History, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Med Humanit. 2022 Jun;48(2):177-189. doi: 10.1136/medhum-2021-012251.
This article explores the development and evolution of 'neglected tropical diseases' (NTDs) as an operative and imaginative category in global public health, focusing on the early intellectual and institutional development of the category in the 1970s. It examines early work around 'neglected' diseases in the Rockefeller Foundation's Health Sciences Division, specifically the Foundation's 'Great Neglected Diseases of Mankind' initiative that ran between 1978 and 1988, as well as intersections with the WHO's parallel Special Programme for Research and Training in Tropical Diseases and efforts by the US-based Edna McConnell Clark and MacArthur Foundations. A key concern of advocates who influenced initial programmes focused around 'neglect' was a lack of sophistication in medical parasitological research globally. Central to the NTDs' capacity to animate diverse energies were claims about parasitic diseases and their place in new biotechnological approaches to medicine. This article explores how the emphasis on 'neglected', 'tropical' or even 'endemic' diseases encoded specific concerns and desires of parasitologists in the early 1970s. Despite the desire to prioritise the needs of 'endemic' countries and the recognition of a widening cohort of experts from both high-income and low-income nations, NTD advocates often recapitulated historic power dynamics privileging research institutions in the USA and Europe. Historicising and contextualising 'neglect' illuminates the contingent and changing politics of global health in a formative period in the late twentieth century.
本文探讨了“被忽视的热带病”(NTDs)作为全球公共卫生领域中一个具有操作性和想象力的范畴的发展和演变,重点关注该范畴在 20 世纪 70 年代的早期知识和机构发展。本文考察了洛克菲勒基金会健康科学部早期围绕“被忽视”疾病所做的工作,特别是该基金会在 1978 年至 1988 年期间开展的“人类重大被忽视疾病”倡议,以及与世界卫生组织(WHO)同期的热带病研究和培训特别规划以及美国埃德娜·麦克科伦·克拉克基金会(Edna McConnell Clark Foundation)和麦克阿瑟基金会(MacArthur Foundation)的交集。影响最初方案的倡导者们关注的一个关键问题是全球医学寄生虫学研究的不成熟。被忽视的热带病能够激发各种能量的核心是关于寄生虫病及其在医学新生物技术方法中的地位的说法。本文探讨了 20 世纪 70 年代初,“被忽视”、“热带”甚至“地方病”等疾病的强调如何体现了寄生虫学家的具体关注和愿望。尽管人们希望优先考虑“地方病”国家的需求,并认识到来自高收入和低收入国家的越来越多的专家群体,但被忽视的热带病倡导者往往重复了历史上赋予美国和欧洲研究机构特权的权力动态。将“被忽视”历史化和情境化揭示了 20 世纪后期一个形成期全球卫生中偶然的、不断变化的政治。