Global Diabetes Encounters: Accounting for Health Technologies in the Global

  • Annegrete Juul NielsenEmail author
  • Henriette Langstrup
Part of the Global Power Shift book series (GLOBAL)


As already recognized, though little theorized within International Relations, the capacity of technology to ensure the achievement of preset policy goals is often grossly overrated. Drawing on Science and Technology Studies, this chapter proposes a lens to investigate global encounters, which take the technologies, involved in such encounters seriously both analytically and methodologically. This approach provides the opportunity not only to see how technology plays an important part in shaping global encounters and gets shaped itself in the process. It also allows us to appreciate the complex and productive nature of the friction these encounters produce. The proposed lens is used to analyze a specific global encounter illustrative of the way in which technologies increasingly become central to global encounters concerning health. In this encounter Danish and Indonesian partners are engaged in implementing a Danish developed quality assurance software for diabetes management in Indonesian primary care. We analyze what is at stake for the partners and what role the technology plays in shaping these stakes. The analysis points to the ambiguous and often contentious nature of technology in global encounters. The challenges met as the technology moves from Danish health care to an Indonesian context cannot be explained with reference to generalizing notions such as structural barriers, local culture or stakeholder interests. Instead attention to the frictions of global encounters provides insights to the conditions for and effects of movement of health technologies across geographical borders and thus to research at the intersection of Global Health and International Relations.


Globalization Science and Technology Studies Partnerships Global health 


  1. Abrahamson, E., & Fairchild, G. (1999). Management fashion: Lifecycles, triggers, and collective learning processes. Administrative Science Quarterly, 44(4), 708–740.CrossRefGoogle Scholar
  2. Akrich, M. (1992). The description of technical objects. In W. E. Bijker & J. Law (Eds.), Shaping technology/building society: Studies in sociotechnical change (pp. 205–224). Cambridge, MA: MIT Press.Google Scholar
  3. Ancarani, V. (1995). Globalizing the world: Science and technology in international relations. In S. Jasanoff, G. E. Markle, J. C. Petersen, & T. J. Pinch (Eds.), Handbook of science and technology studies (Rev. ed.) (pp. 652–670). Thousand Oaks, CA: Sage.Google Scholar
  4. Berwick, D. M. (2003). Disseminating innovations in health care. The Journal of the American Medical Association, 289(15), 1969–1975.Google Scholar
  5. Clifford, G. D., Blaya, J. A., Hall-Clifford, R., & Fraser, H. S. F. (2008). Medical information systems: A foundation for healthcare technologies in developing countries. BioMedical Engineering OnLine, 7, 18.CrossRefGoogle Scholar
  6. Davies, S. E. (2010). What contribution can International Relations make to the evolving global health agenda? International Affairs, 86(5), 1167–1190.CrossRefGoogle Scholar
  7. de Volo, L., & Schatz, E. (2004). From the inside out: Ethnographic methods in political research. Political Science and Politics, 37(2), 267–271.CrossRefGoogle Scholar
  8. Feldbaum, H., Lee, K., & Michaud, J. (2010). Global health and foreign policy. Epidemiologic reviews, 32(1), 82–92.CrossRefGoogle Scholar
  9. Fritsch, S. (2011). Technology and global affairs. International Studies Perspectives, 12(1), 27–45.CrossRefGoogle Scholar
  10. Gardner, C. A., Acharya, T., & Yach, D. (2007). Technological and social innovation: A unifying new paradigm for global health. Health Affairs, 26(4), 1052–1061.CrossRefGoogle Scholar
  11. Garrett, L. (2007). The challenge of global health. Foreign Affairs, 86, 14–38.Google Scholar
  12. Gerber, T., Veronica, O., Brown, K., & Pablos-Mendez, A. (2010). An agenda for action on global e-health. Health Affairs, 29(2), 233–236.CrossRefGoogle Scholar
  13. Giroux, H. (2006). ‘It was such a handy term’: Management fashions and pragmatic ambiguity. Journal of Management Studies, 43(6), 1227–1260.CrossRefGoogle Scholar
  14. Hathaway, M. J. (2010). Global environmental encounters in Southwest China: Fleeting intersections and “transnational work”. Journal of Asian Studies, 69(2), 427–451.CrossRefGoogle Scholar
  15. Hill, P. S. (2011). Understanding global health governance as a complex adaptive system. Global Public Health, 6(6), 593–605.CrossRefGoogle Scholar
  16. Jensen, C. B., & Winthereik, B. R. (2012). Recursive partnerships in global development aid. In S. Venkatesan & T. Yarrow (Eds.), Differentiating development: Beyond an anthropology of critique (pp. 84–101). London: Berghahn.Google Scholar
  17. Kaplan, W. A. (2006). Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries? Globalization and Health, 2, 9.CrossRefGoogle Scholar
  18. Kickbusch, I. (2011). Advancing the global health agenda. UN Chronicle, XLVIII, 4.Google Scholar
  19. Latour, B. (1987). Science in action: How to follow scientists and engineers through society. Cambridge: Harvard University Press.Google Scholar
  20. Latour, B. (1991). Technology is society made durable. In J. Law (Ed.), A sociology of monsters: Essays on power, technology and domination (pp. 103–131). London: Routledge.Google Scholar
  21. Latour, B. (2005). Reassembling the social. An introduction to actor-network theory. Oxford: Oxford University Press.Google Scholar
  22. Latour, B., & Woolgar, S. (1979). Laboratory life: The social construction of scientific facts. Princeton, NJ: Princeton University Press.Google Scholar
  23. Lewis, T., Synowiec, C., Lagomarsino, G., & Schweitzer, J. (2012). E-health in low- and middle-income countries: Findings from the Center for Health Market Innovations. Bulletin of the World Health Organization, 90, 332–340.CrossRefGoogle Scholar
  24. Lund, S., Hemed, M., Nielsen, B. B., Said, A., Said, K., Makungu, M. H., et al. (2012). Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: A cluster-randomised controlled trial. BJOG: An International Journal of Obstetrics and Gynaecology, 119(10), 1256–1264.CrossRefGoogle Scholar
  25. McCannon, C. J., Berwick, D. M., & Rashad Massoud, M. (2007). The science of large-scale change in global health. JAMA: The Journal of the American Medical Association, 298(16), 1937–1939.CrossRefGoogle Scholar
  26. McInnes, C., & Lee, K. (2012). Global health and international relations. Cambridge: Polity Press.Google Scholar
  27. Mol, A., & de Laet, M. (2000). The Zimbabwe bush pump: Mechanics of a fluid technology. Social Studies of Science, 30(2), 225–263.CrossRefGoogle Scholar
  28. Morita, A. (2013). The ethnographic machine: Experimenting with context and comparison in Strathernian ethnography. Science, Technology & Human Values, 39, 214–235.Google Scholar
  29. Nielsen, A. J., & Jensen, C. B. (2013). Travelling frictions: Global disease self-management, local comparisons and emergent patients. Science and Technology Studies, 26(2), 61–79.Google Scholar
  30. Rogers, E. M. (2002). The nature of technology transfer. Science Communication, 23(3), 323–341.CrossRefGoogle Scholar
  31. Shenkar, O., Luo, Y., & Yeheskel, O. (2008). From “distance” to “friction”: Substituting metaphors and redirecting intercultural research. Academy of Management Review, 33(4), 905–923.Google Scholar
  32. Soewondo, P., & Pramono, L. A. (2011). Prevalence, characteristics, and predictors of pre-diabetes in Indonesia. Medical Journal of Indonesia, 20(4), 283–294.CrossRefGoogle Scholar
  33. The Danish Government (Regeringen). (2013). Vækstmarkedsstrategi Indonesien – batik og business. Accessed January 3, 2014.
  34. Tsing, A. L. (2000). The global situation. Cultural Anthropology, 15(3), 327–360.CrossRefGoogle Scholar
  35. Tsing, A. L. (2005). Friction: An ethnography of global connection. Princeton, NJ: Princeton University Press.Google Scholar
  36. Tsing, A. L. (2009). Beyond economic and ecological standardisation. The Australian Journal of Anthropology, 20(3), 347–368.CrossRefGoogle Scholar
  37. Tsing, A. L. (2012). Frictions. In G. Ritzer (Ed.), Wiley-Blackwell encyclopedia of globalization (pp. 707–709). West Sussex: Wiley-Blackwell.Google Scholar
  38. Vrasti, W. (2008). The strange case of ethnography and international relations. Millennium-Journal of International Studies, 37(2), 279–301.CrossRefGoogle Scholar
  39. Wootton, R. (2008). Telemedicine support for the developing world. Journal of Telemedicine and Telecare, 14(3), 109–114.CrossRefGoogle Scholar
  40. World Health Organization. (2010). Telemedicine: Opportunities and developments in Member States: Report on the second global survey on eHealth. Geneva: World Health Organization.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Public HealthUniversity of Copenhagen, Center for Medical Science and Technology StudiesCopenhagenDenmark

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