 REVIEWS

The African Union: Autocracy, Diplomacy and Peacebuilding in Africa

edited by TONY KARBO and TIM MURITHI
London: I.B. Taurus, . Pp. . $ (pbk).
doi:./SXX

The African Union (AU) has long been viewed through the lens of its predeces-
sor, the Organisation of African Unity (OAU), and while the organisation does
face a number of similar challenges, it has sought to establish itself as a critical
actor on the continent. One major way in which the AU differs from the OAU is
its stance on matters of governance, peace and security. This edited volume
surveys the AU’s  years as an institution and brings together experts on the
AU’s role in these areas. This work examines the strengths and weaknesses of
the policies adopted by the organisation and actions taken on its part to
tackle these issues on the continent. It focuses on three critical areas: pan-
Africanism and its role in establishing (or not) a global order; the AU’s work
towards improved governance, security and development; and the AU’s rela-
tionship to its external partners.
A common theme throughout this volume is that the AU is in a better place
than it has been in previous years and is seeking to establish more effective,
balanced partnerships with the United Nations (UN) and the European
Union (EU). With funding its operations a constant challenge, the AU’s part-
nerships with these same institutions are often centred on their ability to
provide financial support to the AU’s operations. This attempt to set itself
apart as a key player in continental politics is acknowledged by the authors in
this work. However, the main strength of this edited volume is that it challenges
the organisation and carefully investigates where the institutional deficits are
and how these affect the organisation’s development and ability to execute its
mandates. This is in keeping with its aim of finding ways to allow the AU to
be ‘fit for purpose’ ().
Throughout this book the authors highlight the major impediments to the
AU’s process including financing the Union, lack of political will on the part
of the leadership, undermining of the AU Commission by political leaders, con-
fusion as to who is to take charge on certain issues, inability of the regional eco-
nomic communities (RECs) to synchronise their protocols with those of the AU,
and the AU’s capacity to address mounting challenges and internal tensions.
Still the book, which focused on South Africa in its discussion on the role of
hegemons, could have benefitted from elaborating on Nigeria’s role within
the AU.
Another key point raised in this edited volume is that the AU cannot address
political issues on the continent without dealing with the economic challenges
its member states face. While this is somewhat addressed by a reliance on the
RECs as ‘building blocks’, the AU needs to take a firmer, more involved
stance on matters of economic development. Economic development is
crucial to addressing political issues but also enables member states to contrib-
ute to the organisation by paying their dues. This requires a conscious shift from
the AU solely defining itself as a political actor and truly embracing its larger
role on the continent.

https://doi.org/10.1017/S0022278X1800071X Published online by Cambridge University Press

 REVIEWS 
With the AU’s increased responsibility in governance and security matters on
the continent this book offers a much-needed look at the determinant factors.
This volume is one that would appeal to those interested in the AU from a the-
oretical, political and policy perspective. Unlike some other works on the AU,
this volume is critical and asks important questions without being pessimistic
about the future of the organisation.
ANNA K. MWABA
Smith College

Medicine in the Meantime: The Work of Care in Mozambique by RAMA MCKAY

Durham, NC: Duke University Press, . Pp. . $. (pbk).
doi:./SX

Built on rich ethnographic materials collected over several years in two health-
care facilities in Mozambique, Medicine in the Meantime provides an in-depth view
of the entanglements among NGO workers, expatriates, community volunteers
and patients that affect health care for people with chronic conditions, particu-
larly HIV. The work situates care in light of a dynamic medical multiplicity, or an
arena with many actors, interventions, aims, scales of operation and temporal-
ities. In the process, it paints a complex picture of the ways transnational
health, humanitarian projects and individual agency affect care and wellbeing.
One of the book’s strengths is its investigation of the ways that Mozambique’s
history of colonialism, socialism, civil war and post-war adoption of neoliberal-
ism shape access to care and perceptions about the right to care. As one
example: the book explores how people living with HIV who get food parcels
compare those parcels to the food they received when they were war-time refu-
gees in Malawi. As new humanitarian norms have emerged, war-time notions of
‘food for the hungry’ have been transformed into ‘food for health’; food no
longer benefits the community, but rather, the individual. Deepening the ana-
lysis, the book uncovers how food distribution schemes linked to health projects
discount the ways that local people use food to forge and/or maintain social
relations that facilitate survival.
With a focus on donors’ exhortation that ‘we will not be around forever’, the
book questions the nature of health care ‘in the meantime’. Even though trans-
national health agencies emphasise their partnership with the state and their
efforts to build state capacity, they continue to engage in practices that under-
mine the state’s long-term capacity. Some of the empirical evidence presented is
familiar – NGOs hire state workers; donors dictate project objectives. But McKay
delves deeper to show that data collection and reporting processes that are
aimed at ostensibly increasing state capacity do not level the playing field
between local and transnational actors. Instead, transnational agencies main-
tain privileges because of technical know-how and material capacity. As inter-
views with expatriates illustrate, the very act of collecting data creates
unequally distributed opportunities for research and career advancement.
Patterns of access and exclusion that are rooted in historical processes, lan-
guage, and nationality not only shape medicine in the meantime, but also medi-
cine in the future.

https://doi.org/10.1017/S0022278X1800071X Published online by Cambridge University Press