Disease maps are ubiquitous in today’s world. Examples abound, from Gates’ Malaria Atlas Project to UNAIDS’ world maps of HIV prevalence to the global burden of disease charts computed by the Institute of Health Metrics & Evaluation. These types of maps have become a key feature of contemporary global health. They render epidemics and other health issues visible, telling stories about their origins, health burden and future course. They guide policymakers, aid agencies and philanthropists on how best to invest their resources. They help patient groups draw attention to particular issues and advocate for more funding. They point to unexplored avenues for medical research and untapped markets for drug companies. They shape the movement of people, from travel clinics for holidaymakers to medical arrangements for military personnel deployed overseas to quarantine facilities at border crossings. Given these critical roles that epidemiological maps play in the administration of global health today, it is important we interrogate and develop a better understanding of these cartographies of disease: What are their colonial genealogies? What are the scientific and political rationales driving these initiatives? What is the socio-technical infrastructure necessary to the production of these maps? What ideas of disease and Africa do these cartographies help bring into being? And, more provocatively perhaps, can these maps be trusted at all?
These questions are at the heart of the present research project. Indeed, drawing on insights from postcolonial science studies and in close partnership with epidemiologists, the aim of this project is to shed light on these epidemiological maps that have become so critical but about which we know so little. Specifically, the project seeks to uncover the socio-technical infrastructures and scientifio-political rationales that underpin these maps as well as the understandings of disease and place that these maps bring into being. To explore these issues, the project focuses on efforts to map cancer in sub-Saharan Africa over the last 70 years. Specifically, it examines, compares and contrasts two types of cartographic initiatives: (1) the production by British and French doctors in the late colonial and early postcolonial periods of small-scale epidemiological maps to advance understandings of cancer aetiology and improve treatment strategies in the metropole; and (2) the contemporary publication by global surveillance organisations like the WHO’s International Agency for Research on Cancer and the Gates-funded Institute for Health Metrics & Evaluation of political altases of the continent with national cancer burdens to rationalise health policy and planning in Africa. The research builds on archival research in France, Senegal, the Ivory Coast, Kenya, Uganda, South Africa, the UK, the USA and Switzerland as well as ethnographic fieldwork in Abidjan, Eldoret, Kampala, Nairobi, Mwanza, Brazzaville, Moshi, Lyon, Seattle and beyond.
This project is funded through a British Academy Knowledge Frontiers Award and a Wellcome Trust Investigator Award. The project is run by David Reubi (PI, responsible for West Africa), Thandeka Cochrane (responsable East & South Africa) and Jenn Fraser (responsible for archival work) at King’s College London. They work in conjunction with Max Parkin, Coordinator of AFCRN and a senior researcher at the University of Oxford, Freddie Bray, Head of the Cancer Surveillance Section at IARC, Anne Korir, head of the Nairobi Cancer Registry at the Kenya Medical Research Institute, and Franck Gnahatin, head of the Abidjan Cancer Registry and member of the National Cancer Control Programme at the Ministry of Health and Public Hygiene of the Ivory Coast. We welcome enquiries from colleagues and health activists working in the field of epidemiology and surveillance in sub-Saharan Africa and beyond.