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Set in future Thailand where oil scarcity has brought the global economy to its knees and GM plagues have wiped put most of the world's species, this is a completely convincing story and one of the best science-fiction novels that I've read. It's also grim as hell.
Given the scarcity of energy following the oil collapse, everything is now measured in terms of calories. Biotechnology rules, energy-intensive activities are powered by GM elephants, and global transportation is carried out using dirigibles and clipper ships. The title role is Emiko, a genetically-engineered human. She is a New Person - manufactured and grown to serve. Engineered to be faster and more capable than any regular human, she is crippled by a built-in stuttering in her movement, and her mental conditioning as a dutiful slave since birth.
As with any fiction, it's the characters that make a story and (in addition to Emiko) they are all excellent. You can't help barracking for almost everyone, even when they are working at cross purposes. Everyone is trying to help themselves, but we since we know their motivations and fears we can forgive them almost anything. Oddly enough, the only "virtuous" character here is a jackbooted government thug. You'll have to read for yourself to see how this works. No one is completely innocent, with the possible exception of the horribly abused Windup Girl. New People are considered soulless in this setting, justifying the most awful treatment of Emiko by the society she exists in.
This book is a just-about perfect example of science fiction; the setting is strange but plausible. The mix of low- and high-tech produces a great sense of future shock. Parts of the book are horrifying - there are some violent moments, including two scenes of sexual assault. However, it's not gratuitous - they serve the story. Don't let this put you off a superb read.
Bottom line: definitely in the running for science fiction novel of 2009/2010. Strongly recommended, even to non-sci-fi fans.