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Dreaming partnership, enabling inequality: administrative infrastructure in global health science

Published online by Cambridge University Press:  11 March 2020

Johanna T. Crane
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Abstract

This article examines the fiscal and administrative infrastructures underpinning global health research partnerships between the US and Uganda, and the power dynamics they entail. Science studies scholars and anthropologists have argued for the importance of studying so-called ‘boring things’ – standards, bureaucracies, routinization, codes and databases, for example – as a way to bring to the surface the assumptions and power relations that often lie embedded within them. This article focuses on fiscal administration as an understudied ethnographic object within the anthropology of global health. The first part of the article is a case study of the fiscal administration of a US–Uganda research partnership. The second part describes the institutionalization of some of the administrative norms and practices used by this partnership within the ‘global health enabling systems’ employed by US universities working in Uganda and elsewhere in Africa. I analyse a case study and ‘enabling systems’ to show how these administrative strategies create parallel infrastructures that avoid direct partnership with Ugandan public institutions and may facilitate the outsourcing of legal and financial risks inherent in international partnerships to Ugandan collaborators. In this way, these strategies act to disable rather than enable (or build) Ugandan research and institutional capacity, and have profound implications for African institutions as well as for the dream of ‘real partnership’ in global health.

Résumé

Résumé

Cet article examine les infrastructures fiscales et administratives qui sous-tendent des partenariats de recherche en santé mondiale entre les États-Unis et l'Ouganda, et les dynamiques de pouvoir qu'elles impliquent. Des chercheurs en sciences et des anthropologues ont plaidé pour l'importance d’étudier les prétendus « aspects ennuyeux » (normes, bureaucraties, routinisation, codes et bases de données par exemple) comme un moyen de faire émerger les hypothèses et les relations de pouvoir qu'ils renferment souvent. Cet article s'intéresse à l'administration fiscale en tant qu'objet ethnographique négligé dans les études anthropologiques de la santé mondiale. La première partie de l'article est une étude de cas de l'administration fiscale d'un partenariat de recherche américano-ougandais. La seconde partie décrit l'institutionnalisation de certaines normes et pratiques administratives utilisées par ce partenariat dans le cadre des « systèmes habilitants de santé mondiale » employés par des universités américaines travaillant en Ouganda et ailleurs en Afrique. L'auteur analyse une étude de cas et les « systèmes habilitants » pour montrer comment ces stratégies administratives créent des infrastructures parallèles qui évitent un partenariat direct avec les institutions publiques ougandaises et peuvent faciliter l'externalisation des risques juridiques et financiers inhérents aux partenariats internationaux vers des collaborateurs ougandais. De cette manière, ces stratégies ont pour effet d’inhiber plutôt que d’habiliter (ou de renforcer) la capacité institutionnelle et de recherche ougandaise, et ont des implications profondes pour les institutions africaines ainsi que pour le rêve de « vrai partenariat » en santé mondiale.

Type
Dream capacity
Information
Africa , Volume 90 , Special Issue 1: Beyond realism: Africa's medical dreams , January 2020 , pp. 188 - 208
Copyright
Copyright © International African Institute 2020

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