The changing climates of global health

• Published in: BMJ global health Vol. 6; no. 3; p. e005442
• Main Authors: Cousins, Thomas, Pentecost, Michelle, Alvergne, Alexandra, Chandler, Clare, Chigudu, Simukai, Herrick, Clare, Kelly, Ann, Leonelli, Sabina, Lezaun, Javier, Lorimer, Jamie, Reubi, David, Sekalala, Sharifah
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-03-2021; BMJ Publishing Group Ltd; BMJ Publishing Group
• Subjects: Accountability; Artificial intelligence; Chronic illnesses; Climate; Climate Change; Conspiracy; Coronaviruses; COVID-19 - epidemiology; COVID-19 vaccines; Environmental health; Epidemics; Geopolitics; Global health; Global Health - trends; Healthcare Disparities; Humanities and Social Sciences; Humans; Inequality; Infrastructure; Medical research; Nation states; Pandemics; Pharmaceutical industry; Pneumonia, Viral - epidemiology; Pneumonia, Viral - virology; Racism; SARS-CoV-2; Social Anthropology and ethnology; Social justice; Surveillance; Transnationalism; COVID-19; health policies and all other topics; environmental health
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2021-005442

The end of global health? 'Global health' has been a contested project since its emergence as a framework and field of practice over 20 years ago.2 3 Variously conceived of as either ‘the health of populations in a global context’ or the particular assemblages of institutions, practices, technologies and norms that produce a field of concern called ‘global health,’ it has remained an unstable object of analysis.4 Critical global health scholarship, in particular, has attended closely to the configurations of knowledge and power that have defined global health as a political enterprise, scrutinising the forms of evidence, efficacy and accountability that are at work in its programmes and tracing the uneven delivery of its promises.4–8 The shift from international health to global health in the 1990s indexed changing geopolitical arrangements. The peculiar epistemology of global health emerged in the post-Cold War period from the widely shared belief that the transnational nature of contemporary threats to health—the propagation of infections through air travel, or the rise of chronic diseases associated with trade liberalisation and multinational corporations—could not be addressed through the old international health system, built around nation-states, but required new global solutions able to work across political and geographical borders.10–14 These global solutions included novel funding mechanisms like the Global Fund to Fight AIDS, Tuberculosis and Malaria, supranational regulatory arrangements like the WHO’s Framework Convention on Tobacco Control and infrastructures allowing medical commodities to travel more efficiently across borders.3 Influenced by the then dominant neoliberal view of the state, efforts to improve health focused on the role of non-state actors, such as civil society groups, private–public partnerships and philanthropies. [...]Bill Gates, a key figure of global health, has become the target of conspiracy theories about the role of COVID-19 as the instrument of a new ‘world order’.32 33 In the wake of the proliferation of conspiracy theories about COVID-19 and their potential impact on vaccination and containment strategies, ‘infodemiology’ has emerged as a community of practice and research premised on the apparent infectiousness of information in the age of globalised social media. [...]tensions manifest in the material sites of basic health systems; drugs and diagnostics (access, certification, regulation, infrastructure, distribution); data management, analytics and surveillance mechanisms; and the competing knowledge and expertise that inform global health governance.