Chasing Polio in Pakistan
Why the World's Largest Public Health Initiative May Fail
Author(s): Svea Closser
From remote villages and nomadic encampments to World Health Organization headquarters, a vivid ethnography of the Global Polio Eradication Initiative
The number of global polio cases has fallen dramatically and eradication is within sight, but despite extraordinary efforts, polio retains its grip in a few areas. Anthropologist Svea Closser follows the trajectory of the polio eradication effort in Pakistan, one of the last four countries in the world with endemic polio. Journeying from vaccination campaigns in rural Pakistan to the center of global health decision making at the World Health Organization in Geneva, the author explores the historical and cultural underpinnings of eradication as a public health strategy, and reveals the culture of optimism that characterizes—and sometimes cripples—global health institutions.
With a keen ethnographic eye, Closser describes the complex power negotiations that underlie the eradication effort at every level, tracking techniques of resistance employed by district health workers and state governments alike. This book offers an analysis of local politics, social relations, and global political economy in the implementation of a worldwide public health effort, with broad implications for understanding what is possible in global health, now and for the future.
This book is the recipient of the annual Norman L. and Roselea J. Goldberg Prize for the best project in the area of medicine.
Biography of Author(s)Svea Closser is Assistant Professor of Anthropology at Middlebury College.
"[Chasing Polio in Pakistan] is a revelation of problems that erode the daily implementation of the eradication initiative in Pakistan."
—Journal of Clinical Investigation
"While remaining in favor of polio eradication, she does not avoid the difficulties involved and discusses them thoughtfully and clearly."
—Journal of the American Medical Association (JAMA)
"A great addition to the literature of medical anthropology, public health, and public policy. . . . Highly recommended."
"Svea Closser tells a compelling story of the well-intentioned global initiative to eradicate polio from all countries, and presents an exceptionally well-researched and balanced analysis of why this goal remains elusive despite unprecedented global effort and financial investment. Although this work is based in Pakistan, the research findings are broadly applicable, providing many insights into the relationship between international organizations, national governments, and local health workers; these conclusions extend beyond health and are relevant to global development initiatives in general. This book will be of interest to the global health and development communities, making a major contribution to the literature in anthropology, public health, policy and development studies, foreign assistance, and the new field of global health sciences, among others."
—Judith Justice, author of Policies, Plans, and People: Foreign Aid and Health Development