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Johanna Tayloe Crane. Scrambling for Africa: AIDS, Expertise, and the Rise of American Global Health Science. Ithaca, N.Y.: Cornell University Press, 2013. xiii + 208 pp. $27.95 (978-0-8014-7917-5).
Johanna Tayloe Crane's multisited ethnographic study of HIV research and treatment makes a conscientious and provocative contribution to a growing body of literature that seeks to locate global health work in diverse historical, social, political, or economic contexts. Here, that context is primarily present-day Mbarara, Uganda. Crane follows American and Ugandan researchers, physicians, and administrators, and occasionally Ugandan patients, as each navigates a world dominated by HIV at Mbarara's Immune Wellness Clinic. In a crisply written and evocatively told story of research, treatment, and expertise, Crane narrates a history of HIV research and treatment in Africa in the era of PEPFAR, and explores the singular role of HIV/AIDS in the broader development of global health in the past two decades.
Scrambling for Africa examines the arrival of antiretroviral (ARV) drugs and American HIV researchers in rural Uganda between roughly 2004 and 2012, highlighting these changes as generative moments in global health science through which particular tensions become visible. Crane, as an inside woman of sorts, is uniquely positioned to pose a sensitive and probing critique of global health at a moment of profound change. At the core of her study is the problem of "valuable inequalities"...