198 American Anthropologist • Vol. 118, No. 1 • March 2016 messages through monumental, and communal, endeavor. This suggests that the multifunctional buildings were as flex- ible as the groups who used them. In a number of cases, the authors admirably strive to illustrate how the pastoralists featured in these case studies move discussions of such groups beyond evolutionary or Marxist explanations (P. Nick Kardulias, Claudia Chang, Nikolay Kradin, Michelle Negus Cleary, and Thomas D. Hall). The result is almost a default switch to world systems analysis, with its focus on economic and social interactions. While this is entirely appropriate for discussions of ecology, it may result in an unresolved yearning for more information on the cultural variability within and between the groups under discussion. The Ecology of Pastoralism is a dynamic and provocative contribution to the archaeological and anthropological liter- ature of pastoral societies. Each of the case studies featured illustrates diverse and adaptable strategies used by pastoral peoples, something that is just beginning to emerge beyond the image of the stereotypical mobile herder living on the margins of sustainability. REFERENCE CITED CC-BY-SA Heinrich Boell Foundation 2014 The Meat Atlas. Berlin: CC-BY-SA Heinrich Boell Founda- tion, Friends of the Earth Europe. Blind Spot: How Neoliberalism Infiltrated Global Health by Salmaan Keshavjee. Berkeley: University of California Press, 2014. 288 pp. DOI: 10.1111/aman.12471 Thurka Sangaramoorthy University of Maryland As one of the poorest republics in the former Soviet Union, Tajikistan’s transformation to an independent nation in 1991 was plagued by what can only be called a humanitarian cri- sis. A civil war had broken out in 1992 and would continue until 1997, resulting in an estimated 300,000 deaths and 850,000 refugees. Living standards had severely declined during this time period, with per capita GDP falling from $2,870 in 1990 to $215 in 1998, and public services, includ- ing healthcare, had collapsed. The impact on the populace was devastating—life expectancy dropped from 72.3 years for women and 67.1 years for men in the early 1990s to 67.5 and 61.1, respectively, by 1998. Infant and maternal mor- tality rates, along with communicable diseases, increased rapidly as the provision of public goods and services came to a halt. The situation was much more dire in Badakhshan, a remote and mountainous region of Tajikistan that became even more isolated in the aftermath of war once travel and access were made nearly impossible by the destruction of roadways. Badakhshan’s residents, who had once survived on direct food and fuel deliveries from Moscow, were now facing death from starvation and exposure to the severe cold. During this critical period, the Aga Khan Founda- tion (AKF), along with other multilateral organizations and NGOs, stepped in to provide not only emergency assistance but also to implement a social service system to deliver nec- essary and vital public services that were once provided by the Soviet Union. In the case of Badakhshan, AKF pursued privatization to create a “sustainable” market for essential medicines while at the same time addressing the shortages of high-quality pharmaceuticals through the creation of a revolving drug fund. Against this backdrop, physician-anthropologist Salmaan Keshavjee’s ethnography, Blind Spot, is a notable journey deep into Tajikistan’s majestic Pamir Mountains where Badakhshan is located. It is an account that helps us understand not only the localized suffering of those facing an extremely precarious future but also the broader ideological framework of neoliberalism that exacerbates this suffering. Drawing on ethnographic fieldwork conducted in this remote and isolated region of Central Asia after the collapse of the Soviet Union, Keshavjee portrays the real-life impacts of neoliberal ideology on the health and well-being of Badakhshanis. Using a case study of the provision of essential medicines, Keshavjee argues that the introduction of a revolving drug fund—namely, a plan to sell medicines to a poor and highly vulnerable population—in the aftermath of extreme social, political, and economic upheaval was driven more by aspirations to institute neoliberal values into this previously communist territory by way of global health development than a desire to safeguard the needy and the vulnerable. Keshavjee begins his exploration of the transformation of healthcare in the Badakhshan region from a universal, social- ized system under the Soviet regime to a privatized venture guided by the priorities of Western and international donors in 1995 as a consultant for AKF. It was during this time that AKF had received funding to deliver healthcare to the region, including providing essential medicines. The revolv- ing drug fund’s mission, Keshavjee argues, drew from the