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This article argues that Egypt's implementation of an economic reform and structural adjustment programme since 1991 has not led to a reduction of its hegemony over certain welfare services. Yet its role in the provision of free health and educational services has been drastically curtailed. This is evident if the pre- and post adjustment situations are analysed in terms of the poor's access to education and health services. The introduction of cost recovery measures has negatively impacted on the poor and increased their vulnerability to exploitation by exposing them to a wide range of ‘hidden’ and informal fees. Further, the introduction of special policies designed to mitigate the rising costs of education and health care are not being implemented due to a set of institutional and political reasons. The consequences of the increasing privatisation of educational and health services on the poor are examined by looking at the detail of those living in the densely populated community of Bulaq el Dakrour in Cairo.

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More details/abstract: This article explores the politics of knowledge involved in understanding and responding to epidemics in an era of global health governance and biosecurity. It develops and applies an approach focused on how multiple, competing narratives about epidemics are constructed, mobilised and interact, and selectively justify pathways of intervention and response. A detailed ethnographic case study of national and local responses to H1N1 influenza, so-called 'swine flu', in Egypt reveals how global narratives were reworked by powerful actors in a particular political context, suppressing and delegitimizing the alternative narratives of the Zabaleen (Coptic Christian) people whose lives and livelihoods centred on raising pigs and working with them to control urban waste. The case study illustrates important ways in which geographies and politics of blame around epidemics emerge and are justified, their political contexts and consequences, and how they may feed back to shape the dynamics of disease itself.