Abstract

This presentation examines the paradoxical problem of spatial enclaving in global health. It argues that contemporary global health initiatives have displaced older alignments of national territory with state-managed biopolitics. Even as advances in biomedicine become available in some of the poorest parts of the world – thus extending forms of biological citizenship that promise post-colonial, post-racial and post-national inclusion – new global health initiatives have created exclusionary effects and newly gradated forms of both sovereignty and citizenship. These enclaving outcomes invite careful geographical analysis and explanation, not least of all because of their similarity with other examples of enclaving – EPZs, gated communities, privatized shopping malls and the like – that geographers have connected with the inequalities and asymmetries of contemporary globalization. In the case of global health, a large number of factors are involved. These include the destructive legacy of debt and structural adjustment policies, the decimation of local public health infrastructures and systems as well as the reconstructive approach of new ‘global health initiatives’ themselves.