Make me a test and I will save the world: towards an anthropology of the possible in global health

What is deemed possible in the wake of failure? The global biotech industry's failure to develop affordable diagnostic devices for use in low- and middle-income countries (LMICs) has inspired a generation of humanitarian entrepreneurs to launch their own diagnostic start-up companies. This essay traces the rise and fall of one such start-up in Boston in the United States, Daktari, which developed a portable HIV testing device in the 2010s. I show how the alignment of humanitarian and economic valuations in a single diagnostic device depended on the ability of the start-up's founders and employees to synchronize the distinct tempos of financial capital, humanitarian design, and global health standards. Yet their failure to achieve this synchronization does not simply offer another story of biotech hype and speculation, the generation of promissory value at the expense of actual things. Instead, the essay examines the hopes and expectations that the firm's employees invested in the device's material qualities, manufacture, and distribution. What, I ask, is the meaning of failure, and its material remains, when it is measured against humanitarian rather than solely commercial expectations? The essay concludes with some reflections on the aftermath of failure in humanitarian entrepreneurship, examining the questions that Daktari's demise poses for understandings of what is possible and desirable in global health.