Built on rich ethnographic materials collected over several years in two health-care facilities in Mozambique, Medicine in the Meantime provides an in-depth view of the entanglements among NGO workers, expatriates, community volunteers and patients that affect health care for people with chronic conditions, particularly HIV. The work situates care in light of a dynamic medical multiplicity, or an arena with many actors, interventions, aims, scales of operation and temporalities. In the process, it paints a complex picture of the ways transnational health, humanitarian projects and individual agency affect care and wellbeing.

One of the book's strengths is its investigation of the ways that Mozambique's history of colonialism, socialism, civil war and post-war adoption of neoliberalism shape access to care and perceptions about the right to care. As one example: the book explores how people living with HIV who get food parcels compare those parcels to the food they received when they were war-time refugees in Malawi. As new humanitarian norms have emerged, war-time notions of ‘food for the hungry’ have been transformed into ‘food for health’; food no longer benefits the community, but rather, the individual. Deepening the analysis, the book uncovers how food distribution schemes linked to health projects discount the ways that local people use food to forge and/or maintain social relations that facilitate survival.

With a focus on donors’ exhortation that ‘we will not be around forever', the book questions the nature of health care ‘in the meantime'. Even though transnational health agencies emphasise their partnership with the state and their efforts to build state capacity, they continue to engage in practices that undermine the state's long-term capacity. Some of the empirical evidence presented is familiar – NGOs hire state workers; donors dictate project objectives. But McKay delves deeper to show that data collection and reporting processes that are aimed at ostensibly increasing state capacity do not level the playing field between local and transnational actors. Instead, transnational agencies maintain privileges because of technical know-how and material capacity. As interviews with expatriates illustrate, the very act of collecting data creates unequally distributed opportunities for research and career advancement. Patterns of access and exclusion that are rooted in historical processes, language, and nationality not only shape medicine in the meantime, but also medicine in the future.

Though the book does not directly engage the ‘vocabularies of development’ literature, McKay shows how jargon, labels and numerical criteria exacerbate inequalities. For example, donors define caregiver ‘visits’ as providing moral or social support, but ‘care’ as distributing medications and overseeing treatments. This distinction matters because Mozambican guidelines require donors to compensate care. But for caregivers who often combine activities, it is a false distinction. Similarly, numbers like Body Mass Index determine a patient's food eligibility instead of the patient's household resources or relations of dependence. Clinic employees may manoeuvre around these criteria, a discretionary process that shows both their agency and their dependence on a system of arbitrary criteria.

The book's examination of the ways that new regimes of health governance are situated within professional and personal relations, historical trajectories, and political, gendered and class positionalities helps us to appreciate the messiness of care. Undergirding these interactions are numerous tools of power – food, data, patient files, vocabularies, meetings, workshops, and even the languages spoken by local and expatriate clinic staff. Though the book questions how ethnography itself may be one such tool, it could do more to analyse the structures of power in health at all levels of governance. Despite this limitation, scholars of transnational health and development can learn much from the book's nuanced insights about how medical multiplicity affects health and wellbeing in Mozambique and more broadly, sub-Saharan Africa.