‘Exotic no more’: Tuberculosis, public debt and global health in Berlin

ABSTRACT

Geographical divisions between North and South are coming increasingly undone in the field of global health. Settings in the global North, such as Berlin, are becoming linked up to those in the global South in manifold ways. In this article, I show through discourse analysis and ethnographic research how tuberculosis and its meanings have been transfigured in Western Europe through the worldwide circulation of the disease and its definition as a global health epidemic returning to the North from the South through global migration routes. I then draw attention to the ways in which public health professionals in Berlin make sense of locally implemented economic processes of debt and austerity that have been in effect since the early 2000s. Such processes of indebtedness and privatisation render the strong public health infrastructures that characterise the global North increasingly fragile, and are comparable to the structural adjustment policies that have been imposed upon countries in the global South. I argue that economic processes of austerity in Berlin complement the meaning of TB as an immigrants’ disease, while older meanings of TB as a disease of poverty resurface.

KEYWORDS:

• Tuberculosis
• austerity
• debt
• public health
• Germany

Acknowledgement

I would like to thank Hansjörg Dilger and Domink Mattes as well as the anonymous reviewers of Global Public Health for their valuable comments and suggestions. Many thanks to Zoe Goldstein for her copy editing, as well as the Chair for the History of Medicine of the University of Zurich, Flurin Condrau, for the financial editing support.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1 By capitalising the terms North and South, I aim to indicate the social and political imaginaries of locations and North–South divides rather than their actual geography.

2 http://digital.zlb.de/viewer/content?action=application&sourcepath=33334659/bilanz_verwmod.pdf&format=pdf

3 Agenda 2010, which was implemented in 2003, involved a depletion of social security together with a liberalisation of the labour market, as put forward by the Social Democrat chancellor Gerhard Schröder and his coalition government.

Additional information

Funding

This work was supported by a Promotionsstipendium nach dem Nachwuchsförderungsgesetz (NaFöG) Berlin research grant of Ph.D. Scholarship (2006–2010).