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From International to Global: Knowledge, Diseases and the Postwar Government of Health

Globhealth Inaugural Conference

Les 12, 13 et 14 février 2015

Domaine de Bierville

In the 1980s and 1990s, the HIV epidemic was the most discussed issue in international health organizations and was increasingly labeled as a global phenomenon. Within this context, "global" referred to various aspects of the epidemic: its scale and the fact that contamination occurred in all countries of the world; the need for coordinated and generalized actions implying programs to be implemented in all countries; the creation of new institutions operating worldwide involved in funding or standardization of prevention (later treatment) protocols; the specificity of problems associated with North-South inequalities and with the fact that the majority of HIV-contamination took place in developing or underdeveloped countries, African in the first place.

In spite of its visibility, one may wonder what is actually global health and what is new in it. The aim of this conference is to discuss the various ways in which this question has been recently addressed by anthropologists, sociologists or historians of health and medicine in order to explore the numerous issues the spreading of the "global" raises, focusing on processes of globalization rather than entering essentialist debates about the true nature of the "global". The conference will in particular discuss three aspects of what could be the agenda for a better understanding of the transition from international to global health, which took place during the past thirty years: historicization, localization and critical engagement.

History is needed to balance a widespread fascination for most recent innovations, be they technical, institutional or social; a fascination, which results in the danger of taking the tree for the forest, the future for the present, the experimental for the routine. Localization is needed because the 'international' or the 'global' are not given but complex and collectively constructed realities. As the term 'glocal' reminds us: globalization does not exist outside processes of generalization from – circulation and aggregation of - local practices while any global agenda or program only becomes real when adopted, resisted and adapted by local actors. Critical engagement is needed since the global is never a view from nowhere. It is always somebody's global, making specific actors, targets and tools highly visible while erasing others, thus producing new hierarchies of power and new inequalities.

The conference is the first event in a series of initiatives originating in the ERC project GLOBHEALTH. This project consists in a social and historical study of the transition between the two regimes, which have characterized the government of health after World War II: first, the regime of international public health, dominating during the first decades of the postwar era, which was centered on eradication policies, nation-states and international UN organizations; second, the present regime of global health, which emerged in the 1980s and is centered on risk management and chronic diseases, market-driven regulations, and private-public alliances. This transition will be approached in terms of actors, forms of knowledge, tools and practices. The project thus targets the tensions and social dynamics underlying four core issues:
- the reconfiguration of health economic governance around the markets
- the emergence of post-national institutions of health governance
- the limits of the therapeutic revolution and drug access policies
- the multiple epidemiological transitions and the management of risks
GLOBHEALTH approaches these questions through a series of specific and local studies in order to in order to grasp how categories, standardized treatment regimens, industrial products, management tools or specific specialties have become elements in our present global government of health. The four fields selected are tuberculosis, mental health, traditional medicine and medical genetics. The project includes historical and anthropological investigations of practices in both international and local sites with strong interests in: a) the changing roles of WHO; b) the developments taking place in non-Western countries, India and East Africa in the first place.

Thursday, February 12th

12h30 Arrival at "Domaine de Bierville"

13h – 14h Lunch

14h – 14h30 Welcome and General Introduction – Jean-Paul Gaudillière (Cermes3, Inserm-EHESS, Paris)

14h30 – 15h30 Keynote lecture
"In search for Global Health"
Didier Fassin (Institute for Advanced Studies Princeton)

15h30 – 15h45 Coffee break

15h45 – 18h45 Panel 1 – Global Psychiatry: From Colonial Histories to World Mental Health

Introduction – Anne M. Lovell (Cermes3, Inserm-Université Paris Descartes)

"Nervousness as Concept and Mood for a Colonial Situation"
Nancy Rose Hunt (University of Michigan, Ann Harbor)

"Decolonizing, Nationalizing and Globalizing the History of Psychiatry: From Colonial to Cross-Cultural Psychiatry in Nigeria"
Matthew M. Heaton (Virginia Tech, Blacksburgh)

"Psychiatry on the Edge: Society and Science in the History of Mental Health Institutions in India"
James H. Mills (University of Strathclyde, Glasgow)

"Critiques of PTSD in Global Health Programs: An Engaged Anthropological Perspective"
Byron Good (Harvard University) and Mary-Jo Del Vecchio Good (Harvard University, Cambridge MA)

Comments – Laurence Kirmayer (McGill University, Montreal)

19h30 Dinner

Friday, February 13th

9h – 10h Keynote lecture
"We Have Never Been Global: Explaining the WHO's Response to Ebola"
Nitsan Chorev (Brown University, Providence)

10h – 11h30 Panel 2 – Globalizing Techniques and Products in Asian Medicine

Introduction – Laurent Pordié (Cermes3, CNRS, Paris)

"Nature Cure and Global Health"
Joseph S. Alter (University of Pittsbrugh)

From Scarcity to Profit: Traditional Medicine and Global Health
Stephan Kloos (Austrian Academy of Science, Viena)

11h30 – 11h45 Coffee Break

11h45 – 13h15 Panel 2 – Globalizing Techniques and Products in Asian Medicine

"You've Got the Point: Seeking the Meaning of Acupuncture in its Techno-Political Bodyscape"
Wen-Hua Kuo (National Yang-Ming University, Taipei)

"Outside the Establishment: Standardization and Contingency in 'Classical' Chinese Medicine"
Mei Zhuan (University of California - Irvine)

Comments – Mark Nichter (University of Arizona, Tucson)

13h15 – 14h15 Lunch

14h15 – 15h15 Keynote lecture
"Metrics of the Global Sovereign: Numbers and Stories in Global Health"
Vincanne Adams (University of California - San Francisco)

15h15 – 15h30 Coffee Break

15h30 – 18h Panel 3 – Medical Genetics and Genetic Testing in the South

Introduction – Claire Beaudevin (Cermes3, CNRS, Paris)

"Finding the Global in the Local: Constructing Population in Genome-Wide Association Studies"
Steve Sturdy (University of Edinburgh)

"Rare Genetic Disease in Globalizing Public Health Genomics: The Case of Li-Fraumeni and R337h in Brazil"
Sahra Gibbon (University College, London)

"Sickle-Cell Anemia in Brazil: Hereditary Condition and Racial Identity"
Ilana Löwy (Cermes3, Inserm, Paris)

Comments – Soraya de Chadarevian (University of California - Los Angeles)

18h30 – 19h30 Discussion with the PhD and postdoctoral researchers currently participating in the GLOBHEALTH project

Mandy GeiseCaroline Meier zu BiesenAnabel Rodriguez

19h30 Dinner

Saturday, February 14th

8h30 – 9h30 Keynote lecture
"The Global Menace and its Interruptions"
Sarah Hodges (University of Warwick)

9h30 – 11h Panel 4 – The Control of a Neglected Disease: DOTS and Tuberculosis

Introduction – Christoph Gradmann (University of Oslo)

"The Historical Origin of WHO Policies to Control the Transmission of Tuberculosis and the Influence of the East African Tuberculosis Trials"
David Macfadyen (University of Glasgow)

"I Can Assure You, DOTS Is Not Happening Here": South Africa's Changing TB Treatment Practices and the Advent of Extensively Drug Resistant Tuberculosis"
Erica Dwyer (University of Pennsylvania, Philadelphia)

11h – 11h15 Coffee Break

11h15 – 13h15 "Innovating Tuberculosis Control in India"
Nora Engel (Maastricht University)

"Lessons Learnt from the DOTS Strategy for TB Control in Nepal"
Ian Harper (University of Edinburgh)

Comments : Christian Bonah (Strasbourg University)

13h15 – 14h30 Lunch

14h30 Departure from Bierville