The health sector is one of the largest and most rapidly growing branches of the global economy. The world’s biggest pharmaceutical companies earn hundreds of billions of dollars per year, thereby exceeding many countries’ gross domestic product. The health sector is also predicted to be the largest source of employment creation in the decades to come, all over the world. Economised forms of health provision and disease prevention generate financial values, for instance in private insurance schemes or high-risk, experimental treatments. On the other hand, publicly funded health care – which has raised societal expectations and hopes for a very long time in most parts of the world – is increasingly being confronted with funding cuts, and in some cases with drastic austerity policies. Furthermore, situations of recent or long-term scarcity in health care systems produce existential uncertainties and concerns in relation to (both formal and informal) medicine and care worldwide. All these examples show how pervasive and commanding many aspects of economics and finance – and the values and logics that the highly advanced capitalist world order is inflicting on all domains of human existence and wellbeing – has become over the last decades, not least with regard to the omnipresent politics and practices of neoliberal governance.
This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experiences and forms of treatment and care in the varying locations and contexts of Egypt, Tanzania, Brazil and India. By introducing the concept of ‘transfiguration’, we highlight the highly ambiguous, ever-evolving and increasingly transnational character of these processes in the vastly contested and power-ridden fields of medicine and wellbeing. We also argue that a moral economy approach can figure as a lens to disentangle and disaggregate these different fields’ values and practices analytically and to account for the need to reflect systematically on people’s struggles for a ‘good life’ in the context of profit-driven and often highly exclusionary economies and their impacts on health care systems. Against this background, the contributions to this special issue ask, through a shared theoretical concern, how medicine, illness experience and medical knowledge production coalesce under the condition of ‘excessive’ economies in relation to subjectivities, materialities and values. In conclusion, we ask which ethical and political demands arise for anthropologists as novel, strongly politicised and morally loaded fields of research open up; and how we can respond to the challenges of doing research in the capital-intensive fields of medicine and health and act accordingly in our investigations and writings.
The contributions to the special issue were first presented at the trinational conference entitled “Transfigurationen: medizin macht gesellschaft macht medizin” (University of Basel, February 2017), which celebrated and reflected upon twenty-five years of Medical Anthropology Switzerland within the Swiss Anthropological Association, twenty years of Work Group Medical Anthropology within the German Anthropological Association, and the establishment of the Vienna Dialogues in Medical Anthropology in 2012. At this conference, the highly ambiguous impact of economic transfigurations on individual and collective wellbeing was also exposed prominently in Andrea Muehlebach’s keynote speech, which explored how everyday lives in the context of austerity measures in Southern Europe are permeated and governed by late capitalist, neoliberal markets in unprecedented affective and transnationalised ways. More insights into the themes of and contributions to the conference can be obtained in the previously published reports by Mira Menzfeld (H-Soz-Kult), Laura Perler and Francesca Rickli (Somatosphere / Blog Medizinethnologie), and Max Schnepf (Medicine, Anthropology, Theory).
Table of Contents (Zeitschrift für Ethnologie 143, 1, 2018)
Janina Kehr, Hansjörg Dilger and Peter van Eeuwijk
„Introduction: Transfigurations of Health and the Moral Economy of Medicine: Subjectivities, Materialities, Values“
„Transfigurative Experiences of Sickness. Medical Regimes, Disease Commodification, and Professional Patients in Egypt“
„From Urine in India to Ampoules in Europe: The Relational Infrastructure of Human Chorionic Gonadotropin“
„Recht auf Gesundheit, citizenship und die Moralökonomie einer sozialmedizinischen Versorgung vulnerabler Bevölkerungsgruppen in Rio de Janeiro“
„Transfiguration(s) of Palliative Care. The Moral Economy of End-of-Life Care in a Tanzanian Cancer Hospital“
„Making the Cells Work. Rendering Autologous Stem Cell Therapies Viable in India“