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Malarial Proximities: Senegal, the Pursuit of Evidence, and the Silver Revolver Approach to Global Health


Through the lens of malaria control and eradication efforts, this dissertation considers the political nature of demarcating global health problems and the pursuit of evidence to support such framings. By attending to past international campaigns to eliminate malaria and shifts in the goals of international health as a whole, I investigate what is new about what some have called the “silver revolver” approach to global health governance: the deployment of simple, technologically-innovative tools to attack a disease from multiple angles through the support of public-private partnerships. Based on fieldwork with health workers, biologists, public health officials, and recipients of care in and around Dakar, Senegal and with designers and funders of malaria interventions in California, Switzerland, and Italy, my dissertation shows what counts as knowledge and who frames possible futures in global health research, design, implementation, and evaluation. I argue that talking about malaria means getting close to malaria or speaking from the proximity of malaria, as the ecologies that malaria produces and that produce malaria vary greatly on the parasite’s and its hosts’ historical, political, and socio-economic contexts. Speaking of malaria on a global scale – in a project of global control or global eradication – means creating and maintaining conceptual proximities through the discourse of a single, unified “malaria” (Kelly and Beisel 2012). Examining the central role of the informal in malaria treatment, practices of approximation in malaria diagnosis, and the space for political resistance in health data collection in Senegal, I argue that attention to conflicts over malarial knowledge and practices is in fact crucial to dreams of malaria eradication, as well as to a “more democratic and equitable” global health (Geissler 2011).

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