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Carémel Jean-François

PhD student in Sociology, EHESS

Associate Researcher, LASDEL (Laboratoire d'Études et de recherches sur les Dynamiques Sociales et le Développement), Niamey, Niger

Contact: caremeljf(at)



Dissertation title: Trajectories of an innovation in transnational humanitarian medicine: Child undernutrition and ready-to-use therapeutic and supplemented food

Under the supervision of Maurice Cassier

Acute undernutrition is a decisive cofactor in 30 to 50% of the deaths of children under five years old worldwide. In the past ten years, the medical response to this pathology underwent two major paradigm changes: moving from a hospital-care to an outpatient-care model (2000-2005), and the emergence of therapeutic prevention solutions, primary and secondary, for acute malnutrition (starting in 2006). Driven by humanitarian medicine in crisis situations, this move from a “clinical” model, focused on individual pathologies, to a “public health” model, geared according to the population-risk link, has made it possible to increase care as well as prevention with results never previously recorded. Driven by NGOs and relayed by UN actors, this model has spread rapidly to become an element of health governance in transnational medicine.

This therapeutic revolution was made possible by the emergence in 1996 of ready-to-use therapeutic food and its variation in 2006 as ready-to-use supplemented food, but also by a change in forms of diagnosis that modified the perimeter of pathology. It is of these products ¬– the result of a partnership, under constant reconfiguration, between public research, the industry, and actors of humanitarian medicine – that we are studying the trajectory and the implications, from their influence on local nosological representations to reconfigurations of transnational health policies.

We consider these elements and their dynamics as a component of a new economy of medical and pharmaceutical innovation that is spreading under a “new institutional ecology” of global health and drugs.

Our analysis leads us to study the interactions among:

  • the long and complex process of the scientific, social, and policy development of pathology and responses to it;
  • the modes of socialization of a pathology and its products from the global to the local levels;
  • and the political and legal controversies as well as the economic operational constraints of upscaling.

The research is being conducted thanks to a research grant from the Île-de-France Region/Ifris within the framework of the Major Interest Field of Innovation, Science, Technology, Society (DIM IS2-IT).

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