Evolution in Four Dimensions: Genetic, Epigenetic, Behavioral, and Symbolic Variation in the History of Life (Revised Edition)

tal levels. He spends time showing that there are competing global health and economic agendas and programs at work. He describes a shift in focus to new technologies in malaria treatment, as drug resistance moved to the forefront of the agenda; this which has led to the production of novel drugs. Kamat shows that local populations are caught in the middle of a confusing process of “frontline” treatment changes as policy and economics collide. This collision results in many different drug options produced in various places around the globe and, depending on whether or not the particular drug is subsidized by the government, a wide range of prices. Similar to other ethnographies that investigate the relationships among longterm consequences of structural adjustment programs, struggling health systems, and increasing privatization for the poor, Kamat concludes the book in Chapter 9 and in a two-page epilogue (Chapter 10) by clearly stating that technological and pharmaceutical fixes are not likely to solve problems stemming from structural inequities. I have no reservations about including this ethnography in a medical anthropology, global health, or biocultural anthropology course. It is a perfect complement to a section focusing on infectious or zoonotic diseases and can be presented alongside the evolutionary history, biology, genetics, and epidemiology of malaria. My only critique is that there is a slight overuse of Swahili words, which to a non-Swahili speaker may make the read a bit challenging at times. That said, this ethnography is still highly accessible. It is well written and would work well at both undergraduate and graduate levels. Using this book in a biocultural anthropology course would provide an opportunity for students to work through how biology, culture, and economics intersect to produce global health outcomes and health disparities. In sum, Kamat positions the health-seeking decisions of mothers in the context of underfunded healthcare systems, the pharmaceuticals industry, and current neoliberal and health policy agendas to bring into relief the realities of the macro–micro interface.