Global Health

by

Ramah McKay

• LAST REVIEWED: 27 March 2019
• LAST MODIFIED: 27 March 2019
• DOI: 10.1093/obo/9780199766567-0211

Introduction

The term global health encompasses a variety of meanings, including the impact of globalization on health as well as threats to health around the globe. In use since the early 20th century, the term has proliferated widely since the 1990s. Most broadly, the term refers to ways of understanding and intervening into health problems and health disparities as they are conceptualized at a global level. The term is most frequently used to describe health issues and interventions in low-income or low- and middle-income countries and to describe the movement of medical goods, technology, expertise, and funding and development assistance from North to South or from wealthy countries to poorer ones. However, these problems and relations are structured by historical and contemporary inequities in how health outcomes are distributed and how health interventions are generated. Because the field has historical roots in colonial medicine and in international health efforts of earlier decades, global health issues have frequently centered on the infectious diseases that were hallmarks of these efforts. As a result, the term global health can signify a variety of conditions and practices. It is used to evoke certain diseases, especially but not only HIV/AIDS, tuberculosis, and malaria and other infectious diseases, as well as maternal-child and reproductive health and, increasingly, noninfectious diseases. It refers to concerns with (and efforts at ameliorating) disparities in the treatment of these conditions. And it describes interventions, largely enacted through nongovernmental or joint state-private coalitions, that are aimed at treating disease and/or ameliorating these health disparities within a framework that reflects and relies on broader inequalities in access to medical resources. Global health actors include a wide range of institutions including nongovernmental organizations (NGOs) and academic and medical organizations as well as corporations, public health agencies, and the state. Philanthropic organizations, medical schools and universities, NGOs and development agencies, private corporations and manufacturers of medical goods, as well as scholars, researchers, and physicians, have all worked to implement and define global health over time. Within this field, anthropologists have been centrally involved in defining global health through research activities that make health problems and disparities visible, through work as advocates or health actors working to ameliorate health issues, through work as educators teaching undergraduate, graduate, and medical students, and through critical reflection on the project of global health itself. This entry focuses attention on four aspects of the anthropology of global health, emphasizing 1) how anthropologists have understood the historical development of global health; 2) anthropological discussions of the politics, antipolitics, and biopolitics of global health as they impact theories of citizenship; 3) key themes in the ethnography of global health; and 4) the roles anthropologists have taken with regard to global health, including as practitioners and teachers.

Overview

Anthropological accounts of global health have drawn from a wide range of approaches, including medical anthropology and the anthropology of development, in order to situate the emergence of global health within broader biomedical, economic, and political contexts. Following Janes and Corbett 2009, anthropological engagements with global health can be described as “ethnographic studies of health inequities in political and economic contexts”; analyses of “the impact on local worlds of the assemblages of science and technology that circulate globally”; studies involving the “interrogation, analysis, and critique of international health programs and policies”; and studies of the “health consequences of the social relations of international health development” (p. 167). Anthropologists have also been centrally located as global health actors, and some ethnographers have also taken on “applied” or practical roles within global health projects or organizations, as described in Pfeiffer and Nichter 2008. At the same time, anthropologists have been vocal critics of the conceptual and practical dimensions of global health. Biehl and Petryna 2013 described the struggle to make ethnographic and anthropological evidence visible within global health approaches that privilege quantitative and epidemiological renderings of health.

• Biehl, João, and Adriana Petryna. 2013. When people come first: Critical studies in global health. Princeton, NJ: Princeton Univ. Press.

  This edited volume presents case studies addressing critical perspectives on global health as envisioned in various countries and in relation to a range of disease processes and health practices. It argues for the value of a “granular” ethnographic perspective in making sense of the diversity of practices, processes, and subjects that are subsumed within the framework of global health.

• Janes, Craig R., and Kitty K. Corbett. 2009. Anthropology and global health. Annual Review of Anthropology 38.1: 167–183.

  DOI: 10.1146/annurev-anthro-091908-164314

  This review essay provides a broad overview of the development of global health and outlines four key ways in which ethnographers have engaged the field.

• Pfeiffer, James, and Mark Nichter. 2008. What can critical medical anthropology contribute to global health? Medical Anthropology Quarterly 22.4: 410–415.

  DOI: 10.1111/j.1548-1387.2008.00041.x

  This essay addresses the relationship between critical medical anthropology, in which the dominant focus has been situating health and health outcomes within a critical, often political-economic, frame, and global health, which has frequently been concerned with intervening in health outcomes rather than critically addressing underlying processes of impoverishment and ill health.