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Kibong’oto Hospital, opened in 1926, is an East African tuberculosis treatment center located on the slopes of Mount Kilimanjaro. Its history is crucial to understanding tuberculosis in Tanzania and, more broadly, in Africa. With the hospital as a point of departure, Christoph Gradmann presents a history of this disease that engages with local and regional contexts rather than with international elite science and health policies.

The book addresses key questions about the African experience with tuberculosis:

• What did it mean to do clinical science on tuberculosis in colonial and postcolonial contexts?
• Along which trajectories did medical practice and research evolve in a place where international advances in medical science were sometimes heard of only faintly and where resources could be scarce?
• How did a large hospital with several hundred beds dedicated to the treatment of just one condition figure in the development of national and regional health systems?
• How did Kibong’oto Hospital, a pride of colonial health governance, transition after Tanzania gained independence?
• How did treating and researching tuberculosis change throughout the twentieth century in an African hospital dedicated to that condition?
• How did research at the hospital contribute to tuberculosis-control strategies on national and international levels?

The book is based on the hospital’s unique archive: its surviving library of thousands of case summaries. Since 1926, this library has documented an enormous number of patient lives, staff careers, diagnoses, treatments, clinical trials, and much more. For today’s readers, the library provides insight into a history of clinical medicine in Africa, for which very few comparable archives exist. Gradmann supplements this site-specific research with material from national and international archives, as well as interviews with former staff involved in that history. The book’s four chapters offer perspectives on colonial epidemiological research in the interwar years; on late colonial healthcare development plans and the arrival of modern drug therapies; on the role of a national tuberculosis hospital in a newly independent country; and on the history of tuberculosis control in an age of economic crisis, HIV, and emergent global health-treatment programs. Finally, Gradmann discusses what the history of a large hospital can add to today’s tuberculosis research, control policy, and historiography.

The United States routinely has one of the lowest voter turnout rates of any developed democracy in the world. That rate is also among the most internally diverse, since the federal structure allows state-level variations in voting institutions that have had—and continue to have—sizable local effects. But are expansive institutional efforts like mail-in registration, longer poll hours, and “no-excuse” absentee voting uniformly effective in improving voter turnout across states?

With How the States Shaped the Nation, Melanie Jean Springer places contemporary reforms in historical context and systematically explores how state electoral institutions have been instrumental in shaping voting behavior throughout the twentieth century. Although reformers often assume that more convenient voting procedures will produce equivalent effects wherever they are implemented, Springer reveals that this is not the case. In fact, convenience-voting methods have had almost no effect in the southern states where turnout rates are lowest. In contrast, the adverse effects associated with restrictive institutions like poll taxes and literacy tests have been persistent and dramatic. Ultimately, Springer argues, no single institutional fix will uniformly resolve problems of low or unequal participation. If we want to reliably increase national voter turnout rates, we must explore how states’ voting histories differ and better understand the role of political and geographical context in shaping institutional effects.