Paper short abstract:

The paper examines five innovative WHO-led, USAID-funded national health plans in anglophone and francophone West and Central Africa, highlighting their concerns with management and distribution of health resources across urban and rural sectors, and assessing their successes, failures and legacy.

Paper long abstract:

This paper is concerned with the conception, framing, innovation and reception of a series of national health plans in early post-Independence Africa. Originating in 1962 as a USAID-funded technical programme of the World Health Organisation (WHO), the exercise brought advisors, government bureaucracy, and fledgling post-colonial health sectors together to evolve national health plans in five African countries: Gabon, Liberia, Mali, Niger, and Sierra Leone. The exercise brought a growing concern with management and finance in health sectors to bear on problems of uneven resource distribution and urban skew in health provision in Africa, and drew on contemporary debates and developments in health planning across WHO regions globally.

The paper investigates what these planning exercises signified in the context of postcolonial global politics in the 1960s, what sort of development state the plans envisaged, and what forms of development the plans foreclosed or made possible. It traces the circulation of these plans, and the extent to which they overlaid an innovative and ultimately problematic infrastructural form - the developmental state in Africa - on existing patterns of urban and rural distribution of health resources. Finally, it highlights the specific forms of engagement that were envisaged and that emerged in the post-Independence state in Africa in the first decades of postcolonial sub-Saharan African history.