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When People Come First: Critical Studies in Global Health
Edited by João Biehl & Adriana Petryna
Princeton University Press (July 2013)
Hardcover ISBN: 9780691157382 ($75.00)
Paperback ISBN: 9780691157399 ($29.95)
Reviewed by HHR editorial intern Laura Faas
In When People Come First, João Biehl and Adriana Petryna note that “magic-bullet approaches” to global health, which target one specific disease, are limited because they overlook the societal, political, and economic contexts that affect the outcome of new health technologies. Moving beyond this decades-long approach, Biehl and Petryna, along with the volume’s other authors, contend that ethnography offers enormous potential as a methodological tool for revealing insights in the global health world. While replicable experiments are central to health research, ethnography is central to humanitarian storytelling. These human stories draw public attention in moments of crisis—crucial in eliciting calls for political and social action. Biehl and Petryna maintain that ethnography “debunks generalized knowledge” and “offers a sharper resolution of how things are,” focusing on the ways people exist and survive. More holistic and personalized approaches to health and human rights emerge throughout the book as not merely valuable, but essential to long-term success in fulfilling the right to health.
The volume is divided into three parts: Evidence, Interventions, and Markets. Each is comprised of multiple case studies, and each case study approaches its own global health issue. The “Evidence” section identifies various historical, disciplinary, political, and economic roots of health programs and institutions. “Interventions” analyzes the ways in which the interventions implemented by these institutions and programs interact with and transform public health and people’s lives in the context of the local. “Markets” explores how the global expansion of therapeutic and medical markets is tied to various political, medical, legal, and social realities.
The case studies cover a wide range of topics, from the history of rights surrounding HIV status, to the social rather than medical implications of Guinea worm disease, to the impact of job insecurity on mental health in Chile. Across disparate topics, When People Come First celebrates the potential of ethnography to transform global health and human rights by employing a people-centered approach.