Beyond realism: Africa's medical dreams Introduction

Curious Utopias

“…Whereas mid-twentieth-century schemes (wherever they were located on the political spectrum) strived towards a public good aimed at a national collective (as Noémi Tousignant's contribution examines), contemporary schemes are oft en selective and partial, as are the collectives or publics they target, imagine or seek to bring into being. Here they echo the shift in twenty-fi rst-century global and public health imaginaries towards 'partial publics' (Geissler 2013;Prince and Marsland 2014;Langwick 2015;Kelly et al 2017;Geissler and Tousignant 2020; see also Hayden 2003). While state-led moves towards 'universal' access to healthcare 'for all citizens' seem to buck this trend (explored by Prince and by Rao in this issue), it is notable that even where interventions tout an ideal of universal access, reach or inclusion, benefi ciaries are approached more as consumers whose desires should be expanded than as citizens with rights and entitlements.…”

“…Our issue also builds on anthropological debates exploring not only hope as political object and social form (e.g. Miyazaki and Swedberg 2017; see Levitas 2010) but also the work of dreaming as a transformative force, and the conditions under which it gains traction, creating blueprints for a future (Gordin et al 2010;Geissler and Tousignant 2020). 2 Analyses of the 'cruel optimism' of contemporary consumption (Berlant 2011) and of the 'privatization of hope' (Th ompson and Zizek 2014) off er further inspiration here, as although they underline how late capitalism confi gures and shapes our aspirations, they also discern forms of possibility and expectation that oppose or point beyond the neoliberal consensus (see Ferguson 2015).…”

Beyond Failure

“…Planning is, of course, central to modern governance and governing. Recent research moves away from a Foucauldian focus on planning as a technology of ordering and creating systems and subjects towards a recognition of the incompletion, breakdown and failures that litter planning projects, and the complex mixture of desire and dreaming, disappointment and deferral that colour, and sometime derail, planning activities (Geissler 2014;Ssorin-Chaikov 2016;Geissler and Tousignant 2020). Th e question raised by Abrams and Weszkalnys, 'What kind of work does the plan do when it is clearly not a blueprint for the future?…”

Digital Health in East Africa: Innovation, Experimentation and the Market

“…Therefore, while digital health in the region stretches back to at least the late 1980s, when the national hospitals began to investigate possible ways to digitise patient records, it was only with the proliferation of mobile phones from the late 1990s that dreams of leapfrogging in health initiated what has come to be called mhealth . The landfall of undersea fibre telecommunication cables on the shores of East Africa around 2009, and the subsequent growth of 4G internet across the region, has nourished new hopes, connecting to dreams concerning health that have much longer histories (see also Geissler and Tousignant, 2020).…”