Social Science Research Council

Abstract

One of the most devastating outcomes of the dissolution of the Soviet Union is the collapse of the centralized medical infrastructure that subsidized health care services for Soviet populations. In the context of large scale economic, political, and cultural upheavals throughout the region, this collapse has led to a dramatic rise in infectious diseases and other social and biological problems. Among the most alarming is the case of tuberculosis; since the mid-1990’s the number of cases of tuberculosis (TB) in the region has doubled.

Disturbingly, the TB problem throughout the former Soviet Union is part of an international epidemic, propelled by globalization and it’s accompanying social inequities such as poverty and inadequate health services. In 1993 the World Health Organization (WHO) declared a global TB emergency; by WHO calculations, an estimated three million people a year die from TB. This is distressing given that TB is a preventable and curable disease. Using the introduction and implementation of WHO standards for TB diagnosis, treatment and management in Georgia as a case study, my dissertation will address questions about the benefits and burdens of globalization in the arena of health care reform and policy.

In Georgia, where corruption, an energy crisis, and intense political and economic instability are influential forces within and between social institutions and everyday life, the obstacles to coping with TB are profound. My dissertation about changing social aspects of TB control in Georgia, researched and written from the perspective of medical anthropology, examines the particularities of local and global aspects of health care to articulate the complex relationships between the state, society, and medicine. By scrutinizing relationships between globalization, health policy, and standardization at the local level, my work will contribute to fruitful debates about the culture and politics of international health, emphasizing the specificities of transformations underway in Georgia and the former Soviet Union.