This book examines the paradox whereby spiritual afflictions (conditions attributed to ancestors, jinns, spirits, witchcraft, and other intangible entities) remain central to everyday therapeutic worlds in Africa and the diaspora, yet are routinely sidelined or rendered invisible in official public health policies and global health agendas. Drawing on ethnographic research in Cameroon, Congo, Côte d’Ivoire, Ghana, Mozambique, South Africa, Tanzania, Zanzibar, and African diasporic communities in Europe, the book’s contributors analyse how people navigate intertwined therapeutic worlds in which invisible forces and biomedical logics coexist, collide, or bypass one another. It conceptualizes public health as a domain of ongoing epistemic struggle, examining how policies, legislation, and clinical encounters enact limited recognition and integration that keep spiritual healing subordinate even when they claim to include it. At the same time, the chapters illuminate vernacular governance, popular epistemologies, and informal infrastructures of care through which communities negotiate forms of accountability, regulate healers, and sustain therapeutic legitimacy beyond the clinic and the state. Ethnography is positioned here as an epistemic infrastructure in its own right, capable of unsettling dominant assumptions and opening space for more equitable, plural public health futures. The book speaks to scholars and students in anthropology, political science, and public health, as well as clinicians, policymakers, and practitioners in global health and development. It offers conceptual and methodological tools for rethinking what counts as evidence, legitimate care, and public health expertise, inviting readers to imagine health institutions that are attentive to plural epistemologies and responsive to the lived realities of those navigating diverse therapeutic worlds.