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The Colonial Politics of Global Health: France and the United Nations in Postwar Africa.

The Colonial Politics of Global Health: France and the United Nations in Postwar Africa. By Jessica Lynne Pearson. (Cambridge, MA: Harvard University Press, 2018. Pp. x, 260. $49.95.)

As world leaders turn away from international organizations, historians are turning back towards them. With this book, Jessica Pearson joins Susan Pedersen and Matthew Connelly in showing how international bodies, in her case the UN and the WHO, forced empires to defend and rethink their colonial policies, while also creating a space for airing anticolonial discourse. (1) Looking at debates over health development in post-WWII French Africa, this is primarily a book about institution-building as colonial politics by other means. It makes an important contribution, but it also points towards further research by historians of science and development.

Pearson shows how, from 1945 to 1960, France attempted to reform its empire and pivot towards a more developmentalist and racially equitable model. However, it ultimately came to depend awkwardly on international funding, while simultaneously remaining hostile to the growing role of international expertise.

In the first half of the book, Pearson shows how UN-mandated collection of demographic data produced evidence of a crisis of public health in Africa and provided weapons for critics of imperialism. World War II looms large in this story: It pushed France's African colonies into a health crisis, delegitimized racially differentiated policies, and created a debt of gratitude, since Africa served as the main staging ground for de Gaulle's Free France. Equally important is the Cold War, and the "anti-imperialism" of the US and the USSR, whose technopolitics would have benefited from closer attention.

The book's second half focuses on the French Union's and the WHO's very different visions of development. Fearing that the WHO's quasi-sovereign status and its language of health as a civic right would undermine attempts to retain a more democratic empire, French elites claimed they had special, local health expertise, fought WHO technical assistance, and established inter-imperial collaboratives together with the Belgians and the British. Africans, who had the least power in these conflicts, ultimately suffered the most. Pearson's close readings of the politics of malaria eradication, family health, and nutrition in these chapters are a high point of the book.

Throughout, Pearson highlights the expansive concept of health used by both the UN and the French Union: this included social and economic welfare, education, prevention, primary care services, and environmental sanitation, as well as treatment. We know the political history of this broad concept: the role of the Great Depression, the LNHO and ILO, and the long trend towards welfare statism that began in the interwar years and would accelerate after WWII. But what were the scientific grounds for this shift? The rise of microbiology and immunology before WWII seemed to point to more narrow, technical concepts of health; global health after 1970 has certainly followed an interventionist, rather than an ecological, path.

The moment during which international expertise and anticolonial pressures pushed empires to accept broader responsibility for social health was narrow indeed. We do not quite understand how this moment arrived, nor why it disappeared. The collective impact of integrated sciences (epidemiology, anthropology, agroecology) in Africa offers one possibility. (2) Notions of the body as an integrated, yet brittle, whole, powered by wartime experiences of injury, endocrinology, and psychiatry, offer another. (3) Better understanding how innovations in scientific knowledge shifted scales in the debate over social health would help historians of development and international organizations, as well. By underscoring the politics of technical expertise and institution-building, and laying the groundwork for future research, Pearson's book constitutes a superb achievement.

University of Southern California

Aro Velmet

(1.) Full disclosure: Pearson and I attended graduate school together, though some years apart, and we share two doctoral advisors.

(2.) Helen Tilley, Africa as a Living Laboratory: Empire, Development, and the Problem of Scientific Knowledge, 1870-1950 (Chicago, IL: University of Chicago Press, 2011).

(3.) Stefanos Geroulanos & Todd Meyers, The Human Body in the Age of Catastrophe: Brittleness, Integration, Science, and the Great War (Chicago, IL: University of Chicago Press, 2019).
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Author:Velmet, Aro
Publication:The Historian
Article Type:Book review
Date:Jun 22, 2019
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