gutted state institutions of care, research and higher education, and abandonment of the collectives and futures towards which care, expertise and knowledge had been oriented (352)
AO: They do not discuss their own data practices.
AO: Writing about the six pieces in the special volume, the authors talk about re-politicize capacity in Africa to recognize capacity as a form of power to act on the world and produce effects, that emerges from, is contested within, and acts on social, institutional and material processes as they unfold within specific locations and histories in a world of unequal life chances, resources and opportunity. They talk about how the authors “relocate capacity in the pursuit of ‘good’ science and care, defined not just as technological efficacy, but also in terms of personal and collective duty, service, pleasure, success, sovereignty, autonomy, membership and progress.” (350)
AO: Geissler and Tousignant ask: “what kinds of tensions arise in and between the making of good institutions, good collaborators, good careers, good science and good health? How do these different goals converge, and what successes, satisfactions, problems, dilemmas and disputes arise?” (351)
AO: The authors argue that to gain capacity, African scientists and clinicians often seek to become ‘collaborators’ at the expense of autonomy in setting and pursuing priorities of knowledge and care (they cite Droney 2017; Waast and Krishna 2003).
AO: Citing Mika’s study, the authors note a performance of partial capacity – such as doing meticulous ward rounds when chemotherapy stocks are exhausted – is, like improvised capacity, an ambivalent good.
“On the one hand, it appears as illusory capacity, an ‘empty’ performance that does not lead to health improvement. On the other hand, ‘performing’ as a good nurse, doctor, scientist or institution may not only attract future capacity building investment (Fullwiley 2011; Moyi Okwaro and Geissler 2015), it is also a source of value in itself as an enactment of service, professionalism and action (e.g. Livingston 2012; Tousignant 2013b) constitutive of subjec- tivity and hence precondition for medical, or political, action.” (355)
AO: They write: “capacity is meant to last, but to do so it must be remembered, accumulated, repaired and protected.” This echoes recent work looking at the unaccounted for labor that often is not planned for or forgotten with regards to technology (in education for example). This is described in the context of digital infrastructures by Crooks and also Kenner in different examples.
AO: Geissler and Tousignant look at the aspects of capacity building which are typically overlooked: “the political and moral charge – for African scientists, clinicians and patients – of skills, technologies, careers, knowledge and care; the contested values, power and futures that capacity might perturb or activate; the incapacities that global health capacity-building initiatives are rooted in, thrive on, reinforce or reproduce; as well as the existing capacities and dreams of capacity that these initiatives often fail to acknowledge, invest in, or engage with.” (350)
AO: The authors argue that, ‘as something to be ‘built’, capacity is often treated as an inherent property of an object, actor or system, which can thus be delivered or deployed, transacted between haves and have-nots” but that by moving beyond specific capacity-building projects, “capacity can also be thought of as potential, projection and direction, as collective memory and futures, as imaginaries of transformation.” With such an extended temporal frame, capacity then becomes a longstanding goal tied to prior social and political projects; as a distributed property of materials, skills, institutions, persons and groups that can be remembered or forgotten, that accumulates, decays, remains and is recomposed; and as a project that takes effect in the future. (353)
AO: Geissler and Tousignant argue that “capacity” gained prominance in international development to label a gap, “just as ‘the community’ and its elusive ‘empowerment’, during the same time, became keywords of international aid precisely when the primary modality of collective belonging and entitlement – national citizenship and the social contract it entailed – lost purchase.” (352)
AO: Citing Ferguson (2006) and Mbembe (2001), the authors note that Africa has been (re-)constituted since the 1980s as a landscape of lack, defined by absences and negativity (esp. to address ‘weaknesses’ in the public sector left (or made) by measures of ‘structural adjustment). This echoes ongoing discourse about the “lack” or deficit of good data in/on/from Africa.
AO: The authors note the erosion of public infrastructures – and the proliferation of non- governmental and private initiatives in the absence of state care and science – that drove a wedge between health and citizens’ rights, public welfare and collective visions of civic progress (Loewenson 1993; Price 1988; Prince and Marsland 2013; Riddell 1992). (351).
AO: Authors note that transnational collaboration in health research and quasi-experimental interventions have emerged as the dominant mode of health capacity building in Africa. The ‘scramble for Africa’ as a site of transnational health research and intervention has also been predicated on the lasting lack of African capacity to investigate and treat HIV (Crane 2013; Gilbert 2013).
AO: the authors argue that the development of “humanitarian technologies” anticipate the absence of state infrastructure and minimize the need for greater public commitments (e.g. Redfield 2008, 2012, 2015). ‘Community participation’ or ‘empowerment’ – common references in the capacity-building discourse – likewise seek to make health research and care function efficiently and ethically with minimal investment in infrastructure (353).
AO: The authors look at “global” and “local” standards of science while Okeke argues that the two cannot be disentangled: “While Droney and Wendland show that supposedly ‘global’ standards of good science and care may not fully capture the capacities most relevant to African health practices and outcomes (albeit in ways that invite reflection on how to define capacity everywhere), Iruka Okeke’s paper argues that African and global bio-scientific capacity are tightly imbricated.”
AO: The authors are politicizing and theorizing the concept “capacity” in Africa which they define as “the skills, technologies and infrastructure that are transferred, built or sought out.” They are working with the concept in the context of health care capacity and note the different valences of the notion of capacity - both material but also affective and temporal.
AO: The authors think about “capacity” in terms of relational, “arising not only in negotiations and trans- actions between African and non-African experts, but also in materiality, in time, in technopolitics and geopolitics, in the cohesion and dissolution of collectives, in points of contact between labor and dreams.”
AO: They argue that the capacity to dream is an important aspect of “capacity” which anticipates change and moves towards different, improved futures. They hold that form of capacity must be “appreciated, maintained ‒ and built in order to energize medical and scientific activity – as political and social action – for improved health.” (354). I appreciate this perspective of capacity but also note that concepts of “techutopias” are already heavily used within tech circles in Africa (which are heavily caught up in “Africa Rising” narratives that perhaps the health and care sector is not. See a lot of the work related to “dreaming up the future” of Africa (via tech). I think there needs to also be further nuance to these “dreams” to denote where many of these imaginaries are stemming from (e.g. Wakanda??).
AO: The authors are strong in their macro and nano descriptions of the notions of capacity and historicize the concept.