Co-opting the Global Health Agenda: The Problematic Role of Partnerships and Foundations in Defining Priorities

Abstract

There is little dispute that the global health agenda is increasingly being shaped by foundations and partnerships, as the introduction to and rationale for this book make plain. In the wake of structural adjustment in the Global South, and in the context of the worldwide dominance of neoliberalism, new actors are addressing global health crises such as HIV/AIDS, malnutrition, and water-borne diseases (Farmer, 2005; WHO, 2008). This book examines the impact of these new global health actors on the wider system of global health governance. In this chapter, we argue that the mainstream global health agenda is being driven by powerful, wealthy, and generally market-oriented (and often corporate-funded) foundations as well as by new Global Health Partnerships (GHPs). Given the resources and political support these actors enjoy, they have become de facto agenda-setters and increasingly shape the trajectory of global health governance. Whilst such actors are investing resources on an unprecedented scale -- especially in combating specific diseases such as HIV, tuberculosis and malaria -- we argue here that they also have a tendency to bolster the same corporate, capitalist, neoliberal agenda that has been so deleterious to health outcomes across the globe (Harvey, 2003; Kim, 2000). Certainly they are not alone in this –much publicly-funded global and national health policy and spending is similarly underpinned by neoliberal ideology (Saith, 2006). Nevertheless, there is a need to further explore the implications of this ‘private turn’ in global health governance as these new actors remake the health agenda in specific ways.