Blind Spot

This excellent historical-anthropological case study documents how the market-based ideology of neoliberalism has shaped global health and development policy since the 1980s.  Despite evidence to the contrary, this unquestioned (and ultimately harmful) set of ideas became the 'common sense' basis of a problematic health reform effort.  With a sympathetic eye towards NGOs and local health practitioners in poverty-stricken Tajikistan, Keshavjee shows how a particular program failed but the underlying assumptions remained unstoppable. This elegantly written book exemplifies the power of shifting the anthropological analytical gaze to the social processes of policy formation that exacerbated the horrific post-Soviet mortality crisis.-Peter J. Brown, Professor of Anthropology and Global Health, Emory University All newcomers to the work of global health should read this book. Writing elegantly about the devastating effects of the Bamako Initiative, but more importantly about the history of neoliberalism itself, Keshavjee offers a cautionary lesson to those who are still enthusiastic about allowing market-driven policies to guide our global health work. Indeed, the case of reduced access to drugs in the post-Soviet Tajikistan community of Badakhshan presents a stunning example of the hypocrisy, ideological blindness, and institutional failures that allowed the principles of supply side economics to both inform the provisioning of health care resources and, ultimately, derail even the best intentions of many a good NGO or global health worker, including physicians like Keshavjee himself. Blind Spot is a quick and pithy study of a problem that refuses to go away.-Vincanne Adams, Professor of Medical Anthropology at the University of California, San Francisco, and author of Markets of Sorrow, Labors of Faith: New Orleans in the Wake of Katrina Blind Spot provides a singularly nuanced critique of neoliberal health policies as they play out on the ground in a desperately impoverished, post-war, post-Soviet setting. Taking readers from the boardrooms of Geneva to the high mountains of Tajikistan, this book is bound to become a classic in medical anthropology and critical global health studies. There is no other book quite like it.-Marcia Inhorn, William K. Lanman Jr. Professor of Anthropology and International Affairs at Yale University Keshavjee's Blind Spot is quite possibly the most important ethnography of social development under neoliberalism applied to health that has been written to date. It is a telling moral lesson in how humanitarian assistance--despite its noble intentions--fails and actually at times even intensifies social suffering.-Arthur Kleinman, Harvard University