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Scrambling for Africa: AIDS, Expertise, and the Rise of American Global Health Science (Expertise: Cultures and Technologies of Knowledge)

af Johanna Tayloe Crane

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Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for "resource-poor" hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science.Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money-as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.… (mere)
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The prevalence of HIV and AIDS in Africa was a looming problem at the turn of the millennium, but heavy American investment in treatment for Africans under George W. Bush’s PEPFAR program addressed the acute symptoms. However, like much in life, smaller, no-less-significant problems exploded soon afterwards, particularly in the vein of post-colonialism.

Was this a scientific partnership of equals or was it a contribution from a superior to an inferior? Does PEPFAR create a health culture of collaboration? Crane’s book addresses these issues at length by performing an ethnology, a cultural analysis around research based on interviews in the field. Her findings relevantly address the future of such aid in the trending field of global health.

I generally find medical anthropologies difficult to read because they discuss inequities that surround my field of work. However, I welcome these challenges because they force me to think about uncomfortable issues. Does global aid truly help the African culture advance and flourish? If not, how can it achieve these aims better? These are not easy issues because few Americans – myself included – have never travelled to this great continent.

Yet there exists so much human potential there. How many intellects the size of Marie Curie or Albert Einstein exist on this so-called “dark continent,” unused because they are uneducated – or because their research interests are unfunded? Again and again, Crane brings out that most Africans in the field just long to be treated like scientific equals in grants and publishing. This simple wish is not extreme or unreasonable, but Western pride after centuries of colonial oppression context seems to neglect this desire.

Medical anthropologists will celebrate this work, but the people who need to read it most are the medical students and researchers involved in global health. These groups make up the cultural structure explored and critiqued here. Like any ethnography, this book is an act of scientific exploration, not an opinion piece driven by an agenda. Will science respond appropriately to such data-filled critiques or continue in ignorance? Will global health science by the Americans become public health science for the Africans? ( )
  scottjpearson | Jan 1, 2022 |
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Countries in sub-Saharan Africa were once dismissed by Western experts as being too poor and chaotic to benefit from the antiretroviral drugs that transformed the AIDS epidemic in the United States and Europe. Today, however, the region is courted by some of the most prestigious research universities in the world as they search for "resource-poor" hospitals in which to base their international HIV research and global health programs. In Scrambling for Africa, Johanna Tayloe Crane reveals how, in the space of merely a decade, Africa went from being a continent largely excluded from advancements in HIV medicine to an area of central concern and knowledge production within the increasingly popular field of global health science.Drawing on research conducted in the U.S. and Uganda during the mid-2000s, Crane provides a fascinating ethnographic account of the transnational flow of knowledge, politics, and research money-as well as blood samples, viruses, and drugs. She takes readers to underfunded Ugandan HIV clinics as well as to laboratories and conference rooms in wealthy American cities like San Francisco and Seattle where American and Ugandan experts struggle to forge shared knowledge about the AIDS epidemic. The resulting uncomfortable mix of preventable suffering, humanitarian sentiment, and scientific ambition shows how global health research partnerships may paradoxically benefit from the very inequalities they aspire to redress. A work of outstanding interdisciplinary scholarship, Scrambling for Africa will be of interest to audiences in anthropology, science and technology studies, African studies, and the medical humanities.

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