- A History of Global Health: Interventions into the Lives of Other Peoples by Randall M. Packard
During the past few years, terms such as “globalization,” “global health,” and the “global south” have captured the imagination of historians. The works produced by historians of medicine have usually advocated a transnational perspective and suggested that the history of international health already done was, basically, parochial, Eurocentric, and anachronic. Some have also suggested the need to focus on a specific period, namely events that occurred after the end of the Cold War. However, some have argued that the study of the circulation of medical people and programs before, during, and after the Cold War cries for the novel transnational perspective.
The remarkable book by Packard is in line with the latter suggestion and is a new outlook on change and continuity in the history of global/international health from the late nineteenth century to the turn of the twenty-first. Some years ago, a professor gave me advice that only after reading this book I realized was wrong: the rule of thumb for writing a general work is to base it on secondary works. This is not the case. Packard examines rare library materials and archival sources—as well as contemporary historical studies—to provide novel insights into the complex relationship between European colonialism and tropical medicine, the achievements and limitations of the sociomedical work of the League of Nations Health Organization, and the different approaches that coexisted in the well-studied Rockefeller Foundation. Of special interest will be his outstanding, nuanced and original comparison between the “failed” campaign to eradicate malaria of the 1950s and the “successful” campaign to eradicate smallpox of the 1970s. According to Packard, a biosocial-historical approach should help to comprehend [End Page 816] both campaigns. Compelling discussions appear on the efforts of primary health care supporters to overcome an adverse neoliberal political context, family-planning programs in India, the plethora of agencies around AIDS such as PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief created in 2003), and the relevance of Ebola to understand the nature of international medicine. The author has a command of the vast literature on medical anthropology, health policy, and Africa’s health problems and development that is especially useful for the final chapters. The engaging organizing principle of the book is that health policies implemented in developing countries contributed to a limited culture of development and technical assistance. This culture overemphasized biomedical technologies, favored top-down programs, and generally paid little attention to local health services, empowering community health workers and improving sanitary infrastructure. The author makes a solid and convincing case of this principle. Important for this argument are captivating images and tables.
There are three minor problems with this otherwise excellent book. First, further research in some archives, such as the archive of the World Health Organization, could have enriched the final product (unfortunately, the book does not have a bibliography or a note on sources). Second, very little discussion is devoted to coding the terms “globalization,” “global health,” and “global health history,” embraced, criticized, or dismissed by other scholars. Many “global health” developments are given for granted, and facts and interpretations are more important than a discussion of concepts. Finally, the subtitle, Interventions into the Lives of Other Peoples, suggests unilateral dynamics questioned in a number of recent studies that give more agency to locals. Some of these studies are cited in Packard’s book, but their full integration into a global history is still a pending challenge. How to do it in a single volume? I really do not know. Does it require a transnational network of historians to produce a balanced global history? Probably.
Meanwhile, Packard’s exceptional History of Global Health comes very close to this ideal. It is by far the best clear and profound panorama of global health to date. It will be an inspiration and a tool for policy makers, public health scholars, and...