How are health systems being reshaped in places of political and social instability? What happens to new frameworks of global health governance, systems of regulation, standardisation and health management when they travel to unstable places? What kinds of state infrastructures are taken for granted by the technical interventions designed and funded by international agencies, organisations and NGOs?

This Nuffield Foundation research explores these questions in Papua New Guinea; a place where the state is often labelled as ‘fragile’ and where many people live in areas without transport infrastructure or access to basic health services. Through ethnographic fieldwork in Australia and Papua New Guinea, Dr. Street traced the programs and policy directives of international organisations such as AusAID and the Global Fund as they travelled through government departments in Papua New Guinea, NGOs, and frontline health services.

Her findings show how attempts to improve health governance in fragile states and technical solutions that bypass the state are generating new geographies of inequality and exclusion. Designing appropriate health systems, Dr. Street argues, involves understanding the complex histories and relationships that are built into health infrastructures. She proposes an approach that incorporates these histories and relationships into the material fabric of new logistical and managerial health interventions.

 For further information, refer to Dr Street's profile.