"With a clear and engaging narrative that delves into complex and debatable issues and, at the same time, tells very entertaining stories, this book is a wonderful addition to the historiography of international health."
---Diego Armus, Swarthmore College
From the Rockefeller Foundation to the Bill and Melinda Gates Foundation, U.S. philanthropies have played a leading role in the evolution of international health. Launching Global Health examines one of the earliest of these initiatives abroad, the Rockefeller Foundation's International Health Board. The flagship agency made its first call in British Guiana in 1914 to experiment with its new "American method" for the treatment of hookworm disease. Within months it was involved in ambitious hookworm programs in six Central American and Caribbean sites, its directors self-consciously choosing to test run the prototype for their global project in the nearest and clearest domain of American imperial influence. These efforts continued until 1930, when most of the International Health Board hookworm campaigns had evolved into public health projects of a different nature.
Launching Global Health is the first book to explore the inaugural Rockefeller Foundation campaigns in depth and to treat them as an ensemble---as a laboratory for discovering and testing the elements of a global health system for the twentieth century. Orienting the study according to the priorities and perspectives of the social and cultural history of medicine and marrying the results with social science and institutional approaches, Steven Palmer rediscovers elements and dynamics in the original history of global health that were either discarded or that have continued to operate beneath the radar of scholarship.
In particular, Palmer examines the extraordinary encounters that took place between the Rockefeller proselytizers of biomedicine and public health and the diverse populations whom they were attempting to help. Launching Global Health devotes special attention to the health narratives and practices of laboring people of different ethnicities and how they clashed and blended with the stories and rituals being promoted by the Rockefeller Foundation, ultimately showing the locally assembled health teams of microscopists, inspectors, and dispensers to have been active agents in the shaping of encounters between imperial and popular medicine.
Steven Palmer is Canada Research Chair in the History of International Health at the University of Windsor and author of From Popular Medicine to Medical Populism: Doctors, Healers, and Public Power in Costa Rica, 1800-1940.
Illustration: Lecture on hookworm disease on public building porch. Courtesy Rockefeller Archive Center.
A volume in the series Conversations in Medicine and Society.
At the turn of the twenty-first century, the United States contended with a state-run biological warfare program, bioterrorism, and a pandemic. Together, these threats spurred large-scale government demand for new vaccines, but few have materialized. A new anthrax vaccine has been a priority since the first Gulf War, but twenty years and a billion dollars later, the United States still does not have one. This failure is startling.
Historically, the United States has excelled at responding to national health emergencies. World War II era programs developed ten new or improved vaccines, often in time to meet the objectives of particular military missions. Probing the history of vaccine development for factors that foster timely innovation, Kendall Hoyt discovered that vaccine innovation has been falling, not rising, since World War II. This finding is at odds with prevailing theories of market-based innovation and suggests that a collection of nonmarket factors drove mid-century innovation. Ironically, many late-twentieth-century developments that have been celebrated as a boon for innovation—the birth of a biotechnology industry and the rise of specialization and outsourcing—undercut the collaborative networks and research practices that drove successful vaccine projects in the past.
Hoyt’s timely investigation teaches important lessons for our efforts to rebuild twenty-first-century biodefense capabilities, especially when the financial payback for a particular vaccine is low, but the social returns are high.
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