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Between Feast and Famine

Shortlisted for the RHS First Book Prize 2026

Ghana’s twentieth century was one of dramatic political, economic, and environmental change. Sparked initially by the impositions of colonial rule, these transformations had significant, if rarely uniform, repercussions for the determinants of good and bad nutrition. All across this new and uneven polity, food production, domestic reproduction, gender relations, and food cultures underwent radical and rapid change. This volatile national history was matched only by the scientific instability of nutritional medicine during these same years.

Moving between the dry Northern savannah, the mineral-rich and food-secure Southern rainforest, and the youthful, ever-expanding cities, Between Feast and Famine is a comparative history of nutrition in Ghana since the end of the nineteenth century. At the heart of this story is an analysis of how an uneven capitalist transformation variously affected the lives of women and children. It traces the change from sporadic periods of hunger in the nineteenth and early twentieth centuries, through epidemics of childhood malnutrition during the twentieth century, and into emergent epidemics of diet-related non-communicable disease in the twenty-first century. Employing a novel, critical approach to historical epidemiology, John Nott argues that detailing the co-production of science and its subjects in the past is essential for understanding and improving health in the present.

Epidemiological Change and Chronic Disease in Sub-Saharan Africa

Epidemiological Change and Chronic Disease in Sub-Saharan Africa offers new and critical perspectives on the causes and consequences of recent epidemiological changes in sub-Saharan Africa, particularly on the increasing incidence of so-called ‘non-communicable’ and chronic conditions. Historians, social anthropologists, public health experts and social epidemiologists present important insights from a number of African perspectives and locations to present an incisive critique of ‘epidemiological transition’ theory and suggest alternative understandings of the epidemiological change on the continent.

Arranged in three parts, ‘Temporalities: Beyond Transition’, ‘Numbers and Categories’ and ‘Local Biologies and Knowledge Systems’, the chapters cover a broad range of subjects and themes, including the trajectory of maternal mortality in East Africa, the African smoking epidemic, the history of sugar consumption in South Africa, causality between infectious and non-communicable diseases in Ghana and Belize, the complex relationships between adult hypertension and paediatric HIV in Botswana, and stories of cancer patients and their families as they pursue treatment and care in Kenya.

In all, the volume provides insights drawn from historical perspectives and from the African social and clinical experience to offer new perspectives on the changing epidemiology of sub-Saharan Africa that go beyond theories of ‘transition’. It will be of value to students and researchers in Global Health, Medical Anthropology and Public Health, and to readers with an interest in African Studies.

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