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Wenzel Geissler and the contributors examine how medicine and public health in Africa have been transformed as a result of economic and political liberalization and globalization, intertwined with epidemiological and technological changes.

The resulting fragmented medical science landscape is shaped and sustained by transnational flows of expertise and resources. NGOs, universities, pharmaceutical companies and other nonstate actors now play a significant role in medical research and treatment.

But as the contributors to this volume argue, these groups have not supplanted the primacy of the nation-state in Africa. Although not necessarily stable or responsive, national governments remain crucial in medical care, both as employers of health care professionals and as sources of regulation, access, and — albeit sometimes counterintuitively - trust for their people.

They may point towards a deep dissatisfaction with the kind of restricted political frame of reference which prevails in our common thought about politics, and they may express the desire to enlarge this repertoire of politicalideological categories with new political -isms that were not invented by westerners and tried out in Europe before being exported to other parts of the world — a 'chtonic' desire, so to speak, to create an 'autochthonous' doctrine uninfected by the West cf.

Arnaut and Blommaert From that perspective, the question as to how original these writings are, is of secondary importance. Similar national histories were written about Swahili, the most notable being Chiraghdin and Mnyampalaand in these fields we witness the growth of a 'chtonic' national science cf.

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