About
This conference reflected on the diverse and changing notions of ‘the public’, in relation to the production of medical knowledge and health in contemporary Africa. We hope that an improved understanding of this basic social and political concept will help strengthen the connection between public health and social progress and confront the power imbalances in global medical research and health care delivery. Extending conversations begun at a previous conference in Kilifi on the ethnography, history and ethics of ‘clinical trial communities’, this forum considered the other spaces in which medical knowledge is debated, negotiated and put to use.
Underlying this conference is the observation that the relationship between medical science and the public – in terms of ideas and intentions, as well as institutional realities – has changed in recent decades, along with changes in government and health. This is especially true in Africa. At around the time of independence, public institutions like universities and ministries produced scientific knowledge largely with public funding. The assumption was that the public would participate in this research as a civic duty, and benefit from its findings through the workings of a nation state that, in principle, represented the public, and that extended welfare policies to its citizenry. There was therefore a widely shared ideal of science and government working hand in hand, with inputs from citizens, to produce a healthy society. In this situation ‘public health’ was an integral project of nation-building.
Over the past few decades, this ideal vision of public health has been affected by alterations of all three constitutive elements – science, government and health. Science is increasingly led by global organisations relying on advanced technology and intensive funding; it tends to be at least partly privately funded by charities and the pharmaceutical industry, and its practices have become modeled upon those of ‘clinical trials’; most governments have suffered dramatically decreased funding for health systems and for national scientific institutions and universities; and health and bodies have changed as HIV, violence and other emergencies have become more important in African people’s experience and in global political priorities.
The consequence of these changes is that the public takes on new spatial, material, and temporal dimensions. It retains its’ association with notions of ‘population’, ‘citizenry’ and ‘society’, but the state no longer provides the obvious frame of scientific production, discussion and policy. The public now includes a diverse range of publics operating at communal and international scales, respectively smaller and much larger than the nation.
Organised by:
London School of Hygiene and Tropical Medicine", Department of History, University of Nairobi and KEMRI/Wellcome Trust Programme; in collaboration with The ESRC STEPS Centre, Institute of Development Studies, Sussex University; African Studies Centre, Cambridge University, and British Institute in Eastern Africa (Nairobi). Core funding provided by the Wellcome Trust.
Conference programme
- Welcome by KEMRI
- Introduction to the conference by organisers: Public health and the health of its ‘public’.
KEY SPEAKER Clapperton Mavhunga: Mobility—On What Defines “Public”, “Health”, and “System”
SESSION 1: HISTORY, THE CHANGING PUBLICS OF PUBLIC HEALTH
KEY SPEAKER Kevin Marsh: The changing face of child health in Africa
KEY SPEAKER Melissa Leach: Where is ‘the public’, what does it know and what should it do? Shifting narratives in a shifting terrain of health science-politics
CHAIR: Milcah Amolo Achola DISCUSSANT: Steven Feierman
- John Manton: Hunger, health, and humanitarianism: nutritional crisis and emergency medical relief in Nigeria, 1968-70
- Maureen Malowany: 'People used to say that I was living like Robinson Crusoe...I used to tell them I was doing scientific research':Researchers and their publics, East Africa, 1950s-1970s
- Estelle Kouakam Magne: The notion of public in a changing health system and its implication on the anthropologist work: the case of a research on medical missions in Cameroon
- Walter Bruchhausen: Regulation or deregulation of health care? Legislation on ‘traditional medicine’ between state, society and individuals
- Kristin Peterson: Markets in the IMF Aftermath: Structural Adjustment, Pharmaceutical Reform, and New Publics in Nigeria
Comments Steven Feierman – END OF SESSION DISCUSSION
SESSION 2: GLOBAL SHIFTS, LOCAL TRANSFORMATIONS
KEY SPEAKER Susan Reynold Whyte: The publics of the New Public Health: life conditions and ‘lifestyle diseases’ in Uganda
KEY SPEAKER Murray Last: The peculiarly political problem behind Nigeria’s primary health care provision
CHAIR: Susan Reynold Whyte DISCUSSANT: Murray Last
- Ruth Prince: Health as a private and a public good: antiretroviral programmes in Kenya
- Julie Livingstone: Shifting Epidemiology and Lagging Publics: Which Afflictions Matter in African Public Health?
- Babatunde Omotosho: Corruption and Public Exclusion: A Serious Challenge to Effective Public Policy on Health
KEY SPEAKER Milcah Amolo Achola: Public Health and Villagers: The Case of Masana Sub-location into the 21st Century
KEY SPEAKER Steven Feierman: Chaola, History, and Health Care Today
SESSION 3: HIV PUBLICS
CHAIR: Michael Parker DISCUSSANT: Melissa Parker
- Lotte Meinert: Therapeutic Clientship and ‘Projectification’ of ART in Uganda
- Rebecca Cassidy: HIV Treatments in the Gambia
- Martha Chinuya: HIV prevention in England: The politics of black African ‘publics’ in Public Health
- Elizabeth Mills: 'I sit of the side of my virus': HIV and the dialectics of space, sociality and differentiated publics in South Africa
Comments Melissa Parker – END OF SESSION DISCUSSION
Visit to Kilifi District Hospital and KEMRI research unit
WED 9TH DEC
SESSION 4: HEALTH RESEARCH AND PUBLIC HEALTH
KEY SPEAKER Michael Parker: ‘Who and where are the ’publics’ in collaborative global health research?’
CHAIR: Nancy Rose Hunt DISCUSSANT: Julie Livingston
- Gemma Jones: Knowledge, “exposure” and identity: the productive power of an HIV research clinic in Western Kenya.
- Chidi Nweneka: Confidentiality and the reality of practice on the field with respect to clinical trials in Africa
- Alice Street: Research in the Clinic: Scientific Emplacement and Medical Failure
- Ann Kelly: Remodeling the public: Domestic Experiments and MRC Hospitality
- Patricia Kingori: What constitutes a ‘good’ public health researcher in the conduct of fieldwork in resource-constrained settings?
Comments Julie Livingston
SESSION 5: COLLABORATION AND PARTNERSHIP
DISCUSSANT: Nancy Rose Hunt CHAIR: Sam Kinyanjui
- Rene Gerrets: The Publics of Partnership in Tanzanian Malaria Control: A bottom-up look.
- Guillaume Lachenal: Playing the public health game in Cameroon: Simulation, performance andnihilism in the neo-liberal biogovernement of Africa.
- Wenzel Geissler: Public secrets in public health: how to know what not to know while making knowledge
- Javier Lezaun: The novel organizational forms of research on neglected diseases: innovations in public accountability?
- Melissa Parker: Controlling neglected tropical disease in Uganda and Tanzania: is it possible to move beyond the rhetoric of success
Comments – Nancy Rose Hunt END OF SESSION DISCUSSION
THU 10th DEC
SESSION 6: ‘COMMUNITY’ AND COMMUNITIES
KEY SPEAKER: Nancy Rose Hunt: Publics and Multitudes in a Colonial Medical "Emergency
CHAIR: Kenneth Ombongi DISCUSSANT: Clapperton Mavhunga
- Sassy Molyneux: Empirical studies on community accountability in health delivery: insights and lessons for biomedical research
- Philister A Madiega: “She’s my sister-law, my visitor, my friend:” experiences of home follow-up in HIV research and intervention in Western Kenya.
- Jenipher Twebaze: Medicines for Life: Clients and Providers in Ugandan ART Programmes
- Shelley Lees: ‘I am participating in the study to find out if the gel will benefit, not just me alone, but the whole of Tanzania’: Tanzanian women as participants in a clinical trial and the implications for citizenship
- Tracey Chantler: 'Negotiating Difference in Health Facilities Hosting Malaria Research'
- Hayley MacGregor & Jerker Edstrom: Aid for Aids in Sub-Saharan Africa: How do Community Groups Conceptualise and negotiate their place in the funding architecture
Comments Clapperton Mavhunga-- END OF SESSION DISCUSSION
STUDENT PRESENTATIONS AND POSTER EXIBITION
CHAIR: Sassy Molyneux
- Prosper Chaki: CORPs: Who is Responsible for successful Malaria Control?
- Gemma Jones: Research and Everday life: an ethnographic exploration of a "research village."
- Bornwell Sikateyo: TBA
- Ferdinand Okwaro: Hybrid Rituals for Hybrid Publics.
- Lauren Hutchinson: 'Morality, Technology and Epistemology: The Ethos of Medical Research in Kenya 1978-Present'
- Dorcus Kamuya: Community engagement in biomedical research; experiences from a collaborative research centre at the Coast of Kenya
- Musonda Simwinga: Engaging the public in clinical trials: Perspectives from Community Advisory Boards in Zambia.
- Birgitte Folman: TBA
SESSION 7: KNOWLEDGE AND CAPACITY
KEY SPEAKER: Sam Kinyanju: Capacity strengthening for research: experiences from the KEMRI-Wellcome Programme in Kenya
CHAIR: Melissa Leach DISCUSSANT: Susan Reynolds Whyte
- Sally Theobald: The politics, processes, challenges and opportunities in the research to policy and practice interface in Sexual and Reproductive Health, HIV and AIDS research in Sub-Saharan Africa.
- Tchaka Ndhlovu: New structures for capacity building in health research in Malawi: A critical reflective analysis
- Uli Beisel: Who bites back first? Science, Democracy and Public Health in Malaria Control Experiments
- Landon B. Kuester:The U.S. President’s Emergency Plan For Aids Relief (Pepfar): Contextualising The Policy
- Morenike Ukpong: Clinical trials as an industry and an employer of labour
- Erick Nyambedha: Trust in health care provider-community relations and its implications for access to tuberculosis services in Nyanza province, Kenya
- Faith Otewa: Intertwining transnational research and public health around vaccine research in western Kenya: ‘You people are loved!’
Comments SUSAN REYNOLDS WHYTE
FOLLOWED BY DISCUSSION ABOUT OVERARCHING THEMES AND EMERGENT ISSUES
How to access abstracts and papers from the conference
Abstracts from the conference can be downloaded below. Several full length papers from the conference have also been made available. These can be read and downloaded on the Contradictions Forum. We also invite dicussion and comment on these papers through the forum.
