Sandy Smith-Nonini, adjunct asst. professor of anthropology at Elon, just published an article that evaluates both governmental and non-governmental health initiatives to treat a drug-resistant tuberculosis epidemic in Lima, Peru. The article, titled “When ‘the Program is Good but the Disease is Better’: Lessons from Peru on Drug-Resistant Tuberculosis” came out in the latest issue of the journal Medical Anthropology Vol. 24(3) 2005, pp. 265-296.
Based on an ethnographic study of health politics within and between institutions, the article gives an in-depth account of the political and economic causes of the epidemic, and the ironic situation that arose when Peru’s well-designed model program for drug-susceptible TB failed to confront the country’s growing problem of drug resistance. The problem was brought to public attention by a small NGO linked to Paul Farmer’s “Partners in Health” group based in Boston, which designed a grassroots out-patient approach to treating drug-resistant patients who would otherwise die. After initially difficult relations, the Peruvian Ministry of Health is now working in collaboration with PIH. Thanks to advocacy by PIH physicians, this new approach to drug-resistant TB has led to changes in global health policy, and efforts are underway to replicate the model in Russian prisons and other “hot-spots” where highly infectious drug-resistant TB threatens both patients’ lives, and the success of TB control programs.
Smith-Nonini conducted the research during a post-doctoral fellowship at Emory University that was funded by the Mellon Foundation.
For those who are interested: This link is to a shorter report on Smith-Nonini’s research that was published by Emory’s Center for the Study of Health, Culture and Society.