Neoliberalism has been the defining paradigm in global health since the latter part of the twentieth century. What started as an untested and unproven theory that the creation of unfettered markets would give rise to political democracy led to policies that promoted the belief that private markets were the optimal agents for the distribution of social goods, including health care. A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan’s remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a "revolving drug fund" program—used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities. Provocative, rigorous, and accessible, Blind Spot offers a cautionary tale about the forces driving decision making in health and development policy today, illustrating how the privatization of health care can have catastrophic outcomes for some of the world’s most vulnerable populations.
In this moving and thought-provoking volume, Arthur Kleinman tells the unsettling stories of a handful of men and women, some of whom have lived through some of the most fundamental transitions of the turbulent twentieth century. Here we meet an American veteran of World War II, tortured by the memory of the atrocities he committed while a soldier in the Pacific. A French-American woman aiding refugees in sub-Saharan Africa, facing the utter chaos of a society where life has become meaningless. A Chinese doctor trying to stay alive during Mao's cultural revolution, discovering that the only values that matter are those that get you beyond the next threat. These individuals found themselves caught in circumstances where those things that matter most to them--their desires, status, relationships, resources, political and religious commitments, life itself--have been challenged by the society around them. Each is caught up in existential moral experiences that define what it means to be human, with an intensity that makes their life narratives arresting. These stories reveal just how malleable moral life is, and just how central danger is to our worlds and our livelihood. Indeed, Kleinman offers in this book a groundbreaking approach to ethics, examining "who we are" through some of the most disturbing issues of our time--war, globalization, poverty, social injustice--all in the context of actual lived moral life.
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