The Role of Historical-Cultural Formations within World-Systems Analysis: Reframing the Analysis of Biomedicine in East Africa

Abstract

This essay introduces a novel analytical concept for world-systems analysis, historical-cultural formations, for the purpose of analyzing reciprocal global cultural exchanges across the capitalist world-system. This is done through four basic procedures. First, the perspective of world-systems analysis is adopted for the purpose of analyzing biomedicine in world-historical context and biomedicine itself is re-conceptualized as a historical-cultural formation across a single capitalist world-system. Second, in order to conceptually incorporate historical-cultural formations, the basic analytical framework of world-systems analysis is expanded to include cultural forms as integral features of the capitalist world-system, parallel with economic and political structures. Third, biomedicine is framed as an ontological whole, comprised of multiple, embedded ontological spheres that define it as a dynamic cultural form subject to ongoing change and development. Fourth, biomedicine’s journey to East Africa is framed as a facet of East Africa’s incorporation into the capitalist world-system — a necessary prelude to the “globalization” of biomedicine as a historical-cultural formation. Ultimately, contemporary East African medical systems are discovered to be but the latest incarnation of an evolving, global biomedicine — understood as a singular historical-cultural formation across the capitalist world-system.