Paper short abstract:

Millions of Africans have been targeted for mass drug administration (MDA) to control parasitic infections. This paper explores ways in which the purported beneficiaries respond to what has been occurring.

Paper long abstract:

Ethnographic research on mass drug administration (MDA) for parasitic infections reveals ways in which the delivery of these huge and highly vertical programmes are perceived by many of those involved as a moral good. To some extent this is a strategy to secure funding and avoid critical scrutiny, but it also leads to a curious disengagement from attitudes and experiences of drug recipients. Millions of Africans have been targeted, with the apparent aim of 'making poverty history'. This paper explores ways in which the purported beneficiaries respond to what has been occurring. It reflects on why they may actively resist treatment or, more often, quietly fail to swallow the tablets. At the same time they too tend to make assertions about the developmental, social and personal benefits of MDA. Indeed, local leaders can be eloquent on the topic, while still not actually taking the medications themselves. Even parents who are strongly opposed to their children being treated in schools by their teachers are likely to share the rhetoric. A consequence is that superficial local-level investigation into the efficacy of programmes produces positive quotes from recipients, reinforcing the evangelical assumptions of bio-medics passionately promoting them at an international level. There is also a strange and sometimes bizarre setting aside of evidence, making it hard to assess whether or not these horrible and potentially debilitating afflictions are in fact being controlled, let alone being eliminated.