In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal.