Developing to Scale - by Heidi Morefield (Hardcover)

About the Book

"Developing to Scale examines the techno-centric structure of global health practice through the history of the concept of appropriate technology. By looking at how certain technologies have been defined as more or less "appropriate" for the global south, based on assumptions about gender, race, culture, and environment, Heidi Morefield reveals the ways in which questions of technological scale have fundamentally shaped global health practice today. The idea that there was an "appropriate" level of technology, between the traditional and the modern, that would lead to sustainable social and economic development originated in the mid-1960s and gained considerable prominence in the 1970s. US foreign assistance oriented away from large-scale modernization projects, like water treatment facilities, toward small-scale, point-of-use technologies, like village water pumps, individual water filters, and oral rehydration salts. Practical shifts in assistance like this were a result of the enthusiastic adoption of the idea but also cuts in foreign aid budgets and other economic interests, principally those of newer donors from the high-tech sector; political interests; and the efforts of various activists, most notably post-colonial and anti-apartheid groups. Dreams of technological salvation have gained a new significance and foothold in the contemporary imagination, and Morefield's book provides the backstory, uncovering precisely how global health came to be understood largely as a problem to be solved with the right technology"--

Book Synopsis

The first critical book on "appropriate technology," Developing to Scale shows how global health came to be understood as a problem to be solved with the right technical interventions.

In 1973, economist E. F. Schumacher published Small Is Beautiful, which introduced a mainstream audience to his theory of "appropriate technology" the belief that international development projects in the Global South were most sustainable when they were small-scale, decentralized, and balanced between the traditional and the modern. His theory gained widespread appeal, as cuts to the foreign aid budget, the national interests of nations seeking greater independence, postcolonial activism, and the rise of the United States' tech sector drove stakeholders across public and private institutions toward cheaper tools. In the ensuing decades, US foreign assistance shifted away from massive modernization projects, such as water treatment facilities, toward point-of-use technologies like village water pumps and oral rehydration salts. This transition toward the small scale had massive implications for the practice of global health.

Developing to Scale tells the history of appropriate technology in international health and development, relating the people, organizations, and events that shaped this consequential idea. Heidi Morefield examines how certain technologies have been defined as more or less "appropriate" for the Global South based on assumptions about gender, race, culture, and environment. Her study shows appropriate technology to be malleable, as different constituencies interpreted its ideas according to their own needs. She reveals how policymakers wielded this tool to both constrain aid to a scale that did not threaten Western interests and to scale the practice of global health through the development and distribution of technical interventions.

Review Quotes

"Developing to Scale's careful tracing of the history of a concept--and its real-world implications--makes it a highly teachable text that would fit nicely into courses on global health, history of technology, or development studies."-- "Technology and Culture"

"Developing to Scale is a highly readable, well-researched account that does a masterful job at untangling the different visions and interests involved in defining appropriate technology. This proves critical to understanding many seeming contradictions in American Cold War development practice. Although the book is dense with bureaucratic and policy history, the author enlivens these elements of the story with illustrative detail and engaging prose. . . . A valuable contribution to the history of global health, the history of capitalism, and the history of American foreign policy."-- "Annals of Science"

"Recommended."-- "Choice"

"The concept of 'appropriate technology, ' Janus-faced, has been used both to inspire and to prevent technological assistance to people in resource-poor communities. Morefield's Developing to Scale provides a fascinating and surprising global history of the origins of the idea and its far-reaching influence on international health and development worldwide. Who should decide what technology is right for whom? What social systems do technologies require to succeed? These questions remain vitally important today."--David S. Jones, Harvard University

"With engaging prose and illuminating detail, Developing to Scale provides a crucial history of appropriate technology in international aid. Anyone nursing a clever fix to improve the world should first read this book." --Peter Redfield, University of Southern California

"The first comprehensive history of advocacy for 'appropriate technology' for global health, Developing to Scale provides a fresh analytical route into understanding the enduring enthusiasm for cheap technological fixes for fundamental problems of global health inequalities. With an extraordinary combination of scholarly rigor and narrative lucidity, the book works across scales to provide a careful account of key individuals, groups, and encounters, while also illuminating anew the broader social and technological field of global health in an era of emerging postcolonial aspirations and complexly intertwining neoliberal endeavors."--Anne Pollock, King's College London

About the Author

Heidi Morefield is a historian of medicine and global health. She currently works for a global consultancy.