A couple of relevant reference: Raul Caetano, Diffusion of an idea: Jellinek's disease concept in Latin America, International Journal of Addictions 20:1629-1641, 1985. Robin Room, The World Health Organization and alcohol control, British Journal of Addiction 79:85-92, 1984. There's a tradition of researchers taking US- or Europe-derived disease-conceptish measures into faraway places and finding they don't work very well. See: S.Z. Klausner and E.F. Foulks, Eskimo Capitalists: Oil, Politics and Alcohol. totowa, NJ: Allanheld, Osmun, 1982. K.-D. Gorenc et al., A crosscultural study: a comparisons of German, Spanish and Ecuadorian alcoholics using the Munich Alcoholism Test (MALT), American Journal of Drug and Alcohol Abuse 10:429-446, 1984. R. Room et al., "WHO cross-cultural applicability research on diagnosis and assessment of substance abuse disorders: an overview of methods and selected results", with commentaries and a response, Addiction (forthcoming). I was a consultant to the 1970s WHO project which had a Zambian leg (as was Ron Roizen, who also reads the stuff here). The WHO project officer, Joy Moser, was determined that the project would as far as possible do stuff which was culturally appropriate, but was hampered in this by the US funding agency (and maybe also by consultants like me). This was the era of the ascendancy of the Chinese "barefoot doctor" model at WHO, with a focus on community-level work and on primary health care. This mainspring of this emphasis in WHO came from T. Lambo, the Nigerian assistant director general with responsibility for mental health. Ironically, Nigeria is one of the African countries which has remained farthest from the community health care model, with a strong tradition of academically-inclined elite psychiatrists staying within the confines of big teaching hospitals. The WHO COmmunity Response project's main collaborator in Zambia was Alan Haworth, a British psychiatrist with a strong community orientation: he showed us pictures of what had been done in Zambia at that time, taking the bars off the mental wards in Zambia and setting up villages of the mentally ill. Alan is still active in Zambia, I believe. Some years ago, he had compiled a lengthy typewritten list of African publications and reports on alcohol and drugs; it would be a good source if you could get him to share it with you. You can get a line on a more recent WHO project with an African leg in: Wayne Hall et al., The structure and correlates of alcohol dependence: WHO collaborative project on the early detection of persons with harmful alcohol consumption -- III, Addiction 88:1627-1636. There was an old tradition of inebriates' asylums in South Africa (there's a reference or two in J. Baumohl and R. Room, "Inebriety, doctors and the state: alcoholism treatment institutions before 1940", pp. 135-174 in M. Galanter, ed., Recent Developments in Alcoholism, vol. 5, New York: Plenum, 1987), and the South African National Council on Alcoholism (SANCA), AA, etc. emerged in the last 40 years as the carriers there of U.S.-derived disease models. Elsewhere there was and is probably not much else in the way of alcohol treatment other than whatever turns up in mental hospital systems. Illicit drugs is another matter, since the US and Europe have poured great amounts of money into the drug control system centred in Vienna, and this system has been trying to pay more attention to "demand reduction", which includes treatment. I don't know much about what this system has done in Africa. Places to start would be the Bulletin on Narcotics, the annual reports of the International Narcotics Control Board, reports of the United Nations Drug Control Programme (and UNFDAC -- UN Fund for Drug Abuse Control before UNDCP), maybe the UN Narcotics Commission annual proceedings. I would be interested in what you find out if you go down this track. Most of the activity on this front would be in the last 20 years. For North Africa, there are also Arabic regional institutions in the drug field. One activity the UNDCP was financing until recently was training courses offered by the International Council on Alcohol and Addictions (ICAA), headquartered in Lausanne. These were first established in Nigeria, starting with many foreign faculty but eventually moving to indigenous teachers, mostly psychiatrists; training courses have also been offered once or twice elsewhere in Africa, including I believe to francophones. ICAA's library and archives in Lausanne might well be worth a visit from your perspective -- you maybe could do some oral history with Eva Tongue, who set up and ran the training courses. My name will not help gain entry. I hope all this is helpful. The irony of the processes of cultural diffusion and transmission you are studying is that sometimes in recent decades it is the Europeans etc. who are more sensitive to cultural differences, and the local professionals who are most determined to do it the right way as they were taught in London or wherever. I look forward to whatever you come up with. Robin Room