“Is the WHO the center of Global Health?” (3). This is the main question that the book Religion in Global Health and Development: The Case of Twentieth-Century Ghana by Benjamin Bronnert Walker seeks to address, using religion and its social welfare provision activities in Ghana as tools of analysis. Through the book's six chronological but overlapping chapters, Walker challenges extant analysis of global health, which privileges a focus on what happens “in the offices of directors-general and departmental heads” over “transnational, regional, local, national, and international sources” (3). Of these sources, the book argues, religion is of singular importance. The picture of Global Health that appears is one of “a diverse and decentralised process that is constantly being remade in local contexts in parallel with international communities and networks” (4).
The central role of religion in linking the local and the global in Global Health to produce a well-rounded picture of the reality of the system is presented in a nuanced manner that avoids the until recently dismissive treatment of religion and its developmental role by mainstream development policy and practice and the broad generalizations of the advocates of the “religion and development” paradigm, which promotes the paradigm as the panacea for all the ills of development policy (Fountain 2013). In the process, it highlights the embedded and ambivalent but indispensable role of religion—not just with regards to the conceptualization and sustenance of the Global Health system but, more importantly, to the rise of and continued provision of social services in African fragile states. The book firmly sets up the model of analysis that “Global Health, to be understood fully, needs a multi-layered, multi-focal, and non-Eurocentric narrative” (6). A crucial part of the book's analysis is the light it sheds on the “large-scale medical mission of West Germany and the Netherlands in Ghana, a country with which they had no previous recent colonial connection” (8) and the use of religion and development as viable tools for state-building and nationalism in both new and long-established states.
The overlapping nature of the analysis in the various chapters of the book makes it a complex read. For example, a similar analysis of the social welfare provision activities of religious missions in neighboring Nigeria (Olarinmoye 2023) adopted a three-phase approach, focusing on a single theme for each phase: first, an initial partnership phase of “active collaboration” between the colonial state and missions to provide social welfare services to the indigenous peoples of the colony of Nigeria; second, a phase of “state-hegemony” of social welfare service provision (Africanization, 1950s–mid-1980s), a period characterized by turbulence in the state-religious social service provision relationship, as witnessed in the expelling of catholic missionaries from the southeast of the country and the nationalization of schools and hospitals by state and federal governments in Nigeria; and third, a current phase (late 1980s–present) of “weak state-assertive religious” provision of social welfare services in Nigeria—this, as international donors adjusted their funding models to incorporate religious organizations in the light of the corruption associated with local and national public institutions in Nigeria.
Despite this limitation, this book—which draws on extensive archival and field research in Europe (UK, Germany, Netherlands), US and Ghana—is to be highly commended for the insight it brings to understanding the dynamics of Global Health and, more importantly, for the empirical evidence it supplies to support the claims of the advocates of the “religion and development” paradigm in development studies. It is also a good study of the comparative politics of Africa and an important analysis of the domestic politics of African fragile states.
