Anthropology in the twenty-first century : a view of, and from, Germany

The article explores the developments in German-language anthropology in the past decades, focussing on the period after the 1970s. It argues that the recent history of German-language Ethnologie (social and cultural anthropology) is one of catching-up modernization. German-speaking anthropologists are increasingly involved in, and contribute to, broader theoretical debates, publish in English and in international journals, and are actively engaged in international academic networks. The paper discusses how and under what conditions of knowledge production these transformations have taken place. It analyses the changing institutional environment in which German anthropologists have worked and work today, as well as the theoretical impulses from within and outside the discipline that have given rise to the contemporary orientation of German-language anthropology as an anthropology of the 'present'. Finally, and beyond the focus on Germany, the article offers some ideas on the future of anthropology as a symmetrical social science, characterized by a continued strong reliance on field work and a high level of 'worldliness', a basic attitude of systematically shifting perspectives, the critical reflection of the social and political embeddedness of knowledge production, and an engagement with social theory across disciplinary boundaries.

Zidovudine impairs immunological recovery on first-line antiretroviral therapy: collaborative analysis of cohort studies in southern Africa

OBJECTIVES Zidovudine (ZDV) is recommended for first-line antiretroviral therapy (ART) in resource-limited settings. ZDV may, however, lead to anemia and impaired immunological response. We compared CD4+ cell counts over 5 years between patients starting ART with and without ZDV in southern Africa. DESIGN Cohort study. METHODS Patients aged at least 16 years who started first-line ART in South Africa, Botswana, Zambia, or Lesotho were included. We used linear mixed-effect models to compare CD4+ cell count trajectories between patients on ZDV-containing regimens and patients on other regimens, censoring follow-up at first treatment change. Impaired immunological recovery, defined as a CD4+ cell count below 100 cells/μl at 1 year, was assessed in logistic regression. Analyses were adjusted for baseline CD4+ cell count and hemoglobin level, age, sex, type of regimen, viral load monitoring, and calendar year. RESULTS A total of 72,597 patients starting ART, including 19,758 (27.2%) on ZDV, were analyzed. Patients on ZDV had higher CD4+ cell counts (150 vs.128 cells/μl) and hemoglobin level (12.0 vs. 11.0 g/dl) at baseline, and were less likely to be women than those on other regimens. Adjusted differences in CD4+ cell counts between regimens containing and not containing ZDV were -16 cells/μl [95% confidence interval (CI) -18 to -14] at 1 year and -56 cells/μl (95% CI -59 to -52) at 5 years. Impaired immunological recovery was more likely with ZDV compared to other regimens (odds ratio 1.40, 95% CI 1.22-1.61). CONCLUSION In southern Africa, ZDV is associated with inferior immunological recovery compared to other backbones. Replacing ZDV with another nucleoside reverse transcriptase inhibitor could avoid unnecessary switches to second-line ART.