Para-States and Medical Science: Making African Global Health (Critical Global Health: Evidence, Efficacy, Ethnography)

In Para-States and Medical Science, P. Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes. The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment. But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and – albeit sometimes counterintuitively - trust for their people. “The state” has morphed into the “para-state” — not a monolithic and predictable source of sovereignty and governance, but a shifting, and at times ephemeral, figure. Tracing the emergence of the “global health” paradigm in Africa in the treatment of HIV, malaria, and leprosy, this book challenges familiar notions of African statehood as weak or illegitimate by elaborating complex new frameworks of governmentality that can be simultaneously functioning and dysfunctional. Contributors. Uli Beisel, Didier Fassin, P. Wenzel Geissler, Rene Gerrets, Ann Kelly, Guillaume Lachenal, John Manton, Lotte Meinert, Vinh-Kim Nguyen, Branwyn Poleykett, Susan Reynolds Whyte Contents......Page 6 Introduction: A Life Science in Its African Para-State (P. Wenzel Geissler)......Page 8 Part I: Rupture, Continuity......Page 52 Chapter 1. Treating to Prevent HIV: Population Trials and Experimental Societies (Vinh-Kim Nguyen)......Page 54 Chapter 2. Trialing Drugs, Creating Publics: Medical Research, Leprosy Control, and the Construction of a Public Health Sphere in Post-1945 Nigeria (John Manton)......Page 85 Part II: Pasts, Futures......Page 108 Chapter 3. Lessons in Medical Nihilism: Virus Hunters, Neoliberalism, and the AIDS Pandemic in Cameroon (Guillaume Lachenal)......Page 110 Chapter 4. What Future Remains? Remembering an African Place of Science (P. Wenzel Geissler)......Page 149 Part III: State Remains......Page 184 Chapter 5. International Health and the Proliferation of “Partnerships” : (Un)Intended Boost for State Institutions in Tanzania? (Rene Gerrets)......Page 186 Chapter 6. Working and Surviving: Government Employees on ART in Uganda (Susan Reynolds Whyte)......Page 214 Part IV: Affective Wholes......Page 242 Chapter 7. Molecular and Municipal Politics: Research and Regulation in Dakar (Branwyn Poleykett)......Page 244 Chapter 8. The Work of the Virus: Cutting and Creating Relations in an ART Project (Lotte Meinert)......Page 264 Part V: Struggling Nation......Page 286 Chapter 9. The Blue Warriors: Ecology, Participation, and Public Health in Malaria Control Experiments (Uli Beisel)......Page 288 Chapter 10. The Territory of Medical Research: Experimentation in Africa’s Smallest State (Ann H. Kelly)......Page 310 Chapter 11. Adventures of African Nevirapine: The Political Biography of a Magic Bullet (Didier Fassin)......Page 340 Contributors......Page 362 Index......Page 364 Treating To Prevent Hiv : Population Trials And Experimental Societies / Vinh-kim Nguyen -- Trialing Drugs, Creating Publics : Medical Research, Leprosy Control, And The Construction Of A Public Health Sphere In Post-1945 Nigeria / John Manton -- Lessons In Medical Nihilism : Virus Hunters, Neoliberalism, And The Aids Crisis In Cameroon / Guillaume Lachenal -- What Future Remains? Remembering An African Place Of Science / Paul Wenzel Geissler -- International Health And Proliferation Of Partnerships : (un)intended Boost For State Institutions In Tanzania? / Rene Gerrets -- Working And Surviving : Government Employees On Art In Uganda / Susan Reynolds Whyte -- Molecular And Municipal Politics : Research And Regulation In Dakar / Branwyn Poleykett -- The Work Of The Virus : Cutting And Creating Relations In An Art Project / Lotte Meinert -- The Blue Warriors : Science, Democracy, And Public Health In Malaria Control Experiments / Uli Beisel -- The Territory Of Medical Research : Experimentation In Africa's Smallest State / Ann Kelly -- Adventures Of African Nevirapine : The Political Biography Of A Magic Bullet / Didier Fassin. P. Wenzel Geissler, Editor. Includes Bibliographical References And Index. Issued Also Online.