............................................................375
Acknowledgments............................................................381
References.................................................................385
Index......................................................................425

CHAPTER 1

A Return to the Magic Bullet?

Malaria and Global Health in the Twenty-First Century


MARCOS CUETO

At the turn of the twenty-first century, international efforts to combatmalaria, one of the deadliest and most insidious rural scourges in modernhistory, entered a new phase, marked by the emergence of new medicaltechnologies and the greater involvement of global agencies and localhealth workers. Initially, these changes raised hopes that a holistic interventionagainst malaria would replace the "magic bullet" approach thatwas launched in the mid-1950s and put an end to the apathy that hadfollowed the failure of that initiative to achieve results. However, after afew years of innovation it now appears that most donors, as well as majorinternational health agencies, including the World Health Organization(WHO), have returned to advocating top-down programs that resemblethose of the 1950s.

An examination of recent successes and failures in malaria control illuminatescontemporary challenges and suggests that traditional assumptionsand a reliance on the medical technology advocated by some expertsstill play a key role in the design of international programs. The relevanceof history to policy discussions also becomes evident. My purpose in thischapter is to examine the recent cycle of malaria elimination and controlefforts and to raise some questions about the future of global health.

The policy changes I discuss occurred against the background of theslow but steady growth of a killer that is second in its global impact onlyto tuberculosis. Despite a general decline in malaria morbidity during the1960s and 1970s, especially in semitropical and temperate climate zones,the number of cases and deaths increased in the following years. Amongthe social factors that explain malaria's increase in the developing worldwere floods of refugees fleeing civil wars and famine, the marked precariousnessof medical systems during a period of structural adjustment, andthe growing number of unemployed rural people moving to previouslyuncultivated lands where infection rates were higher and medical carewas scarce.

In 1988, a malaria epidemic in Madagascar resulted in twenty-fivethousand deaths. By the early 1990s, the disease had resurged in almostall of the regions where it previously had been controlled, so that almosthalf of the world's population was again living in malarial areas. Around1993, over 50 percent of the population living in savanna and forest zonesof Africa was infected. In this area of the world—which had not been fullyinvolved in the previous malaria eradication campaign—malaria was themain cause of death in young children, killing one in twenty before theage of five. At the time, it was estimated that, of the 100 million clinicalcases worldwide, 80 percent occurred in Africa. Between 1994 and 1996,malaria epidemics in fourteen countries in sub-Saharan Africa caused ahigh number of deaths, many in areas previously free of the disease.

At present it is estimated that, globally, more than a million malaria-relateddeaths occur each year (about four-fifths of these in Africa), andthat about 247 million people worldwide became ill with malaria in2006. In addition, about three billion people, more than half the world'spopulation, are at risk of infection. In the Americas, according to PanAmerican Health Organization figures, about 38 percent of the populationlives in malarial areas. Malaria disproportionately affects the ruralpoor, who are more exposed to infection, have the least access to services,and suffer more from the disease's consequences.


The boom and bust of International Health

Between 1955 and the early 1960s, WHO was the unquestioned leaderof a worldwide malaria eradication campaign that embodied the hopesof the recently created field of international health. Although some precedentscan be found, it was only after the Second World War that internationalhealth emerged as an epistemic community, a subdiscipline inAmerican schools of public health, and a web of multilateral organizationsthat formed part of the United Nations (UN) system and worked inclose association with the foreign policy of the US Department of State.Among these organizations were WHO and the United Nations Children'sFund...

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Verlag
Princeton University Press
Erscheinungsdatum
2013
Sprache
Englisch
ISBN 10 
0691157391
ISBN 13 
9780691157399
Einband
Taschenbuch
Auflage
1
Anzahl der Seiten
456
Herausgeber
Biehl João, Petryna Adriana
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