This chapter traces the imperial history of racial and environmental medical research, the economic drivers behind public health initiatives, and the legacies of colonialism in medical research and public health interventions in Africa. Examining this history of African encounters with development interventions around health provides much-needed context for breaking down misconceptions about African resistance to or ignorance of Western biomedical aid. The development episteme has perpetuated the idea that Africa is a place of disease and that Africans are resistant to treatments and cures. The nineteenth-century ad hoc campaigns to protect Europeans and segregate the sick from the healthy grew into state-sponsored public health programs during the interwar period. By World War II colonial development discourses on African health had shifted from the “white man’s grave” to biopower as states harnessed healthy bodies for productive purposes. Medical studies on declining populations, outbreaks of sleeping sickness or tuberculosis, STIs, and maternity and childcare sought healthcare solutions that would increase the productivity of labor. New hospitals, maternity centers, child welfare centers, and dispensaries brought some people relief and others terror. Scientists and officials used public health interventions and biomedical research to bolster the norms of the development episteme.

The pictures show smiling children in western-style clothing, writing in school notebooks with their decorated pencils; one little girl wears a cross dangling from a silver chain and the headlines bleat “Invest in Uganda’s Youth” and “Investing in Ethiopia’s People.” Welcome to the Africa page of the World Bank website. The World Bank is the largest international financial institution dedicated to supporting global economic development through capitalist projects. A quick glance at the World Bank website offers some insight into how institutions with the economic means to determine international aid policies define development.

Enlightenment philosophy introduced the notion that social evolution and progress resulted from scientific inquiry and technological advancements. This view evolved out of the eighteenth-century Enlightenment idea that all societies progressed in a linear fashion toward modernity, the pinnacle of which was European civilization. In this construction “modern” or “progressive” societies were those that mimicked European cultural, social, economic, and political structures. Western missionaries’ efforts in the nineteenth century to bring “Christianity, commerce and civilization” set in motion a progressive ideology that led to modern development practice in Africa. These three words captured the Enlightenment ideology of social progress, the capitalism of the Industrial Revolution, and the mating of Christian doctrine with secular social Darwinian ideas. By defining poverty as a lack of access to capitalist systems “modern” societies defined any cultures not fully participating in capitalism as poor. These concepts are the bedrock of modern development theory. They presume that Western civilization is the highest form of social development, that all societies must progress in a linear fashion to attain this status, and that development will come through an economic transformation that will reshape social and cultural aspects of societies.

European colonial trade with Africa set the stage for international interventions to “modernize” African economies. Since the 1880s colonial economists pressed for modernization and industrialization in Africa, but only to the extent that this aided the extraction of resources through the use of inexpensive African labor. Modernization thus had its limits in Africa, and only very rarely emerged out of partnerships with Africans. Large-scale, colonial industrial projects supplied cheap raw materials and managerial jobs for Europeans. Colonial governments and Western-owned companies industrialized the mining sectors of segregated states in southern Africa in order to generate profit for themselves, and not necessarily to aid the “modernization” of local economies. Even in postcolonial and postapartheid African states, industrialization has helped the few rather than the masses. Yet Africans have established their own projects for developing agriculture, mining, and manufacturing in order to improve their societies. Africans have taken the initiative to modernize their economies and form partnerships with governments and private funders on mutually beneficial terms. Despite the long history of Western dominance over discourses on economic modernization, African industrialization and economic development does not always (and does not have to) look like Western modernity.

This chapter traces the shift in African development policies from the era of modernization in the 1950s to the emergence of Structural Adjustment Policies (SAPs) in the late twentieth century. As colonialism waned and African nation-states came into existence, international organizations and foreign governments replaced imperial powers as the primary investors in African development. The United Nations, the International Monetary Fund (IMF), and the World Bank were at the forefront of this movement. African nationalists and the leaders of newly independent countries forged permanent ties to international development agencies and wealthy donor nations such as the United States and the Soviet Union, the post–World War II superpowers hoping to convince African rulers to support their side of the Cold War. The internationalization of African development expanded during the 1980s when the now widely criticized SAPs of the IMF and the World Bank eroded both state power and state-sponsored social services in African countries. Rising political leaders who made big promises to their constituents in the era of independence during the 1960s found their hands tied by the internationalization of development and Cold War politics over the next two decades. Some, however, managed to play these politics to their advantage.

This chapter takes up the first of the four development “problems” highlighted in Part III. Whether in the name of civilization, modernity, or modernization, interventions to transform the composite materials, structural designs, and locations of African homes represented the development agenda to reform African domesticity and labor. Discourses on improvement masked the political and economic agendas at work and ignored the indigenous logic of African residential construction and organization. From the nineteenth century development efforts urged Africans to build square or rectangular houses in place of round huts. The scientific work of early twentieth-century urban planners set the stage for what “modern” urban spaces would look like in African cities. In the postcolonial era urbanization has far outpaced the ability of states and private enterprise to provide affordable, modern housing for citizens. Urban Africans have begun to fight back against the assumptions made about informal settlements by development specialists and city planners from the global north. These activists are challenging their governments to see urban residential areas as social spaces that belong to all citizens, not just wealthy ones. In their challenge, informal settlement dwellers are forcing the international development community to Africanize the development episteme.

This chapter traces the transformation of the school from the site for instilling ideas about racial and class-based separate development during the colonial era into the key mechanism for ensuring African political and economic development today. Formal schooling introduced during the colonial era contributed to racial and economic divisions by promoting the idea of separate development and segregation. Missionary and colonial education institutionalized the assumptions about racial difference embedded in the development episteme. Colonial educators faced a conundrum; they sought to “civilize” Africans in Western academic traditions and at the same time to reinforce ideologies of racial difference that undergirded colonialism and the development episteme. This conflict was complicated further as schools became a place for challenging these ideas and generating African nationalist ideas of development. Some postcolonial reforms recentered African epistemologies in the schools. Today institutions and scholars of the global north still claim to be the experts in technology, science, and medicine, the sciences necessary for solving development “problems.” Nonetheless, African institutions and scholars are at the forefront of development innovations designed for their own communities including in the expansion of innovative university practices.

This chapter outlines the connections between African resistance to cultural imperialism during the colonial era, the call to “decolonize the mind” in the 1970s and 1980s, and, finally, debates about decolonizing development today. All of these movements have challenged the racial and cultural inequalities built into the development episteme. Decolonizing development entails much more than pointing out the legacies of the civilizing mission or colonialism in contemporary development discourses on Africa. Both Western and African cultures transformed over time, but what has not changed is the perception that the former is “modern” and the latter “traditional.” The false dichotomy between the “developed” West (or “the global north”) and the “less developed” or “developing” countries of Africa (as part of “the global south”) reifies colonial-era stereotypes and continues to fuel the development industry. Whether seeking to transform a “backward” custom or making decisions about expenditure, hierarchies of power are foundational to the development episteme. As long as Africans remain the targets of intervention rather than the policy makers or drivers of development, and as long as development remains an industry whose power base remains in the global north, efforts to decolonize development will fail to restructure the development episteme.

Nineteenth-century Europeans developed scientific methodologies that generated new knowledge about Africa through Eurocentric ideas about progress. These ideas became the foundation for the development episteme. The development episteme emerged out of both these scientific endeavors and the missionary-imperialist project to disseminate European Christianity, commerce, and “civilization” to Africans. Knowledge explorers, cartographers, medical doctors, biologists, economists, ethnologists, and other scientists produced about Africa facilitated colonization by claiming mastery over the continent’s environment and people. Europeans drew on this scientific information to assert their technological expertise and moral right to “civilize” Africans. European scholars suggested their expertise was needed because they knew Africans best. Yet the development episteme was formulated in dialogue with Africans whose own knowledge and interests often determined which development efforts would succeed and which would fail. Many Africans working for Europeans were educated in Western, most often missionary schools. As such, African assistants were adept at filtering information through a Western lens. This filter transformed African knowledge into European “facts.” More recently scholars of the global north have introduced forms of knowledge about Africa that do not perpetuate the notion of Western superiority, but that still rely on some of the assumptions built into nineteenth-century European epistemologies.

While the concept of progress that gave birth to the development episteme in Africa emerged from European post-Enlightenment traditions, the idea of development in Africa has been reshaped as much by the targets of development as by those who claimed expertise. The illusion of the omnipotence of the development episteme will only be exposed when we can see clearly the crumbling stones out of which it was built. Development is not the powerful edifice it claims to be; it is a holdover of colonialism that is quickly losing relevance in our current world. A decolonizing of the mind, not of Africans but of people living in the global north who see Africa as perpetually less than, is the wave of the future. Today the development discourse is a global debate in flux and Africans have more influence than ever over reshaping the development episteme. This final chapter discusses recent debates about progress, modernity, and development in Africa and offers some closing thoughts on what development might mean for Africa’s future.

Chapter 8 takes a broader historical view of humanitarian aid in Africa by revealing how nongovernmental organizations (NGOs) are the “missionaries” of the twenty-first century. In the wake of the 1970s and 1980s Structural Adjustment Policies (SAPs) of the IMF and World Bank, NGOs stepped in to fill the gap in social services that the now bankrupt and inept African governments could not provide. Until recently the vast majority of these NGOs have been international NGOs (INGOs) established, run, and funded by Europeans or North Americans. Like the missionaries who came to end the slave trade and bring “civilization” to Africa a century earlier, INGOs function on a platform of humanitarianism, human rights, and development for the poor. Whether in the form of slave narratives collected by abolitionist missionaries or television commercials asking for donations to help feed starving African children, not-for-profit organizations have generated an industry of fundraising in order to “save” Africans. More recently African individuals and communities have launched local NGOs that target causes they deem most important, such as women’s economic inequality, environmental degradation, and cultural preservation.