GGRB28H3 Chapter Notes -Opportunistic Infection, Neoliberalism, Drug Resistance

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27 Nov 2013
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GGRB28 Reading
The Vitality of Practice (Farmer)
“In my first year there, I witnessed preventable deaths from malaria, tuberculosis, and
postpartum infections”
“The hypocrisies of development are not only morally flimsy but in fact analytically
shallow”
World system's theory
“Aid, I learned through research, brought connections, not discontinuities, into relief
Medical services for the people I’d come to care about were simply not 'cost effective'
in the increasingly dominant framework of neoliberalism
World systems theory, perhaps, helped us to see people like ourselves with one foot in
Harvard and another in Haiti, as possible conduits for resources
Since roughly a third of the world's population carries quiescent tuberculosis infection,
tuberculosis is probably the world's most common AIDS-associated opportunistic
infection
In rural Haiti, failure to respond to therapies accounts for many of the lows, but there
are just are frequently the result of a lack of something: a medicine, a diagnostic
test, a bit of already published information, or cash for families who need food
and housing more than they need medicines.
Successes in Haiti: early detection and aggressive therapy for tuberculosis among the
HIV-infected; the use of ACT during pregnancy to prevent vertical transmission
of HIV
Ruptures de stock-- an interrupted supply of key drugs- which can have implications in
terms of drug resistance
Living with HIV and poverty is brutally painful
MDRTB: Multidrug-resistant tuberculosis
Some believe that a person with active pulmonary tuberculosis infects, on average,
between ten and 20 persons per year
In the clinic we visited, nurses told us about patients who had failed to respond to
directly observed therapy with first-line drugs. Many had died before suspected
resistance could be confirmed
Most were slated to receive 'isonized for life”
Cases of MDRTB contracted in Peru but were diagnosed elsewhere
MDRTB proved no more 'untreatable' in urban Peru than in New York.
What is missing from the debate is acknowledgement that the growing inequalities of
the global era- the context, after all, of research conducted in a poor country but
censored by a rich one-- constitute in and of themselves, a sort of Global
Tuskegee experiment
“It seems quite clear to me that the major complaint has been the great inequalities of
the system, which means the absence of democracy
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