Paper short abstract:

This paper explores the notion of sensitivity to analyse a ‘global health’ market intervention (the large-scale purchase of pneumococcal vaccines for low income countries). In particular it examines the dynamic of attention whereby mundane stuff becomes the focus of (re)action.

Paper long abstract:

This paper explores the notion of sensitivity to analyse a 'global health' market intervention: the large-scale purchase of pneumococcal vaccines aimed at reducing the incidence and mortality of bacterial pneumonia and meningitis in low income countries. Financed by donors, like the UK, the transaction is implemented by GAVI, an organisation specialised in collecting overseas aid to help health administrations buying vaccines for their immunisation programmes. The paper understands mundane as a situated property. Things and processes are mundane when their pervasiveness is relevant to an action but remains unnoticed from its point of view. The paper is interested in how the taken for granted becomes worthy of attention and examines moments when the mundane resists. These, it argues, are trials revealing the degree of sensitivity of an intervention, how quickly it notices recalcitrance, reacts, and adjusts its own terms. Two moments are chosen. First, the paper describes how pneumococcus, a germ lacking the symbolic value of malaria and the political activism of HIV, was targeted by a market initiative. Focusing on prices, it ignored supply chain issues until vaccine delivery started, making fridges noticed. Second, the paper describes an epidemiological survey in an African country meant to evaluate the impact of pneumococcal vaccines made available by the initiative. Devoting much effort to the verification of forms, it neglected some redistribution matters until laboratory technicians went on strike, making their everyday work conditions noticed. These examples show a dynamic of attention, whereby different mundane stuff becomes alternatively the focus of (re)action.