2 Standardization and localization in tuberculosis control
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Nora Engel
Abstract
This chapter discusses the tension between standardization and localization in efforts to control tuberculosis (TB); between programmatic considerations and responding to individual care needs, including particular TB strains, co-morbidities, personal pharmaceutical histories or socio-economic circumstances. Drawing on science and technology studies methodology, including a focus on how standards are made to work, the chapter uses anthropological and sociological literature on the DOTS (Directly Observed Therapy, Short-Course) strategy and examples from fieldwork at multi-drug resistant tuberculosis (MDR-TB) treatment sites in India in the 2000s to examine this tension. Standardized disease control programmes employing drugs, such as DOTS, are often portrayed as struggling with inherent dilemmas between standardization and localization. However, as this chapter shows, such emphasis obscures the productive roles that standards can play. They can act as facilitators in local negation and adaption of global disease control strategies, serving as communicative tools between different actors on different levels.
Abstract
This chapter discusses the tension between standardization and localization in efforts to control tuberculosis (TB); between programmatic considerations and responding to individual care needs, including particular TB strains, co-morbidities, personal pharmaceutical histories or socio-economic circumstances. Drawing on science and technology studies methodology, including a focus on how standards are made to work, the chapter uses anthropological and sociological literature on the DOTS (Directly Observed Therapy, Short-Course) strategy and examples from fieldwork at multi-drug resistant tuberculosis (MDR-TB) treatment sites in India in the 2000s to examine this tension. Standardized disease control programmes employing drugs, such as DOTS, are often portrayed as struggling with inherent dilemmas between standardization and localization. However, as this chapter shows, such emphasis obscures the productive roles that standards can play. They can act as facilitators in local negation and adaption of global disease control strategies, serving as communicative tools between different actors on different levels.
Chapters in this book
- Front matter i
- Contents v
- List of contributors vii
- Acknowledgements xi
- List of abbreviations xii
- 1 Global health and the new world order 1
- 2 Standardization and localization in tuberculosis control 29
- 3 The not-so-distant past, tuberculosis and the DOTS challenge 52
- 4 Decolonizing, nationalizing and globalizing the history of psychiatry 81
- 5 ‘Clearing the streets’ 103
- 6 You’ve got the point? 130
- 7 Finding the global in the local 154
- 8 Rare genetic disease, global health and genomics 183
- 9 The World Health Organization’s response to Ebola in historical perspective 207
- 10 Epilogue 230
- Index 247
Chapters in this book
- Front matter i
- Contents v
- List of contributors vii
- Acknowledgements xi
- List of abbreviations xii
- 1 Global health and the new world order 1
- 2 Standardization and localization in tuberculosis control 29
- 3 The not-so-distant past, tuberculosis and the DOTS challenge 52
- 4 Decolonizing, nationalizing and globalizing the history of psychiatry 81
- 5 ‘Clearing the streets’ 103
- 6 You’ve got the point? 130
- 7 Finding the global in the local 154
- 8 Rare genetic disease, global health and genomics 183
- 9 The World Health Organization’s response to Ebola in historical perspective 207
- 10 Epilogue 230
- Index 247
