The Making of an ‘Anarchical Conglomerate’ Piloting Health Systems in the State of Cauca Valley, Colombia, 1957-1978
This talk is about an early health systems pilot project – what we might now call ‘health systems strengthening’ – that dissolved into something more anarchical than its creators had envisioned. There has been much written about the ‘success cartel’ in global health today and the difficulties of disentangling how and why projects go wrong. This historical case study of COLINPLAS, or Colombian Comprehensive Health Planning Project, is an opportunity for a deep dive into the relational politics of a multi-country research consortia that drew together, for a brief moment in time, a group of key figures in health systems thinking. These key figures include the ‘Harvard Johnnies’, the ‘Johnny Hopkins’, the RECS team at the World Health Organization headquarters, the Rockefeller Foundation and the University del Valle’s Department of Preventive Medicine and Public Health.
To understand what drew this group together in their efforts to design the first scale-able health systems model for a low-income country, as well as the forces that pulled them apart, Erica considers the University del Valle as the locus of a historically-contingent politics of public health planning and the site of visionary community health approaches that emerged two decades prior to the Declaration of Alma Ata. This history offers an illustration of the pragmatics and politics of international research collaborations, and the limits of ‘rational’ and technical approaches to health planning in light of these complex relationships of power. It decentres a narrative of health systems creation in ‘developing’ countries as an exercise in top-down, neo-colonial control and instead considers this flagship pilot project as part of a broader dynamic assemblage of ideas, individuals, resources and agendas.
Erica Nelson is a historian and anthropologist with a strong background in community engagement, primary health services research, and the politics of public health in Latin America. She has been engaged in qualitative and historical research on/in community-based public health programmes and health policy-making processes in Latin America for the past 14 years, with specialist knowledge of the Andes region. Currently, she is a research fellow at the London School of Hygiene and Tropical Medicine’s Centre for History in Public Health with a project focusing on the historical development of community health worker programmes and health systems models in Colombia. She is also a post-doctoral researcher at The Institute of Development Studies contributing to contemporary health systems and accountability research.
Please note that this session will NOT be live-streamed/recorded.