The ‘Africanization’ of science after decolonization was replete with dreams. Claims to Africa's place in the high-modern world, expectations of national technological and economic progress, and individual dreams of scientific discovery, professional development and fulfilled careers drove scientific work and lives. The term Africanization, coined by the colonizers, reproduced colonial notions of race but also stimulated the imagination of mid-twentieth-century African scientists, who hotly debated and enthusiastically embraced it. Half a century later, some dreams have failed, but many more remain unfulfilled. This article examines two reunions of Tanzanian and European science workers – in Amani in 2015 and in Cambridge in 2013 – who had worked together in the decades after Tanzania's independence at Amani Hill Research Station, then one of Africa's foremost laboratories for research on malaria and other tropical diseases. It explores ideas of good science and experiences of social differentiation, divergent dreams and persistent tensions – and the role of joking in remembering these.

Professor Bukheti Swalehe Kilonzo, born 1949: joined Amani in 1968 as a Scientific Assistant. Studied microbiology and parasitology in London; PhD in plague epidemiology from Dar es Salaam in 1984. Left Amani in 1982 as Research Scientist and became professor at Sokoine University.

In 1966, a new hospital was being built in western Kenya with Soviet aid. Designed by Soviet architects and planners, with equipment transported from the USSR, it was to be the largest hospital in Kenya. Still referred to today by Kenyans as ‘Russia’, it was the pet project of Oginga Odinga, the central figure of political opposition in postcolonial Kenya, who cultivated friendship with the USSR. Like the training offered to African students at the Patrice Lumumba University in Moscow, the hospital was a gift of the Soviets, a material embodiment of medical modernity, socialist internationalism and Africa's hopeful future. However, it soon became deeply embroiled in Kenya's Cold War politics. This article explores the remains and legacies of these Soviet gifts, tracing their connections to visions of progress and development, decolonization and struggles for political freedom in postcolonial Kenya. Drawing on ethnographic fieldwork, archival material, newspaper reports and interviews with Kenyans who were educated in the Soviet Union, I trace how, in institutional, bureaucratic, affective and biographical remains, diverging dreams and anticipations of progress and development converged and collided. Russia, like the city of which it forms a part, emerges as a palimpsest: a site of hopes and dreams, violence and disappointment, and the anticipation of futures.

This article explores ‘imaginings’ around hepatitis B in Burkina Faso and their historical genealogies. Hepatitis B is a viral infection afflicting the liver, but asymptomatic carriers may fall ill decades after exposure to the virus. Drawing from ethnographic interviews, we analyse how people living with hepatitis B in Burkina Faso grapple with incertitude about the course of their infections, the possibilities for healing and their illness's influence on social relations by ‘imagining’: that is, diverging momentarily from narratives about their diagnostic and therapeutic pathways to imagine alternative pasts and future consequences of this illness. We investigate how those living with hepatitis B use these imaginings to grapple with absences – of a certain future, of knowledge and of care – the historical genealogies that give rise to these absences, and their longer-term consequences. These ephemeral imaginings emerge from an ‘entanglement’ of the virus, epidemiological incertitude about its course and absences within Burkina Faso's health system and global health policies, which are themselves the consequence of specific historical processes.

Tracing the persistence of community health workers (CHWs) as a key category in both global health policy and anthropological representation, this article asks how enduring scholarly investments in CHWs can reveal changing political stakes for both health work and ethnographic research. Amid renewed calls for a focus on health systems and universal health coverage, the article suggests that the durability of attention to CHWs is instructive. It simultaneously points to the imbrication of health with political and social relations and clinical and technological infrastructures as well as to how ethnographic investments in health systems can sometimes obscure the ambivalent politics of health. Drawing on fieldwork with CHWs, NGO staff and public health officials, and on public health literature on CHWs, it argues for greater attention to the political ambivalence of health labour. It suggests that the experiences of health workers themselves can serve as analytical examples in this regard, pointing to analyses that begin not with normative notions of health systems or the conceptual boundaries of global health ‘projects’ but with a focus on the contested relations through which health labour is realized over time. Such attention can also indicate possibilities for health beyond dreams of projects, clinics or health systems.

This article examines responses to the terrorist attack on the Westgate Shopping Centre in Nairobi in September 2013 in order to investigate the role played by blood donation, as an expression of national dreams, in the political imaginary of contemporary Kenya. It considers the symbolic effectiveness of calls for blood donation made by political figures in the aftermath of the attacks. Such calls drew on a tradition of donation drives begun in the early years of independence, which emphasized the modernizing imperative of the new state and the importance of unity, hard work and self-sacrifice in building the nation. However, the reaction to Westgate, including calls for blood donation, also needs to be understood with reference to the response of American and other leaders to equivalent terrorist attacks in more recent years. These elite dreams found resonance among ordinary citizens and blood donation recruiters. But they were also subjected to trenchant critiques that sought to expose the reality of the transfusion system, as well as the inequality and injustice that mark the general healthcare system and Kenyan society as a whole. These shortcomings were also highlighted by mobilization drives organized by Kenya's Somali and Asian communities both before and during the Westgate crisis. The latter are presented by their organizers as a means of overcoming historic exclusion and discrimination.

This article uses the accelerated saturation initiative (ASI) Soka Uncobe, which took place in the kingdom of eSwatini in 2011 and 2012, to comment on HIV humanitarian health interventions in Africa. Soka Uncobe, the first ASI on voluntary medical male circumcision, aimed to circumcise 80 per cent of all HIV-negative men aged fifteen to forty-nine years over a twelve-month period. Using written and verbal accounts, I draw attention to the dreams and hopes behind the design of the initiative. I also highlight the dynamics of the implementation of Soka Uncobe, and, in doing so, I chart the path to its ultimate failure by showing the reluctance of the implementation partners (based mainly in the global North) to take seriously what have now become well-known critiques of why humanitarian interventions fail. Ultimately, I suggest that, despite having the potential to produce some critical results, Soka Uncobe was no different from previous transnational humanitarian health interventions. Thus, an exposé of why it failed is pivotal to this article about the dreams that underpinned the first ever ASI related to medical male circumcision.

Although Senegal experienced a single ‘imported’ Ebola case, this epidemiological event was experienced locally as a full outbreak in its first phase. Two imaginaries developed in parallel: the nightmare of an uncontrolled infectious threat bringing social disruption and spreading through Senegal to other continents; and the vision of an efficient mobilization of the national public health system as a model for other West African countries hit by Ebola. Based on field data, the article analyses how these antagonistic imaginaries shaped the national narrative of the epidemic and affected its interpretations on an international level. The health system's capacity to control the epidemic gradually dominated the nightmare fantasy in the national narrative, and has effectively articulated a technical discourse and protective measures rooted in lay perceptions – in particular the physical distancing of risk. Charles Rosenberg's model for analysing the temporality of epidemic narratives, which distinguishes four phases (progressive revelation, agreement on an explanatory model, political and ritual action, and closure), proved to be relevant, provided that two phases were added. These phases – before the beginning and after the end of the epidemiological event – appear significant in terms of the social production of the meaning of epidemics.

By the end of the 1990s, molecular approaches predominated in biomedical science, but, for West African scientists, biology could not have ‘gone molecular’ at a worse time. Resource constraints led to knowledge expiry and many discovery dreams were terminated, exported or at least postponed. Pivotal transitions in methodologies, knowledge and resources temporally overlapped with an emergent imperative to address infectious disease in Africa. This prompted new initiatives from global health programmes in the North, which imported visions, disciplinary focus and equipment for new laboratory spaces. A handful of African researchers, however, have reimagined and reconstructed existing laboratories as a means to weave their own dreams. This article examines three such laboratories. It outlines how their equipment was accumulated, the ad hoc ways in which the laboratories are supplied and maintained, their extraordinary accomplishments and their key role as domestic nodes for research. The picture that emerges is one that extends beyond technological acquisition to an enactment of the scientists’ own dreams. Importantly, it is a record of outcomes from those who continued to dream while others stilled their imaginations or became canvases coloured by the dreams of other people.

This article examines the fiscal and administrative infrastructures underpinning global health research partnerships between the US and Uganda, and the power dynamics they entail. Science studies scholars and anthropologists have argued for the importance of studying so-called ‘boring things’ – standards, bureaucracies, routinization, codes and databases, for example – as a way to bring to the surface the assumptions and power relations that often lie embedded within them. This article focuses on fiscal administration as an understudied ethnographic object within the anthropology of global health. The first part of the article is a case study of the fiscal administration of a US–Uganda research partnership. The second part describes the institutionalization of some of the administrative norms and practices used by this partnership within the ‘global health enabling systems’ employed by US universities working in Uganda and elsewhere in Africa. I analyse a case study and ‘enabling systems’ to show how these administrative strategies create parallel infrastructures that avoid direct partnership with Ugandan public institutions and may facilitate the outsourcing of legal and financial risks inherent in international partnerships to Ugandan collaborators. In this way, these strategies act to disable rather than enable (or build) Ugandan research and institutional capacity, and have profound implications for African institutions as well as for the dream of ‘real partnership’ in global health.

This article traces a shift in how hospital workers at a Tanzanian public hospital thought about their workplace. In 2010, for the first time, staff began collectively imagining what they called ‘a real hospital’. This collective dreaming of institutional possibilities emerged due to two transformations: a shift in Tanzanian government policies enabling government institutions to initiate their own ‘public–private partnerships’ (PPPs) with non-state ‘partners’ such as NGOs, private businesses, investors, missionary organizations and others; and the hospital's early successes in attracting (a few) partners. Unlike familiar global PPPs such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, Tanzania's PPP policy allowed health facilities to initiate their own partnerships in order to improve public services. Drawing on longitudinal ethnographic research in one government hospital, this article traces successful, failed and fraught partnership initiatives through which public-sector health workers tried to improve hospital infrastructure and capacity. In tracing institutional aspirations and local workers’ efforts to achieve them through homegrown PPPs, this article highlights the contingency and malleability of public and private spheres operating within public health service provision in Tanzania, as well as the opportunities available to health workers and the constraints involved in attempting to improve hospital care.