Watson Institute for International and Public Affairs
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Luke Messac ─ No More to Spend: Neglect and the Construction of Scarcity in Malawi's History of Health Care

Friday, October 30, 2020

12 p.m. – 1 p.m.

Watch on Watson's YouTube channel.

Watch on YouTube

Dr. Messac will join us to discuss his new book, No More to Spend.

Dismal public spending on health is often considered a necessary consequence of a low per-capita GDP, but are patients in poor countries really doomed to go without modern medicine? In many countries, officials speak of health care as a luxury, and convincing politicians to fund quality health services is a constant struggle. Yet, in many of the poorest nations, health care has long received a tiny share of government spending. Colonial and postcolonial governments used political, rhetorical, and even military campaigns to rebuff demands by patients and health professionals for improved medical provision.

No More to Spend challenges the inevitability of inadequate social services in twentieth-century Africa, focusing on the political history of Malawi. Using the stories of doctors, patients, and political leaders, No More to Spend demonstrates how both colonial and postcolonial administrations used claims of scarcity to justify the poor state of health care. During periods of increased global interest in social protection, forestalling improvements in health care required new rationalizations. Calls for better medical care compelled governments, like that of Malawi, to either increase public health spending or offer reasons for their inaction. Because medical care is still sparse in many regions in Africa, the recurring tactics for prolonged neglect have important implications for global health today.

Meet the Author
Rhodes Center for International Economics and Finance

Luke Messac is a physician and historian whose research focuses on the histories of health policy in southern Africa and the United States. He is a resident in emergency medicine at Brown University in Providence, Rhode Island.