A History of Global Health

If all books hailed as required reading really were, no one would get anything done. But practitioners of medicine and public health, and tightfisted guardians of the shrinking public purse, should all set down headlamps and flashlights and blinkers to read Randall Packard's powerful new exploration, a history of global health. Packard swivels his piercing searchlight on the specific—tuberculosis and AIDS in Southern Africa, Ebola in west Africa, malaria across it, as well as debates about what to do about these plagues of the poor and the malnutrition and high rates of fertility that were held to be leading to a "population crisis"—to the general, cutting through the fog of intentions good and bad of what is now widely termed global health. His riveting synthesis is not a study of human motivations but rather a sweeping review of the historical roots of attempts to address, with varied motivations and even more varied outcomes, pathogens and pathogenic forces still reaping a grim harvest among the poor, and not just in Africa. In doing so, Packard offers a comprehensive look at the origins of public health's primary transnational institutions, the debates that churned within and beyond them, and campaigns that failed or sometimes succeeded. Packard writes not to cheer us, but rather to remind us that history never starts when we say so: new epidemics are less new than noticed; innovation in medicine and public health is more aptly understood as a series of fits and starts; novel funding mechanisms and global institutions designed to address runaway epidemics are built from rusty and fissured colonial debris; avowed motivations are rarely as unimpeachable as advertised but rooted, rather, in neoliberal ideologies of long duration. But A history of global health is no catalogue of woe. It's result is to instruct and inspire and illuminate. No historian shines a brighter torch on the mortal dramas of our day—or of the dark night that preceded it.