The Precariousness of Public Health: On Tuberculosis Control in Contemporary France

Through an ethnographic exploration of tuberculosis control in one of France's poorest regions, Seine-Saint-Denis, I interrogate the relationships between public health planning and interventions in conditions of multiple precarity. I show that the encounter between the feasible and the fantastic in the realm of public health generates feelings of absurdity and futility among medical professionals, characteristic of disease control in the precarious present. Precarity is neither a social and economic condition per se, nor is the link between disease and precarity static. It is a dynamic process of political inclusions, exclusions, and inequalities, which differ substantially within the unequal spheres of precarious lives. The contradictions in tuberculosis control that I describe are thus not only characteristic of French public health but of global public health today, where illusions in disease control encounter the exclusionary realities of social life.