The (non)charisma of noncommunicable diseases

This paper uses the idea of a “charismatic gap” to help explain the disjuncture between the burden of disease attributable to noncommunicable diseases (NCDs) in the global south and a tendency to view this as something of ‘an esoteric distraction from more pressing concerns in global health’ such as HIV/AIDS, malaria, TB, vaccination and maternal health (Livingston, Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic. Durham: Duke University Press, 2012, p. 9). NCDs are a composite category of cardiovascular disease, respiratory diseases, cancer and diabetes grouped together by virtue of four shared risk factors (tobacco, alcohol, unhealthy diets and sedentarism). While infectious diseases spread through viruses or bacteria under conditions of contagion that can provoke fear, disgust, suspicion and irrationality amid physical suffering and high mortality rates, NCDs have too often been met with ennui. This paper draws on the concept of charisma to help explore and explain the ‘neglected epidemic’ of NCDs in the global south through four themes: The lexicon used to describe, frame and communicate NCDs; risk factors and culpability; the temporality of disease and its embodiment. In conclusion, the paper reflects on how to activate the latent charismatic potential of NCDs in the global south.