Making and Unmaking Public Health in Africa

Making and Unmaking Public Health in Africa – Ethnographic and Historical Perspectives

Ohio University Press (2013)

Edited by Ruth J. Prince and Rebecca Marsland

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.

Introduction by Prince, With chapters by Tousignant, Brown, Prince and Geissler

“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.”

Henrietta L. Moore, author of Still Life: Hopes, Desires and Satisfactions

“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.”

Stacey A. Langwick, author of Bodies, Politics, and African Healing: The Matter of Maladies in Tanzania

“Anchored in a clear and nuanced political and social history, an expansive anthropological understanding of healing, and an ethnographically rich comprehension of policy as it plays out on the ground, this excellent new collection gets at the heart of the plural and contradictory meanings of the publics that underlie African public health. Together the ethnographies of public health collected here demonstrate that we cannot assume the nature of public health by reading it through the logics of contemporary global health. Instead, the anthropologists in this book call for a careful rethinking of African public health as a domain of experimentation, political imagination, and social contestation, tracing its effects on the ground, and its future possibilities on the continent.”

Julie Livingston, author of Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic