Constructing Health Regions in Late Colonial French Africa

This article examines debates about the future of health coordination between French African colonies in the era of decolonisation. These debates illuminate tensions over the future of French doctors in Africa, the role of international organisations, and the meaning of colonial borders for public health. In the late 1950s, French officials sought to reformulate inter-territorial colonial medical structures in a way that could be sustained with African independence, resulting by the 1960s in the creation of new West and Central African regional health organisations. Newly appointed African health ministers supported these organisations for various reasons, including sharing costs of medical infrastructure and the idea of a French debt that could be addressed through technical assistance. Both French and African health officials in turn naturalised the idea of post-colonial health coordination between former French colonies, regardless of shared borders with other African states. Both French and African health officials used the rhetoric of “disease knows no borders” to engage in a process of health “region-making,” although the outcome was health coordination rooted less in epidemiological realities than colonial histories. Late colonialism catalysed change in public health and medicine that mirrored broader political developments but also produced distinct discourses, agendas, and institutions.