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Putting Anthropology into Global Health

A Century of Anti–Human African Trypanosomiasis Campaigns in Angola

Jorge Varanda and Josenando Théophile

This analysis of over a century of public health campaigns against human African trypanosomiasis (sleeping sickness) in Angola aims to unravel the role of (utopian) dreams in global health. Attention to the emergence and use of concepts such as neglected tropical diseases (NTDs) and ideas about elimination or eradication highlights how these concepts and utopian dreams are instrumental for the advancement of particular agendas in an ever-shifting field of global health. The article shows how specific representations of the elimination and eradication of diseases, framed over a century ago, continue to push Western views and politics of care onto others. This analysis generates insight into how global health and its politics of power functioned in Angola during colonialism and post-independence.

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Sarah B. Rodriguez

As many have noted, global health is now ‘fashionable’ in the United States, with philanthropies, governments and universities interested in the field ( Brown 2008 ; Koplan et al. 2009 ). A central part of a commonly recognised definition of global

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Sara Van Belle

In this article, I set out to capture the dynamics of two streams within the field of global health research: realist research and medical anthropology. I critically discuss the development of methodology and practice in realist health research in low- and middle-income countries against the background of anthropological practice in global health to make claims on why realist enquiry has taken a high flight. I argue that in order to provide a contribution to today’s complex global issues, we need to adopt a pragmatic stance and move past disciplinary silos: both methodologies have the potential to be well-suited to an analysis of deep layers of context and of key social mechanisms.

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Diane Duclos, Sylvain L. Faye, Tidiane Ndoye and Loveday Penn-Kekana

The notion of performance has become dominant in health programming, whether being embodied through pay-for-performance schemes or through other incentive-based interventions. In this article, we seek to unpack the idea of performance and performing in a dialogical fashion between field-based evaluation findings and methodological considerations. We draw on episodes where methodological reflections on performing ethnography in the field of global health intersect with findings from the everyday practices of working under performance-based contracts in the Senegalese supply chain for family planning. While process evaluations can be used to understand contextual factors influencing the implementation of an intervention, we as anthropologists in and of contemporary global health have an imperative to explore and challenge categories of knowledge and practice. Making room for new spaces of possibilities to emerge means locating anthropology within qualitative global health research.

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Mohammad Shahbazi

This article presents an account of a Qashqa'i health worker's upbringing, education and training, noting in particular his transition from life in a traditional nomadic family through completion of a formal education. The health worker, Jamal, describes certain problems of modernity and the personal conflict he faces as someone who loves his culture but also wants to see improvements in the health status of his people. Written by a Qashqa'i author, who brings his own sensitivity and cultural knowledge to the text, the article makes some recommendations about the training and integration of rural health workers in Iran.

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Kearsley A. Stewart

Interest in short-term international placements in global health training for U.S.-based medical students is growing; the trend is mirrored for global health undergraduate students. Best practices in field-based global health training can increase success for medical students, but we lack a critical framework for the undergraduate global health field experience. In what ways does an undergraduate field experience in global health resemble a medical student's first international health elective? Is it more similar to a study-abroad programme or a service-learning experience with a focus on personal development, civic responsibility and community engagement? This article suggests that an undergraduate global health field experience contains features of both the international medical elective and a traditional service-learning programme. I analyse a case study of a short-term U.S.-based undergraduate global health project and explore the intersections of research, professional training and service learning.

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Introduction

Anthropological Knowledge and Practice in Global Health

Rodney Reynolds and Isabelle L. Lange

Since the turn of the millennium, conceptual and practice-oriented shifts in global health have increasingly given emphasis to health indicator production over research and interventions that emerge out of local social practices, environments and concerns. In this special issue of Anthropology in Action, we ask whether such globalised contexts allow for, recognise and sufficiently value the research contributions of our discipline. We question how global health research, ostensibly inter- or multi-disciplinary, generates knowledge. We query ‘not-knowing’ practices that inform and shape global health evidence as influenced by funders’ and collaborators’ expectations. The articles published here provide analyses of historical and ethnographic field experiences that show how sidelining anthropological contributions results in poorer research outcomes for the public. Citing experiences in Latin America, Angola, Senegal, Nigeria and the domain of global health evaluation, the authors consider anthropology’s roles in global health.

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‘I’m Not that Kind of Doctor’

On Being In-Between in a Global Health Intervention

Erica Nelson

Within multi-disciplinary global health interventions, anthropologists find themselves navigating complex relationships of power. In this article, I offer a critical reflection on this negotiated terrain, drawing on my experience as an embedded ethnographer in a four-year adolescent sexual and reproductive health research intervention in Latin America. I critique the notion that the transformative potential of ethnographic work in global health remains unfulfilled. I then go on to argue that an anthropological practice grounded in iterative, inter-subjective and self-reflexive work has the potential to create ‘disturbances’ in the status quo of day-to-day global health practice, which can in turn destabilise some of the problematic hubristic assumptions of health reforms.

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Health interregionalism in combating communicable diseases

EU cooperation with ASEAN and the African Union

Vincent Rollet

English abstract: This last decade, regional organizations progressively became unavoidable actors of regional health governance and have been supported by some global health actors to strengthen such a role. Among these actors, the European Union (EU) is the only regional organization that implements health initiatives in cooperation with its regional counterparts. This article focuses on such “health interregionalism” toward Southeast Asia and Africa and in the field of communicable diseases, with the main objective of assessing its nature and identifying its main functions. It concludes that although appreciated and needed, the EU’s health interregionalism should better reflect the EU’s experience in regional health governance in order to represent a unique instrument of development aid and an added value for regional organizations.

Spanish abstract: En el último decenio, las organizaciones regionales se han convertido progresivamente en actores inevitables de la gobernanza regional de la salud, recibiendo el apoyo de actores mundiales para fortalecer esa función. Entre éstos, la Unión Europea (UE) es la única organización regional que implementa iniciativas de salud en cooperación con sus contrapartes regionales. Este artículo se centra en este ““interregionalismo en salud”” hacia el sudeste asiático y África y en el ámbito de las enfermedades transmisibles, con el objetivo de evaluar su naturaleza e identificar sus principales funciones. Concluye que el interregionalismo en salud de la UE debería reflejar mejor su experiencia en materia de gobernanza regional de la salud, al representar un instrumento único de ayuda al desarrollo y un valor añadido para las organizaciones regionales.

French abstract: Au cours de la dernière décennie, les organisations régionales sont progressivement devenues des acteurs incontournables de la gouvernance régionale de la santé et ont été soutenues par certains acteurs mondiaux. Parmi ces acteurs, l’Union européenne (UE) est la seule organisation régionale qui mette en oeuvre des initiatives en matière de santé en coopération avec ses homologues régionaux. L’article se concentre sur cet «interrégionalisme en matière de santé» vers l’Asie du Sud-Est et l’Afrique dans le domaine des maladies transmissibles, afin d’évaluer sa nature et d’identifier ses principales fonctions. Il conclut que, bien qu’apprécié et nécessaire, l’interrégionalisme devrait mieux refléter l’expérience de l’UE en matière de gouvernance de santé régionale afin de représenter un instrument unique d’aide au développement et une valeur ajoutée pour les organisations régionales.

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Neglected Tropical Diseases

Creating a New Disease Grouping

Samantha Vanderslott

Neglected tropical diseases (NTDs) are a collection of communicable diseases, coined in the early 2000s, that have received growing policy attention within global health ( Vanderslott 2019 ). Globally, one out of six people suffers from at least one