Understanding Tuberculosis and its Control Anthropological and Ethnographic Approaches

Over the last two decades, attempts to control the problem of tuberculosis have become increasingly more complex, as countries adopt and adapt to evolving global TB strategies. Significant funding has also increased apace, diagnostic possibilities have evolved, and greater attention is being paid to developing broader health systems. Against this background, this book examines tuberculosis control through an anthropological lens. Drawing on ethnographic case studies from China, India, Nepal, South Africa, Romania, Brazil, Ghana and France, the volume considers: the relationship between global and national policies and their unintended effects; the emergence and impact of introducing new diagnostics; the reliance on and use of statistical numbers for representing tuberculosis, and the politics of this; the impact of the disease on health workers, as well as patients; the rise of drug-resistant forms; and issues of attempted control. Together, the examples showcase the value of an anthropological understanding to demonstrate the broader bio-political and social dimensions of tuberculosis and attempts to deal with it.

1. Introduction: Persistent pathogen 2. "I wish one of these patients would sue us": Malpractice at the policy level and how Romania is not treating M/XDR-TB this year 3. "Where is the state?" Tuberculosis strategies in Ghana 4. "Time standing still": Nurses, temporality and metaphor in a paediatric tuberculosis ward in Cape Town, South Africa 5. "It’s also the system": Republican dilemmas in French tuberculosis prevention 6. Using local statistics to tinker with TB treatment in a central Indian clinic 7. Community DOTS and beyond: Tackling the collective processes that (re)produce tuberculosis in Rio de Janeiro 8. The price of free: Contextualizing the unintended expenditures of diagnosing tuberculosis patients in Kunming, China 9. Innovating tuberculosis diagnostics for the point of care 10. India’s national TB programme: The struggle for innovation and control 11. Excluded from reciprocity: Tuberculosis, conspicuous consumption and the medicalization of poverty 12. Consumed in car: Healthcare workers in Mumbai’s TB-control program 13. Between representing and intervening: Diagnosing childhood tuberculosis during a vaccine trial in South Africa 14. Diagnosing tuberculosis: A case study from Nepal

Helen Macdonald is an Associate Professor of Anthropology at the University of Cape Town, South Africa.

Ian Harper is Professor of Anthropology of Health and Development and Director of the Centre for Medical Anthropology at the University of Edinburgh, UK.