MAKING UNCERTAINTY, tuberculosis, substance use, and pathways to health in South Africa

151pp., paperback, Rutgers University Press, New Brunswick, 2023

ISBN: 9781978822474

Anna Versfeld examines lives and care in Cape Town to demonstrate how patterns of substance use, tuberculosis disease, and their interaction are shaped by history, social context, and political economy, and offers new perspectives on and what good health and care might look like.

"This is an outstanding ethnography that makes important contributions to medical anthropology specifically in relation to infectious diseases, substance use, and anthropological studies of global health practices and interventions. The nuanced anthropological focus on the intersections of substance use and tuberculosis among marginalized and impoverished persons that Versfeld analyzes in relation to historical legacies of colonialism and Apartheid is both in-depth and accessible. Critical reading for medical anthropologists, global public health scholars, and those interested in health inequalities in Africa and the Global South." Erin Koch, author of Free Market Tuberculosis: Managing epidemics in postsocialist Georgia

"South Africa has among the highest tuberculosis rates in the world, related to indoor residential crowding, occupational hazards like mining, and high background HIV prevalence. Drug resistance and active TB resurgence magnify the original problem, increasing costs of care and reducing survival. I recommend this important contribution for anyone seeking deeper insights into the healthcare and community challenges facing the syndemic of substance use and TB, often complicated by HIV co-infection. Only a multifaceted response is likely to succeed for a disease too often addressed with limited 'vertical” programs.'" Sten Vermund, Anna M.R. Lauder Professor of Public Health, and Dean of the Yale School of Public Health

Anna Versfeld is an independent South African medical anthropologist.