Diagnosing tuberculosis

In this chapter Harper and Khatri take as their example the GeneXpert, a new diagnostic machine for use in TB control, and explore its introduction in Nepal. This new technology, sanctioned for use with great fanfare by the WHO in 2010 is able to deliver within two hours a diagnosis of both tuberculosis and resistance to one of the main drugs used in the treatment of the disease. Through fieldwork done in laboratories, it explores the issues around the machine’s implementation in this specific local cultural and political context. The initial machines were purchased with a grant from TB REACH, a fund developed for increasing the diagnosis of tuberculosis and was introduced into government facilities by the International Organisation of Migration. This points to the specific nature of partnerships in the control of TB and the intersection of global control politics, national control programmes and specific local conditions. The introduction and use of this new technology highlights resource inequalities and the politics of migration and aid, and cannot escape the politics of development interventions in Nepal.