Contenu du sommaire : Politiques de santé.

The significance of the «return» to african medicine. African states are showing an innovative interest in traditional medicine. But this is due more to sociological and political struggles rather than to a hypothetical synthesis of «modern» and natural medical techniques.

The role of social space in epidemics. Trypanosomias and onchocerciasis share a common means of transmission. It is thus tempting to consider that these major epidemics «inevitably» strike when the carriers come into contact with human societies. Against this somewhat deterministic vision we defend the hypothesis that humans are actors who have a degree of control over the spread of depending on their specific social behaviour.

Aids, epidemics and anthropology. Despite the quantity and quality of knowledge accumulated during the past six years of research AIDS remains a subject of global uncertainty and concern. In Africa there is a quasi-paralysis of medical staff in the public sector on the issue. More than any other illness medical research on AIDS requires am analysis of cultural and individual representations within African societies.

«Urban bias» in the analysis of living conditions and health in Niger. The provision of health care offers a useful case for an objective analysis of urban bias. Though a study of the inhabitants of Niger's second largest town, Maradi, this paper examines what, in city life, can constitute a factor of différenciation in health conditions. The role of the state in the distribution of resources gives this process a political significance.

The economic crisis and the financing of health care. There is evidently an economic dimension to health care. The present crisis has prompted a revision of health strategies structures and the call for a more efficient allocation of ressources. Such measures pose agonizing alternatives for planners; either a threadbare medical service available free to all, or a fee-paying service capable of providing minimum service.

How can we evaluate the gap between the medical needs of developing countries and the aid offered by the international community ? Such a question inevitably raises political issues, particularly the «abusive» multiplication of aid institutions, the disrespect for strategies of Primary Health Care, die frequently limited choice of target groups and die rigid and often insensitive management of projects which don't take into consideration the specificities of the recipient populations.

The effects of an assault on health care in the Congo. In an environment of general shortages what happens when there are suddenly abundant supplies ? The effects of an operation of increased medical supplies staged in the Congo are analyzed. The impact on health care is examined alongside the effects on the functioning of the health care system as a whole and the attitudes of both the professionals and the populations involved.

The politics of emergency medicine. Where it is presented as a «political priority» emergency medicine frequently becomes a political spectacle which all too often is a symptom of a decline in overall health care services. The emphasis on emergency medicine in effect increases the incapacity of states and citizens to face their real problems and aggravates the existing dependency on outside aid.