Paper short abstract:

I draw on 14 months of fieldwork in Khayelitsha, South Africa, to interrogate the logics and implications of a new global health focus on ’the first thousand days of life’, in the context of local conceptions of citizenship, responsibility, care and the future.

Paper long abstract:

A preoccupation with the future is a central tenet of development ideologies, but this is newly formalised by epigenetic research, which implies a transgenerational transmission of disease risk and amplifies the scope of the future to create a multi-generational temporality in which epidemiology and policy must operate. Global health policy reflects this emergent knowledge in its call for a focus on the 'first thousand days of life'. The period from conception to age two is considered to be the 'international window of opportunity' for nutrition interventions to target undernutrition and stunting, promote future 'human capital', and prevent a potential future burden of adult non-communicable disease. This paper draws on 14 months of fieldwork in the antenatal clinics and maternal communities of Khayelitsha, South Africa, to chart the ways in which the utopian and dystopian versions of the future encapsulated in the first thousand days project are in concert with and/or in conflict with other aspirations and potentialities that shape the landscapes of women and their (future) children here. The new discourses of risk, potential and good citizenship that are embedded in contemporary perinatal health services are shown to be incongruent with local notions of citizenship, responsibility, care, and the future, and it is thus necessary to rethink the notions of 'environment' and 'exposure' central to contemporary epigenetic epidemiological frameworks that influence health policy in this setting.