Faking global health

Abstract

Globally, human health is improving. Aggregate world health data indicate enormous improvement over the last 100 years. Life expectancy, vaccination, and sanitation rates are higher. Rates of infectious disease, HIV/AIDS, child and maternal mortality are lower. These gains have all been accomplished during a time when governments orchestrated, or aspired to provide, albeit often imperfectly, the systemizations of health care. Now austerity and privatization campaigns shape health services worldwide, and we witness a massive ideological shift in approaches to the world's wickedest health problems: Public health endeavors must 'show return on investment.' This commentary takes up activities in three health domains where effort goes into the appearance of global health prowess and accomplishment: health security; health innovation; and health finance. Pseudo global health, as an analytic, helps us take measure of the in-between phenomenon between real and fake accomplishment, success and failure, improved health outcomes and continued suffering. I show: 1) how global health security documents sometimes serve as 'alibis'that is, contrivances offered to intimate local readiness or safety despite their actual absence; 2) how global health innovation influencers often privilege tech-fixes developed far removed from realtime people, places, and practices; and 3) how global health finance has already evolved in ways that makes suffering profitable. The examples are meant to enlighten rather than depress and are offered with the hope that critical analyses using the pseudo health concept as an analytic prompt new strategies for sustainable changes rather than merely their appearance.

Appraising and addressing design and implementation failure in global health: A pragmatic framework

“…Limited understanding of context leads to the development of interventions which are often deployed using a 'cut and paste' approach (Erikson, 2019); interventions that Olivier de Sardan et al 2017referred to as 'traveling models'. Local actors, in trying to make these well-funded initiatives work, try to modify the design using 'discretionary power' (Lipsky, 2010).…”

More than sample providers: how genetic researchers in Pakistan mobilized a prenatal diagnostic service for thalassemia

“…Many researchers agreed that it is important that the families are not treated as means to an end, even though in significant ways they are exactly that. In a different context, Susan Erikson (2019) has shown how "the profitization of suffering" is enabled in settings characterized by scarcity as it triggers opportunity. Samples are hence multiple: they are assets used strategically in exchanges with international collaborators, and at the same time they are a community that needs and wants help made to cohere through a range of tactics.…”

Why the pseudo matters to global health

“…Moreover, attention to magic and misdirection can expose many performative aspects of pseudo global health: its onstage and backstage features, its audience and its props. Examining these interconnected facets, as Erikson (2019) argues in her commentary, which concludes this special issue, is critical to understanding emergent manifestations of global health centring on health security, health innovation and health finance.…”