Developing to scale : technology and the making of global health

"Developing to Scale examines the techno-centric structure of global health practice through the history of the concept of appropriate technology. By looking at how certain technologies have been defined as more or less "appropriate" for the global south, based on assumptions about gender, race, culture, and environment, Heidi Morefield reveals the ways in which questions of technological scale have fundamentally shaped global health practice today. The idea that there was an "appropriate" level of technology, between the traditional and the modern, that would lead to sustainable social and economic development originated in the mid-1960s and gained considerable prominence in the 1970s. US foreign assistance oriented away from large-scale modernization projects, like water treatment facilities, toward small-scale, point-of-use technologies, like village water pumps, individual water filters, and oral rehydration salts. Practical shifts in assistance like this were a result of the enthusiastic adoption of the idea but also cuts in foreign aid budgets and other economic interests, principally those of newer donors from the high-tech sector; political interests; and the efforts of various activists, most notably post-colonial and anti-apartheid groups. Dreams of technological salvation have gained a new significance and foothold in the contemporary imagination, and Morefield's book provides the backstory, uncovering precisely how global health came to be understood largely as a problem to be solved with the right technology."