Staging global public health : workshops, technologies of participation, and the authorization of knowledge in anti-retroviral therapy in Uganda / Sung-Joon Park

Abstract

In this essay I focus on workshops to examine how scientific knowledge in global public health is authorized. More specifically, in this essay workshops will be approached to elaborate on the public performance of knowledge, which is often considered to be a crucial element in the conduct of scientific research. The performance of scientific knowledge will be conceptualized as the staging of global public health through which experts craft the credibility of their advice by involving the publics in the form of so-called ‘stakeholders’ and thereby create the basis for global public health interventions. I will narrate the staging of science in global health in the form of fictionalized minutes and capture some of the techniques deployed in creating order out of disorder in the supply of medicines in Uganda. The plot of this account begins with the stock-out of antiretrovirals in the country, which occurred between 2009 and 2010 and incited concerned questions about the fragmented landscape of antiretroviral therapy and more importantly the responsibility for the life-long supply of antiretrovirals in the country. I will trace these concerns through national and international media responses. These media responses will be contrasted with workshops held to discuss a shortfall of funding and advance particular institutional reforms. The discussion of techniques to present facts (powerpoint presentations), practices of deliberation (working group discussions) and material objects (paper sheets) in authorizing claims to knowledge suggest that workshops are better understood as technologies of participation. Workshops are neither simply inclusive nor coercive. They are productive in redefining what ought to be ‘public’ in global public health in Uganda by fostering agreements over the causes of the stock-out of antiretrovirals and the measures to be taken in the public interest in the context of an underfunded national health system.