Paper short abstract:

What might global health look like from the shop floor? Considering one London hospital’s cancer services in terms of its global reach and constitution, I argue that any ‘global cancer health’ rests on competing, sometimes conflicting and intrinsically multiple positions.

Paper long abstract:

Contemporary references to global health express concerns with privatisation of the international public sphere; persistent, growing inequities and increased mobility as well as aspirations to restore an inclusive public 'welfare'. It is unclear, however, what global health might look like from from below rather than from a bird's eye view.

Focusing on a hospital site in London, breast cancer services involve a 'global' population of staff and patients and global practices, based on experimental and translational research that spans the world supported by a range of industry, government and NGO consortia. Cancer care is closely entwined with this research through the protocols that dictate steps and evidence to follow in assessing risk, diagnosis and therapy.

This cancer-care assemblage depends, I argue, on fundamentally plural views within the workforce, among patients and on the part of any one individual. In brief, pursuit of biologically-, socially- or individually-determined pathways rarely coincide any more than do the idioms that accord participants contrasting roles in decision-making. On the shop floor, it is impossible to find a unifying perspective. It will be helpful, therefore, to consider global cancer health in terms of these constitutive and multiple interests, misunderstandings and intrinsically different positions.