Political Science Globalization, Health Crises, and Health Care
by
Ted Schrecker
  • LAST REVIEWED: 18 March 2021
  • LAST MODIFIED: 29 May 2015
  • DOI: 10.1093/obo/9780199756223-0068

Introduction

The term “globalization” is itself contested terrain. This article recognizes the plurality of legitimate definitions that have in common a focus on economic, political, and social processes that operate across national borders. The recent multiplication of such processes is not in dispute. Neither is the “globalization” of health concerns as diverse as the transmission of communicable disease—the longest-standing concern—and the supply of health professionals as they migrate across national borders. The 2008 financial crisis has added to the list. It also reminds us that health is influenced by factors many of which lie entirely outside the domain of the health care system—hardly a new observation, but one that bears repeating. The study of globalization and health is unavoidably transdisciplinary, as reflected in the range of disciplines from which the sources in this bibliography are drawn. If there is a single guiding principle behind their selection, beyond emphasizing a diversity of disciplinary and methodological orientations, it is the contribution that each cited reference can make to understanding that global health issues must be analyzed with reference to distributions of power and resources that affect opportunities to live a healthy life, and that those distributions are closely connected to global economic and geopolitical processes.

General Overviews

Each of these overviews is distinctive and should be in the library of all serious researchers. None of the books is a conventional academic volume. Farmer 2003, written by the cofounder of the civil society organization Partners in Health; People’s Health Movement, et al. 2008; and Kim, et al. 2000 all have an activist orientation. (In April 2012, co-editor J. Y. Kim was appointed president of the World Bank.) In Garrett 2000, more than 150 pages of endnotes provide ample documentation to support the author’s argument about the urgency of taking public health more seriously in a global frame of reference. Inoue and Drori 2006 and Zielinski Gutiérrez and Kendall 2000 provide complementary introductions to global health politics, with the first being organized around chronology and institutions and the second around key concepts and debates. Although not about globalization per se, Stuckler and Basu 2013 is an indispensable assessment of policy responses to the globalization-related financial crisis of 2008.

  • Farmer, Paul. Pathologies of Power: Health, Human Rights, and the New War on the Poor. Berkeley: University of California Press, 2003.

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    Making explicit reference to social determinants of health (before the term was popularized by a WHO commission), physician and anthropologist Farmer combines insights from extensive field experience in Haiti, southern Mexico, and Russia with a commitment to human rights and a critique of the “war on the poor” that he views as intrinsic to contemporary globalization.

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  • Garrett, Laurie. Betrayal of Trust: The Collapse of Global Public Health. New York: Hyperion, 2000.

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    Elaborates on the interaction of poverty and politics that contributes to resurgence of infectious diseases, and offers a provocative comparison of the collapse of public health in the former Soviet Union and the very different, but comparably serious, situation of public health in the United States at the end of the Reagan era. A concluding chapter introduces the threat of bioterrorism.

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  • Inoue, Keiko, and Gili S. Drori. “The Global Institutionalization of Health as a Social Concern: Organizational and Discursive Trends.” International Sociology 21 (2006): 199–219.

    DOI: 10.1177/0268580906061376Save Citation »Export Citation » Share Citation »

    The authors provide an historical overview of the development of a “global organizational field of health,” starting in the 17th century but accelerating post-1870. They argue for periodization in terms of successive organizational themes: charity, professionalism, health and development, and human rights. Usefully read in conjunction with some sources in the section on Globalizing Health Governance. Reprinted in Labonté, et al. 2011 (cited under Reference Works).

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  • Kim, Jim Yong, Joyce V. Millen, Alex Irwin, and John Gershman, eds. Dying for Growth: Global Inequality and the Health of the Poor. Monroe, ME: Common Courage Press, 2000.

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    A volume produced by a Massachusetts-based group of researchers and activists that situates case studies of health crises (from Haiti, sub-Saharan Africa, Peru, Mexico, India, and Russia) in a normative framework explicitly critical of neoliberal globalization, transnational corporations, and US policy. Its scope and depth have yet to be replicated in a single volume.

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  • People’s Health Movement, Medact, and Global Equity Gauge Alliance. Global Health Watch 2: An Alternative World Health Report. London: Zed Books, 2008.

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    The second of three such reports produced by a coalition of civil society organizations, all available for free online, this one is especially useful as an inventory of major global health issues and description of the role of major actors like the World Health Organization (WHO), World Bank, Gates Foundation, and transnational corporations.

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  • Stuckler, David, and Sanjay Basu. The Body Economic: Why Austerity Kills. London: Allen Lane, 2013.

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    Critique of the austerity measures that followed the financial crisis of 2008, and are often portrayed as unavoidable. Authors argue that this was not the case and that “in countries where austerity is ascendant, we’re undergoing a massive and untested experiment on human health, and left to count the dead” (p. xxi). Extensively documented with reference to authors’ own epidemiological studies.

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  • Zielinski Gutiérrez, Emily C., and Carl Kendall. “The Globalization of Health and Disease: The Health Transition and Global Change.” In The Handbook of Social Studies in Health & Medicine. Edited by Gary L. Albrecht, Ray Fitzpatrick, and Susan C. Scrimshaw, 84–99. London: SAGE, 2000.

    DOI: 10.4135/9781848608412Save Citation »Export Citation » Share Citation »

    A succinct description of “the globalization of disease,” connecting urbanization and epidemiological transition (from communicable to noncommunicable diseases as causes of illness and death) with global-scale economic and political processes, including the increased volume and reduced cost of transportation and communication. Useful for teaching purposes in various courses where opportunity for more in-depth exploration of the globalization-health nexus is limited.

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Blogs and Content Aggregators

The Internet age has brought with it a torrent of (mis)information; the three portals cited here offer complementary coverage of issues related to global health and are also well quality controlled. Environmental Health News focuses on the often-neglected contribution of environmental hazards to population health and health inequalities. Laurie Garrett’s Blog provides commentaries on global health that are informed by her earlier groundbreaking journalism in the field. International Health Policies benefits from access to a range of European sources that may be unfamiliar to North American users, in particular.

Reference Works

Kirton 2009 and Labonté, et al. 2011 (and there is minimal overlap between them) together provide a reasonably comprehensive documentary history of the emergence of global health as a field of research, policy, and (to a lesser extent) professional practice. The implicit definitions of globalization are quite different, with political economy more central to Labonté, et al. 2011. Brown, et al. 2014 is, at this writing, the single best “desk reference” on current issues in globalization, health, and health policy. Jamison, et al. 2006 is a useful open access reference, especially for those without a background in medicine or health systems.

  • Brown, Garrett W., Gavin Yamey, and Sarah Wamala, eds. The Handbook of Global Health Policy. Malden, MA: Wiley Blackwell, 2014.

    DOI: 10.1002/9781118509623Save Citation »Export Citation » Share Citation »

    Thirty chapters address many of the issues covered by this article, including critical topics like the limits to “evidence-based” global health policy, the nature of global health justice, changing influences on global health policy, securitizing health, the challenges of building equitable health systems, and the role of human rights. Many chapters explicitly consider globalization. Unfortunately cost currently rules it out as a textbook.

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  • Jamison, Dean, Joel G. Breman, Anthony R. Measham, et al., eds. Disease Control Priorities in Developing Countries. 2d ed. Washington, DC: Oxford University Press, 2006.

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    Seventy-three chapters review conceptual, medical, and health system challenges of improving health. Now a bit dated, but valuable especially on the science of treatment and prevention, despite the preoccupation of some (although not all) contributors with the cost-effectiveness of particular interventions.

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  • Kirton, John J., ed. Global Health. Farnham, UK: Ashgate, 2009.

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    Thirty-four reprinted papers, published between 1919 and 2007 (contents online), that document the emergence of global health as a field of study and institutional development, emphasizing communicable disease, health and trade, and “global health governance.” Political scientist Kirton is a leading authority on the G7/G8 and founded the University of Toronto G8 Research Group.

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  • Labonté, Ronald, Katia S. Mohindra, Ted Schrecker, and Kirsten Stoebenau, eds. Global Health. 4 vols. SAGE Library of Health and Social Welfare. London: SAGE, 2011.

    DOI: 10.4135/9781446261828Save Citation »Export Citation » Share Citation »

    Seventy-six reprinted papers and book/report excerpts, published between 1974 and 2009 (contents online). The focus on governance and institutions is less strong than in Kirton 2009; these selections incorporate more material from the medical and health sciences literature as well as social sciences, and pay more attention to key developments outside the industrialized world, such as Latin American social medicine. Cross-cutting themes include ethics and gender.

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Textbooks

Two very different approaches for a similar audience, with Birn, et al. 2009 more explicitly situating global health in the context of economics and geopolitics than Parker and Sommer 2011, in which many chapters do not offer social scientific explanation. Krieger 2011 is valuable as a reflection on dominant research methods and their history and politics. See also Benatar and Brock 2011, cited under Ethics of Global Health Crises, which would be useful as a textbook in (mainly graduate) courses in global health policy, health ethics, or international ethics; it provides enough substantive background about major health problems to be used as a “stand-alone” in the latter context.

  • Birn, Anne-Emanuelle, Yogan Pillay, and Timothy H. Holtz. Textbook of International Health: Global Health in a Dynamic World. 3d ed. New York: Oxford University Press, 2009.

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    Especially valuable for analytical distinction among biomedical, behavioral, and political economy models of health and disease. Chapters on social determinants of health, trade and employment, environment, and health-care systems as well as more usual descriptive material. Suitable for both undergraduate and graduate courses; the former (and the latter, for students without a social science background) might require explanation by way of lectures or supplementary notes.

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  • Krieger, Nancy. Epidemiology and the People’s Health: Theory and Context. New York: Oxford University Press, 2011.

    DOI: 10.1093/acprof:oso/9780195383874.001.0001Save Citation »Export Citation » Share Citation »

    Not about global health per se, but an indispensable guide to the history of population health research methodologies, and the often-unexamined assumptions made by epidemiologists and the process by which their discipline became hegemonic in the study of population health. Valuable for graduate students without a background in epidemiology, medicine, or public health, but also useful for stimulating methodological self-consciousness among students and professionals.

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  • Parker, Richard, and Marni Sommer, eds. Routledge Handbook of Global Public Health. New York: Routledge, 2011.

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    A mix of previously published and (mainly) new material (contents online). Historical observations on the transition from “international” to “global health” are followed by sections on economic and political inequalities, conflict and violence, and global public health policy. It also addresses global mental health and ecological transformations, two generally neglected areas.

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Historical Perspectives on Health, Disease, and Health Policy

Until relatively recently, when governments looked outside their own borders on matters of health, or cooperated about them, their concern was with the impacts of communicable disease. Histories of global health often begin with the 14th-century adoption of quarantine periods for foreign vessels by the city-state of Venice, or the start of formal international cooperation to halt the spread of communicable diseases in the mid-19th century. Adams 2013 provides an overview dating from that point. These are important milestones, but as Diamond 1997 and (especially) Green 2012 remind us, the cross-border spread of disease has a much longer history, and that history is bound up with the distribution of power in the world system. Lee and Dodgson 2000 concludes that the global reach of cholera illustrates the need for “global governance,” specifically with respect to the spread of infectious disease. Cueto 2004 takes us into more recent history; this work, like Lee and Goodman 2002 (cited under Role of the International Financial Institutions), emphasizes the importance of key individual protagonists like Halfdan Mahler, Director-General of the World Health Organization from 1973 to 1988 (Jonathan Mann, first head of the United Nations Program on HIV/AIDS or UNAIDS, is another example) and their role in international networks. Birn 2005 and Birn 2009 provide a valuable counterpoint to work that views the history of global health mainly in terms of agendas and initiatives driven by high-income countries and institutions that they control. Indeed, history tends to be told from the perspective if not of the winners then at least of the powerful. The work of medical anthropologists can offer a powerful corrective to this tendency, which is why work by several of them (such as Fassin 2012) is included in this article. Riley 2008 may seem somewhat out of place here, but it represents an important application of comparative case study methodology to the question of how and why some societies are able to achieve much higher levels of health than most others with comparable GDP/capita at a particular point in time. Riley’s answers are not always reassuring.

  • Adams, Vincanne. “A History of International Health Encounters: Diplomacy in Transition.” In 21st Century Global Health Diplomacy. Vol. 3 of Global Health Diplomacy. Edited by Thomas E. Novotny, Ilona Kickbusch, and Michaela Told, 41–64. Singapore: World Scientific, 2013.

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    Succinct, descriptive history of the relations between health and politics from the 19th century to the present, including key social theorists, medicine and public health in the colonial context, and the expanded role of development assistance for health. Useful overview for teaching purposes.

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  • Birn, Anne-Emanuelle. “Uruguay on the World Stage: How Child Health Became an International Priority.” American Journal of Public Health 95 (2005): 1506–1517.

    DOI: 10.2105/AJPH.2004.038778Save Citation »Export Citation » Share Citation »

    Birn is perhaps best known for her historical work on the Rockefeller Foundation and public health in Latin America. Here, she demonstrates the importance of leadership in domestic and international policy from protagonists in a “peripheral” location, resulting in infant mortality rates lower than those in many European countries by the early 20th century.

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  • Birn, Anne-Emanuelle. “The Stages of International (Global) Health: Histories of Success or Successes of History?” Global Public Health 4 (2009): 50–68.

    DOI: 10.1080/17441690802017797Save Citation »Export Citation » Share Citation »

    Birn has written widely on Latin America. Here, she reflects more generally on historiographical questions like periodization as applied to global health, and on the need to ask how (and by whom) success is defined. She argues that contemporary definitions privilege “technically based disease control measures” whose centrality is not self-evident based on the historical record.

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  • Cueto, Marcos. “The Origins of Primary Health Care and Selective Primary Health Care.” American Journal of Public Health 94 (2004): 1864–1874.

    DOI: 10.2105/AJPH.94.11.1864Save Citation »Export Citation » Share Citation »

    Account of the 1978 Alma Ata meeting that proposed Health for All in the Year 2000 as a goal, and of how the agenda of comprehensive primary health care was undermined by individuals and organizations concerned about its excessive breadth and ambition. Usefully read in conjunction with Lawn, et al. 2008 (cited under Global Politics of Health Systems).

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  • Diamond, Jared. Guns, Germs and Steel: The Fates of Human Societies. New York: Norton, 1997.

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    Most of this popular volume is not about health, but the “lethal gift of livestock” chapter is a valuable introduction to the role of infectious disease and animal-human transmission in historical explanation, suitable for assignment in junior undergraduate or multidisciplinary courses.

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  • Fassin, Didier. “That Obscure Object of Global Health.” In Medical Anthropology at the Intersections: Histories, Activisms, and Futures. Edited by Marcia C. Inhorn and Emily A. Wentzell, 95–115. Durham, NC: Duke University Press, 2012.

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    History from an anthropological perspective of the rapid emergence of “global health” as field of inquiry and practice, which begins with a striking example of the unquestioned exclusion of undocumented immigrants from coverage under the US Affordable Care Act, considered as a global issue. Sassin argues that “the globalization of health must . . . be thought of as a heterogeneous and contested historical phenomenon.”

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  • Green, Monica. “The Value of Historical Perspective.” In The Ashgate Research Companion to the Globalization of Health. Edited by Ted Schrecker, 17–38. Farnham, UK: Ashgate, 2012.

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    Green, a medievalist turned to the history of global health, combines recent findings from paleopathology and genomic analyses of pathogens with other historical material to describe the progress of tuberculosis, malaria, smallpox, leprosy, plague, syphilis, cholera, and HIV/AIDS over more than ten thousand years. From various points of origin, all eight became globally distributed. The end point is an unusually multidimensional understanding of “where diseases come from.”

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  • Lee, Kelley, and Richard Dodgson. “Globalization and Cholera: Implications for Global Governance.” Global Governance 6 (2000): 213–236.

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    The history of seven cholera pandemics since the early 19th century is viewed through the “lens” of globalization, defined as having spatial, temporal, and cognitive dimensions. Authors show that both technological change and social conditions associated with globalization must be considered in explaining the pattern of disease. Reprinted in Labonté, et al. 2011 (cited under Reference Works).

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  • McMichael, Anthony J. “Population Health in the Anthropocene: Gains, Losses and Emerging Trends.” Anthropocene Review 1 (2014): 44–56.

    DOI: 10.1177/2053019613514035Save Citation »Export Citation » Share Citation »

    Argues that an Anthropocene era arrived over the last two centuries, and “today’s depleting and disrupting of Earth’s . . . systems will sooner or later translate into a substantial decline in population health.” Could be used creatively in teaching in combination with Green 2012 or sources on global environmental change that do not specifically address health.

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  • Riley, James C. Low Income, Social Growth, and Good Health: A History of Twelve Countries. Berkeley: University of California Press, 2008.

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    China, Costa Rica, Cuba, Jamaica, Japan, Korea, Mexico, Oman, Panama, the former Soviet Union, Sri Lanka, and Venezuela are dissimilar in many respects. All, however, achieved rapid increases in life expectancy while national income/capita was relatively low. Riley argues that they did so through policies that emphasized investment in infrastructure and “social growth,” often without democracy or an explicit concern with social justice.

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Health Security and Communicable Diseases

Security is the oldest motivation for governmental concern with globalization and health, and it remains important (some would say dominant). Bergh and Gill 2013 provides a useful analytical introduction to motivations and issues. King 2002 and Abraham 2011 (cited under Influenza) both highlight the role of the United States, and of key actors within its borders, in the “securitization” of global health—instantiating the point made in Rushton 2011 that, like history, security problems as they emerge on international agendas are likely to reflect the priorities of the powerful. Kamradt-Scott and Lee 2011 (cited under Influenza) elaborates on this point with reference to a specific, and revealing, episode in the politics of global health. “Securitization” in the contemporary context may be both empirically and normatively suspect. Health security concerns are real, as Grais, et al. 2003 (cited under Influenza) and, on a larger scale, Garrett 2000 (cited under General Overviews) remind us. In contrast to the Price-Smith 1999 perspective, Peterson 2002, Elbe 2011, and Fourie 2007 (cited under HIV/AIDS) argue, each with a different emphasis, that communicable diseases do not threaten national interests to the extent often claimed by proponents of the emerging disease worldview described in King 2002. Elbe 2006 (cited under HIV/AIDS) further argues that securitization is likely to be not just irrelevant, but actually destructive. See also Lakoff and Collier 2008.

  • Bergh, Kristofer, and Bates Gill. “Global Health and Security.” In 21st Century Global Health Diplomacy. Vol. 3 of Global Health Diplomacy. Edited by Thomas E. Novotny, Ilona Kickbusch, and Michaela Told, 165–189. Singapore: World Scientific, 2013.

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    An overview that distinguishes among what the author calls normative, subjective, and objective approaches. Specific issues addressed include conflicts and catastrophes, sanctions, infectious diseases, and use of biological knowledge in warfare and terrorism. Useful introduction for those new to the topic.

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  • Elbe, Stefan. “Pandemics on the Radar Screen: Health Security, Infectious Disease and the Medicalisation of Insecurity.” Political Studies 59 (2011): 848–866.

    DOI: 10.1111/j.1467-9248.2011.00921.xSave Citation »Export Citation » Share Citation »

    Elbe, closely identified with the study of health and security, distinguishes the primarily economic security dimensions of SARS and H5N1 (influenza) from the primarily military and institutional apprehensions that surfaced in the early years of the HIV pandemic. He argues that a broader pattern of “medicalization of insecurity” is now emerging, while questioning whether current pandemic preparedness initiatives actually reduce insecurity.

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  • King, Nicholas B. “Security, Disease, Commerce: Ideologies of Postcolonial Global Health.” Social Studies of Science 32 (2002): 763–789.

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    Like Birn, King points to the origins of concern for international health in the economic and political imperatives of empire. The main value of this article, though, is its detailed description of the rise of “emerging diseases” on the US security policy agenda during the 1990s, and the subsequent dominance of the US worldview.

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  • Lakoff, Andrew, and Stephen J. Collier, eds. Biosecurity Interventions: Global Health and Security in Question. New York: Columbia University Press, 2008.

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    Multidisciplinary overview organized around the contested concept of biosecurity, which responds not only to communicable diseases but also to other microbial threats. Focus is on US policy, but valuable comparative perspective is added by discussions of, for example, responses to tuberculosis in Georgia, “mad cow disease” in France, and avian influenza in Egypt.

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  • Peterson, Susan. “Epidemic Disease and National Security.” Security Studies 12 (2002): 43–81.

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    Adopting a definition of national security that emphasizes interstate conflict rather than the broader rubric of “human security,” Peterson argues that emerging infectious diseases do not threaten US security to the extent that was claimed c. 2000. She further suggests that the strategy of linking global health to national security concerns may backfire because of the tenuousness of many such connections. Reprinted in Kirton 2009 (cited under Reference Works).

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  • Price-Smith, Andrew T. “Ghosts of Kigali: Infectious Disease and Global Stability at the Turn of the Century.” International Journal 54 (1999): 426–442.

    DOI: 10.2307/40203404Save Citation »Export Citation » Share Citation »

    A highly articulate statement of the emerging disease worldview identified by King. In retrospect somewhat alarmist, at least with respect to HIV/AIDS.

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  • Rushton, Simon. “Global Health Security: Security for Whom? Security from What?” Political Studies 59 (2011): 779–796.

    DOI: 10.1111/j.1467-9248.2011.00919.xSave Citation »Export Citation » Share Citation »

    Unlike many authors writing on health and security, Rushton recognizes that the priorities of the “Global South” might be radically different from those of the major powers—a point expanded upon in Abraham 2011 (cited under Influenza), with specific reference to the existence of other, more immediate priorities in the South than planning for an influenza pandemic.

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Influenza

Apprehensions about the emergence of influenza strains comparable in virulence to that of 1918–1919 prompted an unprecedented mobilization of resources during the 2000s. Grais, et al. 2003 is an especially striking demonstration of how changing patterns of air travel would hasten the spread of such a strain. The Abraham 2011 and Kamradt-Scott and Lee 2011 articles are two early assessments of the politics of response.

  • Abraham, Thomas. “The Chronicle of a Disease Foretold: Pandemic H1N1 and the Construction of a Global Health Security Threat.” Political Studies 59 (2011): 797–812.

    DOI: 10.1111/j.1467-9248.2011.00925.xSave Citation »Export Citation » Share Citation »

    Abraham analyzes the high level of political attention to pandemic preparedness in the 2000s using the concept of framing. In the case study, he emphasizes the “issue culture around emerging infectious diseases” (p. 802) within the United States, strengthened after the 2001 attacks, and the central US role in the process of securitization that led to extraordinary efforts at pandemic planning, in the United States and much of the rest of the world.

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  • Grais, Rebecca F., J. Hugh Ellis, and Gregory E. Glass. “Assessing the Impact of Airline Travel on the Geographic Spread of Pandemic Influenza.” European Journal of Epidemiology 18 (2003): 1065–1072.

    DOI: 10.1023/A:1026140019146Save Citation »Export Citation » Share Citation »

    An effort to test, rather than merely repeat, claims about how globalization magnifies risks of infectious disease transmission. Grais and colleagues repeated a model-based account of how influenza traveled by air during the 1968–1969 pandemic (“Hong Kong flu”) using year 2000 data on air travel volumes, suggesting that an average of 188 percent more cases would occur.

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  • Kamradt-Scott, Adam, and Kelley Lee. “The 2011 Pandemic Influenza Preparedness Framework: Global Health Secured or a Missed Opportunity?” Political Studies 59 (2011): 831–847.

    DOI: 10.1111/j.1467-9248.2011.00926.xSave Citation »Export Citation » Share Citation »

    Skeptical assessment of the nonbinding 2011 agreement that resulted from Indonesia’s 2007 refusal to share H5N1 virus samples with an established World Health Organization network for identifying new influenza strains and supplying samples for vaccine development in cooperation with the pharmaceutical industry.

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HIV/AIDS

The emergence of global health as a distinctive trope, policy concern, and field of study is inseparable from the history of HIV/AIDS. Pepin 2011 offers a history of the AIDS epidemic that emphasizes the interplay of biology, colonial imperatives, and international migration, leading to a point where “its subsequent transformation into a global epidemic became unavoidable” (p. 213). Securitization superimposed racial stereotypes and symbolic concerns about threatening “others” on plausible apprehensions about economic and geopolitical impacts. Elbe 2006 offers an ethical argument against securitizing AIDS, and Fourie 2007 points out that some of the dire predictions made at earlier stages of the epidemic (see, e.g., Price-Smith 1999, cited under the section on Health Security and Communicable Diseases) have not materialized. Securitization is only one connection between AIDS and globalization. Freedman and Poku 2007 elaborate on this point with reference to the impacts of Africa’s subaltern status in the postcolonial economy; O’Manique 2004 and Schoepf 2004 complement these insights with specific, and critical, discussion of two countries affected by the epidemic. Gillespie, et al. 2007, superficially without a political dimension, nevertheless confirms that macro-scale processes that perpetuate or intensify economic inequality, and the choices behind them, are directly implicated in the spread of HIV. AIDS has dominated many aspects of global health politics post-2000: in addition to the security agenda, consider, for example, how AIDS and the perceived shortcomings of existing international institutions mobilized the G7 to establish the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, as described in Hein, et al. 2007. In addition, Klot and Nguyen 2011 (cited under Globalization, Gender, and Health) provides critical gendered perspectives on how HIV affects the security of individuals and households.

  • Elbe, Stefan. “Should HIV/AIDS Be Securitized? The Ethical Dilemmas of Linking HIV/AIDS and Security.” International Studies Quarterly 50 (2006): 119–144.

    DOI: 10.1111/j.1468-2478.2006.00395.xSave Citation »Export Citation » Share Citation »

    Elbe argues that “securitization” is attractive as a way of mobilizing additional resources, but entails the risk of expanding the role of the military and intelligence communities in the response and of building into the response a “threat-defense” logic that emphasizes national interests rather than those of people living with or at risk for HIV infection. Reprinted in Kirton 2009 (cited under Reference Works).

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  • Fourie, Pieter. “The Relationship between the AIDS Pandemic and State Fragility.” Global Change, Peace & Security 19 (2007): 281–300.

    DOI: 10.1080/14781150701599473Save Citation »Export Citation » Share Citation »

    Fourie demonstrates that many apocalyptic predictions of the political and economic consequences of the AIDS pandemic were overdone, but warns that complacency is premature, given the “long-wave” nature of the epidemic and potential future demographic pressures.

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  • Freedman, Jane, and Nana Poku. “The Socioeconomic Context of Africa’s Vulnerability to HIV/AIDS.” Review of International Studies 31 (2007): 665–686.

    DOI: 10.1017/S0260210505006686Save Citation »Export Citation » Share Citation »

    Authors argue that external debt burdens and structural adjustment programs contributed to the poverty and “economic retrogression” that play a role, directly and indirectly, in the spread of AIDS. They further emphasize that subsequent debt cancellation was inadequate and contingent on compliance with what were, in effect, a new generation of structural adjustment conditionalities.

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  • Gillespie, Stuart, Suneetha Kadiyala, and Robert Greener. “Is Poverty or Wealth Driving HIV Transmission?” AIDS 21 (2007): S5–S16.

    DOI: 10.1097/01.aids.0000300531.74730.72Save Citation »Export Citation » Share Citation »

    Reviews qualitative and quantitative studies of the socioeconomic context for HIV infection in sub-Saharan Africa published early in the 2000s. Economic inequality and insecurity (including gender-related “asymmetries”), rather than poverty per se, are critical, although “[m]any of the wealthiest groups in affected communities may actually fall below an absolute poverty line” (p. S15). Reprinted in Labonté, et al. 2011 (cited under Reference Works).

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  • Hein, Wolfgang, Sonja Bartsch, and Lars Kohlmorgen, eds. Global Health Governance and the Fight against HIV/AIDS. Basingstoke, UK: Palgrave Macmillan, 2007.

    DOI: 10.1057/9780230591349Save Citation »Export Citation » Share Citation »

    Chapters provide detailed explanations of the new organizational context for global AIDS policy and of its political economy, including useful overviews of Brazilian and South African cases. However, this is much more than a book about AIDS; it provides valuable conceptual frameworks (especially in the first chapter) for studying the multiplication of actors in global health and the consequent transformation of global health politics.

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  • O’Manique, Colleen. Neoliberalism and AIDS Crisis in Sub-Saharan Africa: Globalization’s Pandemic. Houndmills, UK: Palgrave Macmillan, 2004.

    DOI: 10.1057/9780230504080Save Citation »Export Citation » Share Citation »

    O’Manique argues that the history of AIDS in Africa must be understood against the background of a macroeconomic context shaped by the neoliberal policies promoted by the World Bank (and others). Two chapters based on field research use the epidemic in Uganda and the country’s qualified “success story” in responding as a case study.

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  • Pepin, Jacques. The Origins of AIDS. Cambridge, UK: Cambridge University Press, 2011.

    DOI: 10.1017/CBO9781139005234Save Citation »Export Citation » Share Citation »

    Pepin, a microbiologist who has worked in sixteen African countries, argues that changed sexual behaviors associated with European colonization partly explain the HIV epidemic in Africa, but also that it was “jump-started” by nonsterile injections at clinics in central Africa. He traces the subsequent path of the virus from the Congo to Haiti (between 1960 and 1966), and thence to the United States.

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  • Schoepf, Brooke G. “AIDS, History, and Struggles over Meaning.” In HIV & AIDS in Africa: Beyond Epidemiology. Edited by Ezekiel Kalipeni, Susan Craddock, Joseph R. Oppong, and Jayati Ghosh, 15–28. Oxford: Blackwell, 2004.

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    Schoepf is an anthropologist whose work on HIV prevention dates back to her founding role in an ethnographic research project in Zaire (now Democratic Republic of Congo) in the 1980s. Her anthropology of the epidemic has a strong political subtext; she is harshly critical of the indifference both of the international financial institutions (IFIs) and many African governments.

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Malaria

Although WHO estimates that malaria continues to kill more than an estimated 600,000 people per year, mainly children under five, remarkably little social scientific research has addressed malaria control policy and politics.

  • Shah, Sonia. The Fever: How Malaria Has Ruled Humankind for 500,000 Years. New York: Farrar, Straus & Giroux, 2010.

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    Despite the rather breathless title, journalist Shah has produced a well-researched history of malaria and the politics (including those internal to the scientific establishment) of efforts to control it.

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Politics of Noncommunicable Diseases

Although noncommunicable conditions like cardiovascular diseases, cancer, diabetes, and chronic lung diseases are sometimes thought of as diseases of the affluent, their contribution to the burden of disease is rising rapidly in low- and middle-income countries (LMICs), even among those with low incomes within those countries. In September 2011, the United Nations devoted only the second General Assembly–level meeting on a health issue in its history to NCDs; the first, in 1990, was on HIV/AIDS. The research literature on NCDs and globalization is relatively sparse, even though clear connections can be drawn between, for example, trade and investment liberalization and diet-related chronic diseases. (Residents of Mexico now drink more Coca-Cola products per capita than their neighbors to the north.) The 2011 meeting framed its response to NCDs with reference to risk factors defined in terms of individual behavior: tobacco use, unhealthy diet, harmful use of alcohol, and physical inactivity. Structural influences on these variables were largely downplayed—as they were in at least the earlier stages of responses to the HIV/AIDS epidemic. Moodie, et al. 2013 suggests one reason for this: the powerful influence of the transnational food and alcohol corporations. However, this must be understood, as Glasgow 2005 compellingly argues, in conjunction with a longer history of individualized health promotion. Neither of these elements of political context receives much attention from Alleyne, et al. 2013. For LMICs, responding to NCDs will require not only sophisticated policy analysis of the kind provided in Hawkes, et al. 2012, but also resources. Nugent and Feigl 2010 points out that donors have historically neglected NCDs, favoring programs that address communicable diseases. Fidler 2011, cited under Globalizing Health Governance, offers a memorable insight into this preference: “[N]either national health nor economic prosperity in the United States depends on whether India controls obesity-related diseases, and vice versa. Neither security nor the protection of human rights in the European Union depends on whether countries in sub-Saharan Africa control diseases driven by tropical climatic conditions or local water or air pollution . . .” (p. 36). Hawkes and Thow 2008 and Hawkes, et al. 2010, both cited under Trade, provide additional detail on how liberalization of trade and foreign investment have contributed to the spread of diet-related NCDs.

  • Alleyne, George, Agnes Binagwaho, Andy Haines, et al. “Embedding Non-communicable Diseases in the Post-2015 Development Agenda.” The Lancet 381 (2013): 566–574.

    DOI: 10.1016/S0140-6736(12)61806-6Save Citation »Export Citation » Share Citation »

    Authors make a strong case for greater emphasis on preventing noncommunicable diseases (NCDs) in international development policy, because of socioeconomic inequalities in prevalence and because of their economic consequences. However, they do not reflect on how or why individualized, biomedical approaches have been emphasized in this context.

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  • Glasgow, Sara Mae. “The Private Life of Public Health: Managing Chronic Disease in an Era of Neoliberal Governmentality.” PhD diss., University of Maryland, College Park, 2005.

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    Glasgow combines Foucauldian and Marxist perspectives, by way of the rubrics (respectively) of governmentality and neoliberalism, to argue that public policy toward NCDs in national, regional, and global frames of reference depoliticizes NCDs by framing them largely as consequences of individuals’ choices and risk behaviors. Central to any serious study of the topic.

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  • Hawkes, Corinna, Sharon Friel, Tim Lobstein, and Tim Lang. “Linking Agricultural Policies with Obesity and Noncommunicable Diseases: A New Perspective for a Globalising World.” Food Policy 37 (2012): 343–353.

    DOI: 10.1186/1744-8603-2-4Save Citation »Export Citation » Share Citation »

    Authors argue that agricultural and food policy influence diet (and therefore the prevalence of NCDs) through multiple pathways, and that the complex global food supply chains that result from processes of trade liberalization and economic adjustment demand a variety of policy responses to address unhealthy diets, obesity, and associated diseases.

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  • Moodie, Rob, David Stuckler, Carlos Monteiro, et al. on behalf of The Lancet NCD Action Group. “Profits and Pandemics: Prevention of Harmful Effects of Tobacco, Alcohol, and Ultra-Processed Food and Drink Industries.” The Lancet 381 (2013): 670–679.

    DOI: 10.1016/S0140-6736(12)62089-3Save Citation »Export Citation » Share Citation »

    Argues that the rising prevalence of NCDs should be understood as “industrial epidemics” in which “the vectors of spread are not biological agents, but transnational corporations” that are rapidly penetrating low- and middle-income country markets. A variety of strategies used to undermine effective public health policies are documented, as part of a case for stronger regulation and an arm’s length relationship modeled on responses to the tobacco industry.

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  • Nugent, Rachel A., and Andrea B. Feigl. Where Have All the Donors Gone? Scarce Donor Funding for Non-communicable Diseases. Working Paper 228. Washington, DC: Center for Global Development, 2010.

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    Authors estimate that only 3 percent of total development assistance for health was dedicated to NCDs in 2007—relative to estimates of their contribution to the global burden of disease, a vastly smaller quantum of funding than was directed to HIV, tuberculosis, and malaria. They do not inquire into the reasons for this gap, but Fidler 2011 (cited under Globalizing Health Governance) would have something to say on the matter.

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Trade

Trade liberalization and increased trade flows are the most familiar aspect of contemporary economic globalization. The binding provisions and dispute resolution mechanisms under the WTO regime and a proliferation of bilateral and regional agreements also contrast with the lack of supranational mechanisms for protecting health. Blouin, et al. 2008 and Blouin, et al. 2009 describe potential channels of (both positive and negative) trade influences on health by way of social determinants; Shaffer, et al. 2005, one of the first critiques of trade liberalization to appear in a major public health journal, expands the frame of reference to include reductions in the “policy space” available for regulation and de-commodification. Hawkes and Thow 2008 and Hawkes, et al. 2010 provide abundant evidence of negative health impacts by way of accelerated nutrition transitions. Friel, et al. 2013 provides an analytical template that is broadly applicable to treaties that incorporate provisions related to foreign investment. Unfortunately, the case study literature on health impacts connected to lost or precarious livelihoods subsequent to trade liberalization remains, for the most part, underdeveloped. See also Grown, et al. 2006, cited under Globalization, Gender, and Health, which provides a distinctive gender perspective on trade liberalization. Hawkes, et al. 2012, cited under Politics of Noncommunicable Diseases, show how trade liberalization fits into a broader range of processes that are constitutive of globalization.

Access to Essential Medicines

Following the harmonization of intellectual property provisions under the Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) in 1995, an international groundswell of opposition based on the perceived consequences for access to medicines led to an eventual reinterpretation of the agreement; the chronology and politics are provided in ‘t Hoen, et al. 2011 and Correa and Matthews 2011. Special concern is in order about provisions in bilateral and regional trade agreements (TRIPS-plus) that go beyond the protections in TRIPS, as described in Shaffer and Brenner 2009 (see also the chapter by Roffe, von Braun, and Vivas-Eugui in Blouin, et al. 2008, cited under Trade). Intellectual property issues are, as Correa 2009 points out, a subset of the larger ethical and economic question of how to finance research and development that addresses disease mainly affecting those too poor to constitute an attractive market. Consultative Expert Working Group on Research and Development 2012 provides one, admittedly generic solution. A more specific proposal is the Health Impact Fund that Thomas Pogge and colleagues have proposed to address the human rights challenges presented by the lack of access (Pogge 2007). If implemented, it would represent a remarkable “globalized” response to a problem that cannot be addressed simply by appealing to the self-interest of the wealthy (individuals or countries). More broadly, efforts to achieve “policy coherence” between trade and health objectives are the focus of Blouin, et al. 2008 (cited under Trade), with one chapter at least expressing skepticism about the enterprise.

Globalization, Gender, and Health

Surprisingly little research literature specifically connects globalization with gender disparities in health; the larger literature on globalization and gender per se is too extensive to canvass here. The schematic view provided in Meacham 2001 is therefore valuable as a guide for future research, as is the comprehensive treatment in Petchesky 2003. Hawkes and Buse 2013 points out how much has yet to be done at the level of development policy, with Yamin 2013 making a similar point about women’s health rights. Mohindra, et al. 2011 and the contributors to Grown, et al. 2006 focus on more specific instances of gendered impacts of globalization, providing useful templates for future research. Schoepf 2004 is exemplary in describing the macro-micro linkages that are essential to any adequate understanding of globalization’s health consequences “on the ground,” whether or not gender is involved (although it usually is, as pointed out in Sen and Östlin 2010). Klot and Nguyen 2011 is an indispensable compendium of case studies and analyses incorporating a gender perspective on the political economy of HIV/AIDS, conflict, and global health.

  • Grown, Caren, Elissa Braustein, and Anju Malhotra, eds. Trading Women’s Health & Rights? Trade Liberalization and Reproductive Health in Developing Countries. New York: Zed Books, 2006.

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    Assessment of trade liberalization’s effects on reproductive health, emphasizing effects on health services (including financing and health worker migration) and women’s employment. Country studies involve Bangladesh, Egypt, Vietnam, China, Mexico, Sri Lanka, Tanzania, and South Africa.

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  • Hawkes, Sarah, and Kent Buse. “Gender and Global Health: Evidence, Policy, and Inconvenient Truths.” The Lancet 381 (2013): 1783–1787.

    DOI: 10.1016/S0140-6736(13)60253-6Save Citation »Export Citation » Share Citation »

    Document-based review of the general absence of “gender mainstreaming,” as defined by the United Nations Economic and Social Council, in the approaches taken by selected international organizations. Authors do not inquire into or speculate about the reasons for this failure.

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  • Klot, Jennifer F., and Vinh-Kim Nguyen, eds. The Fourth Wave: Violence, Gender, Culture & HIV in the 21st Century. Paris: UNESCO, 2011.

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    Important collection that includes numerous country case studies of the gender politics of HIV/AIDS transmission, treatment, and prevention. Anthropology is the discipline best represented, but is not the only one. Emphasizes the importance of structural rather than individual-level influences, and correspondingly of research and interventions that go beyond the biomedical.

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  • Meacham, Deborah, ed. Globalization, Health Sector Reform, Gender and Reproductive Health. New York: Globalization Committee Reproductive Health Affinity Group, Ford Foundation, 2001.

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    Succinct and readable synthesis of findings on how globalization affects women’s health in general and access to health care and reproductive rights protections in particular. Contributors draw on an extensive literature in feminist political economy that does not directly address health impacts, and focus on (among other topics) the gender dimensions of structural adjustment and market-oriented health sector “reforms.”

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  • Mohindra, Katia S., Ronald Labonté, and Denise Spitzer. “The Global Financial Crisis: Whither Women’s Health?” Critical Public Health 21 (2011): 273–287.

    DOI: 10.1080/09581596.2010.539593Save Citation »Export Citation » Share Citation »

    Authors review literature showing that impacts of financial crises, like those of other macro-scale processes, are gender-stratified. Cases studied are the era of structural adjustment and the decline of the Cuban economy after the Soviet collapse. Authors anticipate that women in LMICs will be especially hard hit by the recession that followed the crisis of 2008.

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  • Petchesky, Rosalind P. Global Prescriptions: Gendering Health and Human Rights. London: Zed Books, 2003.

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    Series of essays on two related themes: the formation of transnational women’s health movements and their trajectory within the UN system, and why global capitalism in its present form is inimical to health. Essays are unified by Petchesky’s commitment to feminism and social democracy, and unfortunately are not at all dated. Excerpt reprinted in Labonté, et al. 2011 (cited under Reference Works).

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  • Schoepf, Brooke G. “AIDS in Africa: Structure, Agency, and Risk.” In HIV & AIDS in Africa: Beyond Epidemiology. Edited by Ezekiel Kalipeni, Susan Craddock, Joseph R. Oppong, and Jayati Ghosh, 121–132. Oxford: Blackwell, 2004.

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    Summarizes two decades of ethnographic research on how gender inequalities interact with, and are exacerbated by, macro-scale economic and political processes to increase women’s vulnerability to HIV infection. In the literature on this topic, Schoepf’s work is notable for its implicit challenge to the currently fashionable emphasis on “agency,” which neglects hard facts about power and deprivation.

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  • Sen, Gita, and Piroska Östlin. “Gender Inequity in Health: Why It Exists and How We Can Change It.” Global Public Health 3 (2010): S1–S12.

    DOI: 10.1080/17441690801900795Save Citation »Export Citation » Share Citation »

    Succinct overview, by scholars who led the gender research component of the WHO Commission on Social Determinants of Health, of gender inequalities as “among the most influential of the social determinants of health” (p. 2). Their diagrammatic conceptual framework is especially useful. The authors’ chapter in Parker and Sommer 2011, cited under Textbooks, covers similar material.

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  • Yamin, Alicia Ely. “Women’s Health and Human Rights: Struggles to Engender Social Transformation.” In Advancing the Human Right to Health. Edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, 275–290. Oxford: Oxford University Press, 2013.

    DOI: 10.1093/acprof:oso/9780199661619.001.0001Save Citation »Export Citation » Share Citation »

    Reviews the role of international treaties in advancing women’s health rights, and the political obstacles that continue to confront initiatives to advance women’s sexual and reproductive health rights, in particular.

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Global Health in an Age of Multiple Crises

In 2008, a financial crisis swept across the world, throwing millions out of work and requiring trillions of dollars in bailout and stimulus funding from governments—as Benatar, et al. 2011 point out, twenty-two times the amount pledged to achieve the United Nations’ Millennium Development Goals. The year before, major increases in food prices generated more drastic impacts in LMICs, yet received far less publicity. The evidence summarized in Ruel, et al. 2010 suggests, not surprisingly, that the impact of the combined crises was especially destructive for the poor in LMICs. Development policy researchers at least temporarily considered the possibility of a future characterized by multiple, interacting crises, as in Addison, et al. 2011. Schrecker 2012 is the first article specifically to connect interacting crises of finance, food security, and global environmental change with globalization, one another, and the prospect of adverse health outcomes. Hale, et al. 2013 describes difficulties confronting multilateral, coordinated action to address a range of crises that demand such initiatives.

  • Addison, Tony, Channing Arndt, and Finn Tarp. “The Triple Crisis and the Global Aid Architecture.” African Development Review 23 (2011): 461–478.

    DOI: 10.1111/j.1467-8268.2011.00299.xSave Citation »Export Citation » Share Citation »

    Argues that the “triple crisis” of climate change, food insecurity, and (especially) finance has important implications for development in the world’s poorest region and for development assistance. (The impacts on development assistance have not so far been as serious as initially feared.) There is no specific reference to health, but potential threats to health of failure to respond effectively to the triple crisis are clear at least by implication.

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  • Benatar, Solomon R., Stephen Gill, and Isabella Bakker. “Global Health and the Global Economic Crisis.” American Journal of Public Health 101 (2011): 646–653.

    DOI: 10.2105/AJPH.2009.188458Save Citation »Export Citation » Share Citation »

    Critique of health consequences of the post-2008 economic crisis and of the neoliberal development model that generated it (“geared primarily to the pursuit of profit at the expense of human flourishing and human rights,” p. 651) and continues to drive calls for post-crisis austerity. Light on the political economy of barriers to authors’ sweeping recommendations for change.

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  • Hale, Thomas, David Held, and Kevin Young. Gridlock: Why Global Cooperation is Failing When We Need It Most. Cambridge, MA: Polity, 2013.

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    Although not specific to health, important argument that current multilateral institutions are inadequate to address complex problems and processes that cross multiple national borders. Many of these, notably in the areas of finance and climate, have important implications for health.

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  • Ruel, Marie T., James L. Garrett, Corinna Hawkes, and Marc J. Cohen. “The Food, Fuel, and Financial Crises Affect the Urban and Rural Poor Disproportionately: A Review of the Evidence.” Journal of Nutrition 140 (2010): 170S–176S.

    DOI: 10.3945/jn.109.110791Save Citation »Export Citation » Share Citation »

    A useful review of the micro-scale impacts on the poor of the multiple crises of 2007/2008. Fuel affects the cost of living directly, and also contributes to food price increases because many agricultural inputs are fossil fuel–based and agricultural commodities are often transported long distances in today’s global agrifood system.

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  • Schrecker, Ted. “Multiple Crises and Global Health: New and Necessary Frontiers of Health Politics.” Global Public Health 7 (2012): 557–573.

    DOI: 10.1080/17441692.2012.691524Save Citation »Export Citation » Share Citation »

    Explains the rationale for considering the future of global health in terms of multiple crises, linked at least in the case of food security and finance directly to globalization, and outlines the political economy of obstacles to health-positive responses. Unlike many others writing in this area, the author is skeptical of solutions that involve new global institutions.

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Financial Volatility and Capital Flight

Financial crises have been a recurring feature of life in LMICs, becoming more frequent post-1980. Schrecker 2014 provides an overview of why globally integrated financial markets may threaten health. Hopkins 2006 surveys evidence of negative impacts on health following the East Asian financial crisis of 1997–1998, in a paper that has clear implications for anticipating health effects of the 2008, vastly larger crisis; Ruckert and Labonté 2012 provides a clear analytical framework for assessing those effects. Sassen 2010 is not concerned specifically with health, but the author’s political economy of new patterns of exploitation that include the practices that led to the financial crisis is nevertheless indispensable. Capital flight is not a new phenomenon, but it has been facilitated by the globalization of finance and can precipitate or worsen financial crises at the national level. The analysis provided in Ndikumana and Boyce 2011 is indispensable for any understanding of the scarcity of resources for health in LMICs, and no responsible analysis of the need for and effectiveness of development assistance for health can ignore the impacts of capital flight. Stuckler and Basu 2013 (cited under General Overviews) addresses the negative health consequences of austerity policies widely adopted as responses to the crisis.

  • Hopkins, Sandra. “Economic Stability and Health Status: Evidence from East Asia before and after the 1990s Economic Crisis.” Health Policy 75 (2006): 347–357.

    DOI: 10.1016/j.healthpol.2005.04.002Save Citation »Export Citation » Share Citation »

    Hopkins finds that declines in household income combined with reduced government expenditure contributed to increases in mortality and declining health indicators in Indonesia and Thailand, but effects were less severe in Malaysia, which adopted an unorthodox economic policy of capital controls.

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  • Ndikumana, Léonce, and James Boyce. Africa’s Odious Debts: How Foreign Loans and Capital Flight Bled a Continent. London: Zed Books, 2011.

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    Two economists who have investigated capital flight from sub-Saharan Africa for more than a decade estimate its cumulative value (plus interest earned) between 1970 and 2008 at just under a trillion (2008) dollars, or roughly the equivalent of the region’s GDP in 2008, and more than five times the value of the region’s foreign debts.

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  • Ruckert, Arne, and Ronald Labonté. “The Global Financial Crisis and Health Equity: Toward a Conceptual Framework.” Critical Public Health 22 (2012): 267–279.

    DOI: 10.1080/09581596.2012.685053Save Citation »Export Citation » Share Citation »

    Succinct description of the pathways by which the post-2008 crisis can be expected to increase health disparities, which will be useful for teaching purposes and as a template for future case study research.

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  • Sassen, Saskia. “A Savage Sorting of Winners and Losers: Contemporary Versions of Primitive Accumulation.” Globalizations 7 (2010): 23–50.

    DOI: 10.1080/14747731003593091Save Citation »Export Citation » Share Citation »

    Sassen is best known for research on global cities. Here she situates the securitization of high-risk mortgages that led to the financial crisis of 2008 as one of several “logics of extraction” that characterize a new and distinctively predatory form of global capitalism. These are likely to have far-reaching consequences for Social Determinants of Health and Globalization.

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  • Schrecker, Ted. “The Exterritorial Reach of Money: Global Finance and Social Determinants of Health.” In The Handbook of Global Health Policy. Edited by Garrett W. Brown, Gavin Yamey, and Sarah Wamala, 393–408. Malden, MA: Wiley Blackwell, 2014.

    DOI: 10.1002/9781118509623Save Citation »Export Citation » Share Citation »

    In the aftermath of the financial crisis that swept across the world in 2008, explains how the operations of global financial markets may influence health by generating financial crises, draining economies of resources needed for development and health, and limiting the space for national economic and social policies.

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Political Economy of the Global Agrifood System

Adequate nutrition is one of the most basic requisites for health, yet (depending on estimates) it remains elusive for hundreds of millions of people—a situation that was worsened by the food price and financial crises of 2007–2008. De Schutter 2011 relates the crisis to the changing global political economy of both food production and food consumption over the past few decades. The chapter by Wahl in Murphy and Paasch 2009, which is a valuable overview of globalization’s influences on the contemporary food system, emphasizes (as do Clapp 2014 and Isakson 2014) “financialization” of the agri-food system. George 1976 provides an important longer-term historical perspective, which would be complemented in a more extensive literature review by consideration of the effects of declining development assistance for agriculture and—at least in the sub-Saharan context—by assessment of market-oriented prescriptions for development, starting with the World Bank’s 1981 Berg report and subsequent structural adjustment programs. Lappé, et al. 2013 demonstrates that official figures actually understate the significance of global undernutrition. More than in many other areas related to the requisites for health, a long history exists of collaboration between academic researchers and civil society organizations, of which FIAN International is one of the best known.

Food Security and “Land Grabs”

Especially post-2007, large-scale acquisitions of agricultural land by foreign purchasers or long-term lessors (“land grabs”) have become a prominent feature of the agrifood system, as described in Cotula 2012 and White, et al. 2012, two articles introducing a special double journal issue that includes numerous case studies on which their overviews are partly based. Deininger, et al. 2011 provides a conventional justification for such acquisitions, but the argument is robustly challenged by de Schutter and by collaborations between academic researchers and civil society organizations like GRAIN. Margulis, et al. 2013 describes the rapid recognition of land grabbing as a problem requiring institutional responses. Both Zoomers 2010 and Cotula 2012 identify agricultural land transactions as just one among several categories of cross-border bidding wars for valued resources, which are likely to become a key element of the health policy landscape in the future—not least because of the link between land and water (Rulli, et al. 2013). Health Worker Migration and Medical Tourism instantiate cross-border bidding wars of a different kind.

Global Environmental Change

Climate change is not a specific outcome of globalization, but it is the quintessential problem that demands global solutions, and climate stability is a true global public good. Earlier literature on global environmental change emphasized that its effects are never straightforward, and always mediated by political institutions and distributions of economic power. Efforts to improve global health will play out against the background of global warming that will exacerbate a variety of existing vulnerabilities, probably increase incentives for migration (addressed in detail in McMichael, et al. 2012), and further complicate the urgent tasks of improving agricultural productivity in regions where it has stagnated, notably (as explained in Thornton, et al. 2011) in sub-Saharan Africa, where food insecurity is most prevalent. The articles included here generally do not address the global political economy of policies to limit climate change, although the multiple failures of international efforts from Kyoto through Copenhagen underscore the formidable nature of the barriers to increasing the supply of this particular public good. Indeed discussions, and proposals for reform, of global health politics and governance generally occur without considering these challenges. The synthesis of evidence in Costello, et al. 2009 and the two articles O’Brien and Leichenko 2000 and Leichenko, et al. 2010 show the perils of this omission. Dauvergne and Neville 2009 adds a further layer of complexity, suggesting that the role of some emerging economies as major biofuel producers and markets reflects a changing distribution of global economic power (as does the role of countries like fast-growing China and India as increasingly important greenhouse gas emitters), but does not necessarily bode well for either environmental sustainability or equity. It is important, as McMichael 2013 suggests, to view climate change in the context of other human-driven, large-scale transformations of the physical environment.

  • Costello, Anthony, Mustafa Abbas, Adriana Allen, et al. “Managing the Health Effects of Climate Change.” The Lancet 373 (2009): 1693–1733.

    DOI: 10.1016/S0140-6736(09)60935-1Save Citation »Export Citation » Share Citation »

    Authoritative synthesis of evidence of direct and indirect health effects of climate change, emphasizing equity dimension: “Climate change will have its greatest effect on those who have the least access to the world’s resources and who have contributed least to its cause.” The authors do not address the political economy issues underlying this distribution of risks and benefits.

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  • Dauvergne, Peter, and Kate J. Neville. “The Changing North–South and South–South Political Economy of Biofuels.” Third World Quarterly 30 (2009): 1087–1102.

    DOI: 10.1080/01436590903037341Save Citation »Export Citation » Share Citation »

    Authors argue that biofuel production and use, whose benefits in terms of reducing greenhouse gas emissions are questionable, is attractive as a route to economic development for a growing number of emerging economies marketing mainly to other countries of the South. They caution that it is likely to involve destructive local environmental impacts as well as upward pressure on food prices resulting from competition for land.

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  • Leichenko, Robin M., Karen L. O’Brien, and William D. Solecki. “Climate Change and the Global Financial Crisis: A Case of Double Exposure.” Annals of the Association of American Geographers 100 (2010): 963–972.

    DOI: 10.1080/00045608.2010.497340Save Citation »Export Citation » Share Citation »

    A decade after their initial article (O’Brien and Leichenko 2000), the authors apply their “double exposure” framework to the effects of financial crisis and climate change (drought) in one region of California, highlighting the inadequacy of governmental responses.

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  • McMichael, Anthony J. “Globalization, Climate Change, and Human Health.” New England Journal of Medicine 368 (2013): 1335–1343.

    DOI: 10.1056/NEJMra1109341Save Citation »Export Citation » Share Citation »

    Situates climate change in the context of other forms of environmental change and global increases in the “scale, interconnectedness, and economic intensity of contemporary human activity.” Introduction that will be valuable in survey courses not least for introducing the concept of the Anthropocene (see McMichael 2014, cited under Historical Perspectives on Health, Disease, and Health Policy).

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  • McMichael, Celia, Jon Barnett, and Anthony J. McMichael. “An Ill Wind? Climate Change, Migration, and Health.” Environmental Health Perspectives 120 (2012): 646–654.

    DOI: 10.1289/ehp.1104375Save Citation »Export Citation » Share Citation »

    Authors survey the evidence of health effects of population movements that respond to climate change under three headings: forced displacement, planned resettlement, and rural-urban migration. Each category is associated with a range of adverse health effects, which will usually exceed health benefits, but migration can also be an economically positive strategy of adapting to climate change.

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  • O’Brien, Karen L., and Robin M. Leichenko. “Double Exposure: Assessing the Impacts of Climate Change within the Context of Economic Globalization.” Global Environmental Change 10 (2000): 221–232.

    DOI: 10.1016/S0959-3780(00)00021-2Save Citation »Export Citation » Share Citation »

    Authors propose a “double exposure” framework involving multiple pathways (outcomes, context, and feedback) that takes into account the interaction of globalization and climate change in a way that recognizes the spatial distribution of gains and losses.

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  • Thornton, Philip K., Peter G. Jones, Polly J. Ericksen, and Andrew J. Challinor. “Agriculture and Food Systems in Sub-Saharan Africa in a 4°C+ World.” Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 369 (2011): 117–136.

    DOI: 10.1098/rsta.2010.0246Save Citation »Export Citation » Share Citation »

    Reviews research findings on the probable impact of climate change on agriculture in sub-Saharan Africa, where food insecurity remains a major health concern. Authors argue for policy responses grounded in “much better understanding of the limits to adaptation and the thresholds beyond which much more radical action will be needed . . .” (p. 131).

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Global Politics of Health Systems

Although the provision of health care is an inherently local activity, with some exceptions like the long-distance interpretation of electronically transmitted diagnostic data and images, the environment in which health systems operate is increasingly affected by a range of global processes, including those that influence the prevalence of both communicable and noncommunicable diseases; developments in the global economy, such as economic recessions and trade agreements that affect intellectual property rights and trade in health services; and the policies of the international financial institutions (IFIs) and aid donors. The World Bank became a key player in the global politics of health systems in the 1990s, by the end of which it was the largest single supplier of development assistance for health. As John Lister points out (Lister 2013), along with many other authors (see, e.g., Lee and Goodman 2002, cited under Role of the International Financial Institutions), the Bank has until recently been relentless in its promotion of market-oriented health system design on grounds of “efficiency,” with public provision and insurance regarded as residuals. World Bank 1993 is a detailed and historically important statement of this position. Reich and Takemi 2009 and Lawn, et al. 2008 indicate cautious rejection of this model on the part of the broader international community, with the 2008 G8 summit and the World Health Organization’s 2010 annual World Health Report representing key turning points. Balabanova, et al. 2010 and Biesma, et al. 2009 (both cited under Development Assistance and/for Health) provide descriptions of new initiatives in global health that complement those provided here.

The Quest for Universal Coverage

At the level of global policy, the “inside story” of the commitment to universal health coverage (UHC) remains to be told, but an expanding body of research addresses the conditions under which this is likely to be achieved effectively and equitably. Balabanova, et al. 2013; Lagomarsino, et al. 2012; and Marten, et al. 2014 provide useful empirical detail on moves toward universal coverage in diverse low- and middle-income countries, although the level of political analysis is uneven. Bennett, et al. 2010 summarizes domestic political barriers to universal coverage but fails to mention possible obstacles presented by commitments under trade agreements, as noted in Shaffer, et al. 2005 (cited under Trade). Aspinall 2014 is especially useful on domestic politics. Sengupta 2013 argues that universal coverage may be less equitable than it appears, and under some circumstances may effectively function as a smokescreen for privatization and commodification.

  • Aspinall, Edward. “Health Care and Democratization in Indonesia.” Democratization 21 (2014): 803–823.

    DOI: 10.1080/13510347.2013.873791Save Citation »Export Citation » Share Citation »

    Case study of steps on the road to providing UHC, as part of a larger post-democratization expansion of social security. Illustrates the many political difficulties presented by a context in which much health care is still privately purchased, and “the health care system is a site of major corruption” that is “integral to the system.”

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  • Balabanova, Dina, Anne Mills, Lesong Conteh, et al. “Good Health at Low Cost 25 Years On: Lessons for the Future of Health Systems Strengthening.” The Lancet 381 (2013): 2118–2133.

    DOI: 10.1016/S0140-6736(12)62000-5Save Citation »Export Citation » Share Citation »

    Authors revisit the question asked by a classic 1985 Rockefeller Foundation study of achieving Good Health at Low Cost with reference to five jurisdictions: Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and Tamil Nadu state in India. They identify four characteristics necessary for rapid improvements in health: good governance and political commitment, effective institutions, capacity for innovation, and health system resilience. Unfortunately, discussion of the last factor is cursory, and treatment of the politics that influence all four characteristics is uneven.

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  • Bennett, Sara, Sachiko Ozawa, and Krishna D. Rao. “Which Path to Universal Health Coverage? Perspectives on the World Health Report 2010.” PLoS Medicine 7 (2010).

    DOI: 10.1371/journal.pmed.1001001Save Citation »Export Citation » Share Citation »

    Authors observe, correctly (and with reference to the US experience), that in many contexts the barriers to achieving universal coverage are political. More comparative social science on this point in LMICs is urgently needed.

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  • Lagomarsino, Gina, Alice Garabrant, Atikah Adyas, Richard Muga, and Nathaniel Otoo. “Moving towards Universal Health Coverage: Health Insurance Reforms in Nine Developing Countries in Africa and Asia.” The Lancet 380 (2012): 933–943.

    DOI: 10.1016/S0140-6736(12)61147-7Save Citation »Export Citation » Share Citation »

    Description of recent national health insurance initiatives or reforms aiming toward universal coverage in nine low- and lower-middle–income countries provides useful detail and emphasizes the diversity of national approaches. Relatively little discussion of domestic politics and sources of resistance—an issue to which Bennett, et al. 2010 correctly attaches considerable importance.

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  • Marten, Robert, Diane McIntyre, Claudia Travassos, et al. “An Assessment of Progress Towards Universal Health Coverage in Brazil, Russia, India, China, and South Africa (BRICS).” The Lancet 384 (2014): 2164–2171.

    DOI: 10.1016/S0140-6736(14)60075-1Save Citation »Export Citation » Share Citation »

    Review of progress toward UHC in countries that contain 43 percent of the world’s population. Laudable attention to differences in domestic political context, and to the gap between official commitments to UHC and the reality on the ground. Discussions of China and South Africa are superficial relative to those of other study countries.

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  • Sengupta, Amit. Universal Health Coverage: Beyond Rhetoric. Occasional Paper No. 20. Kingston, ON: Municipal Services Project, 2013.

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    While strongly supportive of the principles underlying UHC, Sengupta argues that many current initiatives do not include an adequate commitment to comprehensiveness of coverage or public provision, relying instead on market-oriented separation of provision and financing (the purchaser-provider split). “This discourse is in sharp contrast with the vision of Primary Health Care envisaged in the Alma Ata declaration of 1978,” and with the ideal of solidarity that drove establishment of UHC in Europe.

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Health Worker Migration and Medical Tourism

Along with the role of the IFIs, the phenomena of medical tourism and health worker migration illustrate with special clarity the impact of global processes on national health systems. Indeed, the two have sometimes been related, with Connell, et al. 2007 noting that expenditure restraint demanded by the IFIs “has sometimes led to simultaneous high unemployment and high vacancy rates: real incentives to migration” (p. 1886; see also Baker 2010, cited under Role of the International Financial Institutions). In effect, medical tourists and health systems in destination countries are outbidding others, across national borders, for the services of health-care providers—a dynamic analogous in many respects to the agricultural land grab phenomenon. Chen, et al. 2004 provides a global overview of the crisis created by health worker migration, with Connell, et al. 2007 providing additional detail about the region (sub-Saharan Africa) where the crisis is most severe. Mills, et al. 2008 argues that the predominant response—voluntary commitments to ethical recruitment—has clearly failed, and compensation to sending countries is required. Plotnikova 2012 gives additional detail about the limited effectiveness of such commitments in the United Kingdom. Alsharif, et al. 2010 provides evidence of the motivations of medical tourists from diverse countries, and Connell 2011 skeptically assesses the claimed benefits to destination countries, arguing on the basis of Asian experience that more explicitly redistributive policies would be required. The organ trade for transplants to the wealthy, usually medical tourists, is perhaps the darkest side of the commodification of health care, and the world leader in research on the topic (Scheper-Hughes 2006) assesses the scope of the trade and situates it with reference to larger questions of political economy.

  • Alsharif, Mohd J., Ronald Labonté, and Zuxun Lu. “Patients beyond Borders: A Study of Medical Tourists in Four Countries.” Global Social Policy 10 (2010): 315–335.

    DOI: 10.1177/1468018110380003Save Citation »Export Citation » Share Citation »

    Survey study of medical tourists in India, China, Jordan, and the United Arab Emirates that aims to overcome the data limitations cited in Connell 2011 and underscores differences both in motivations for seeking care abroad and in choice of a destination country.

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  • Chen, Lincoln, Tim Evans, Sudhir Anand, et al. “Human Resources for Health: Overcoming the Crisis.” The Lancet 364 (2004): 1984–1990.

    DOI: 10.1016/S0140-6736(04)17482-5Save Citation »Export Citation » Share Citation »

    Definitive statement of the crisis shortage of health professionals, noting AIDS, labor migration, and underinvestment in health systems over “[t]wo decades of economic and sectoral reform” (p. 1984). Authors estimate that sub-Saharan countries alone will need to add a million health workers by 2015, but do not address the hard politics of mobilizing the resources needed to come close to this objective.

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  • Connell, John. “A New Inequality? Privatisation, Urban Bias, Migration and Medical Tourism.” Asia Pacific Viewpoint 52 (2011): 260–271.

    DOI: 10.1111/j.1467-8373.2011.01454.xSave Citation »Export Citation » Share Citation »

    South and Southeast Asia appear to be the leading destinations for medical tourism—the purchase of care by foreign nationals. Connell notes that such tourism, marketed by corporate medical chains, may worsen existing economic and regional access to health care in destination countries, not least by drawing health workers into the (urban) private sector. “Trickling down” of financial and technological benefits appears seldom to have materialized.

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  • Connell, John, Pascal Zurn, Barbara Stilwell, Magda Awases, and Jean-Marc Braichet. “Sub-Saharan Africa: Beyond the Health Worker Migration Crisis?” Social Science & Medicine 64 (2007): 1876–1891.

    DOI: 10.1016/j.socscimed.2006.12.013Save Citation »Export Citation » Share Citation »

    Regional overview of the extent of physician and nurse migration from sub-Saharan Africa. The authors provide an unsurprising inventory of major “push” and “pull” factors and impacts on health-care provision, noting the problem of “internal brain drain” from overstressed public health systems to the private sector.

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  • Mills, Edward J., William A. Schabas, Jimmy Volmink, et al. “Should Active Recruitment of Health Workers from Sub-Saharan Africa Be Viewed as a Crime?” The Lancet 371 (2008): 685–688.

    DOI: 10.1016/S0140-6736(08)60308-6Save Citation »Export Citation » Share Citation »

    Authors link health worker migration from the region to aggressive recruitment by western employers, which they argue should “be viewed as an international crime” (p. 687) because of its destructive effects on, for example, the number of physicians available to treat AIDS patients. Meanwhile, rich countries are saving large sums in training costs by “importing” professionals.

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  • Plotnikova, Evgeniya V. “Cross-border Mobility of Health Professionals: Contesting Patients’ Right to Health.” Social Science & Medicine 74 (2012): 20–27.

    DOI: 10.1016/j.socscimed.2011.02.012Save Citation »Export Citation » Share Citation »

    A case study of the politics of ethical recruitment policies as applied to nurses in Britain’s National Health Service (NHS). Limited by reliance on documentary sources, but nevertheless a useful map of claims and counterclaims related (for example) to the right to health in sending countries versus health professionals’ right to freedom of movement.

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  • Scheper-Hughes, Nancy. “Organs Trafficking: The Real, the Unreal and the Uncanny.” Annals of Transplantation 11.3 (2006): 16–30.

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    A necessarily incomplete assessment of the scope of the global transplant trade is here complemented with details of fieldwork among organ sellers that is part of a long-term research project; the author’s analysis connects the growth of the trade with the larger pattern of commodification of human life under neoliberalism.

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Globalizing Health Governance

In parallel with the rise of health on foreign policy agendas, noted in Feldbaum, et al. 2010, the literature on global health governance, politics, and diplomacy—terms clearly distinguished by at least one leading author in the field—has proliferated since 2000. As Fidler 2011 points out, this process is usefully understood with reference to changes in how states and other actors define their interests. The more complex proliferation of nonstate actors and public-private ventures in global health is exemplified by the establishment of the H8, comprising senior officials of four UN agencies (UNAIDS, itself a multiorganizational partnership; UNICEF; the UN Population Fund; and WHO); the World Bank; the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria; GAVI; and the Bill and Melinda Gates Foundation. (Horton 2013 also sees the H8 as a vehicle for the continuing dominance of the United States in setting the global health agenda.) Transnational corporations, and more recently civil society organizations, have become prominent as well—leading Hein, et al. 2007 (cited under HIV/AIDS), among others, to refer to the emergence of “post-Westphalian” systems of governance. However, the proposals for new institutions made by Gostin 2012 and Kickbusch, et al. 2010 involve agreements among national governments. Kirton, et al. 2014 notes the rise of a new set of players—the national governments of emerging economies. Obituaries for the nation-state may therefore be premature; the important question may rather be why and for what purposes nation-states will relinquish sovereignty (as they have done to some extent under the current regime of trade agreements, but to only a limited extent in global health, as noted in Gostin and Sridhar 2014). Global public goods have been the focus of much research on the management of globalization, but contributors to Smith, et al. 2003 suggest that there are only a limited number of truly global public goods for health, although it can be argued that at least two genuine public goods—climate stability and avoidance of financial crises—have received insufficient attention from a health perspective. A third issue involves the changing balance between public and private power, and the resulting shift in accountability. Several authors have made this point with respect to the Bill and Melinda Gates Foundation, built on a single private fortune. It is also relevant, however, to the shift of power even in formal democracies from governments and those who elect them to corporate investors and financial markets.

  • Feldbaum, Harley, Kelley Lee, and Joshua Michaud. “Global Health and Foreign Policy.” Epidemiologic Reviews 32 (2010): 82–92.

    DOI: 10.1093/epirev/mxq006Save Citation »Export Citation » Share Citation »

    A largely descriptive survey of literature on the growing salience of health in foreign policy; the motivations, including security, for rising development assistance for health; and the emergence of “health diplomacy,” as elaborated upon in Fidler 2011. A useful initial reading for those new to the field.

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  • Fidler, David P. “Navigating the Global Health Terrain: Mapping Global Health Diplomacy.” Asian Journal of WTO & International Health Law and Policy 6 (2011): 1–43.

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    Fidler is one of the scholars most closely identified with the study of health in foreign policy. He draws an important distinction among diplomacy, politics, and governance and emphasizes the increased participation of nonstate actors in international relations generally and global health in particular. The result is a template for mapping global health diplomacy that should prove valuable for future comparative case study research.

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  • Gostin, Lawrence. “A Framework Convention on Global Health: Health for All, Justice for All.” Journal of the American Medical Association 307 (2012): 2087–2092.

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    Gostin summarizes the case for a Framework Convention on Global Health that would specify states’ obligations to protect health, both domestically and (in the case of wealthier countries) through aid. These would be fleshed out in subsequent protocols. The author is unclear about why a critical mass of nations would commit to this process.

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  • Gostin, Lawrence O., and Devi Sridhar. “Global Health and the Law.” New England Journal of Medicine 370 (2014): 1732–1740.

    DOI: 10.1056/NEJMra1314094Save Citation »Export Citation » Share Citation »

    Useful overview, especially for those without a background in international law or international relations, of the various areas of international law and legal institutions that influence global health; includes a glossary of key terms and concepts.

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  • Horton, Richard. “Offline: Challenging America’s Hegemony in Global Health.” The Lancet 382 (2013): 382.

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    The editor of The Lancet argues that the H8 is characterized by a lack of transparency and is in fact dominated by the United States—a situation he sees as unhealthy and ripe for change.

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  • Kickbusch, Ilona, Wolfgang Hein, and Gaudenz Silberschmidt. “Addressing Global Health Governance Challenges through a New Mechanism: The Proposal for a Committee C of the World Health Assembly.” Journal of Law, Medicine & Ethics 38 (2010): 550–563.

    DOI: 10.1111/j.1748-720X.2010.00511.xSave Citation »Export Citation » Share Citation »

    Authors describe influences that weakened WHO in the first decade of the 21st century. They propose to strengthen its coordinating function by way of a new committee of the World Health Assembly (the governing body of the organization) that would invite participation by nonstate actors, while resolutions it proposed would still be decided upon in the WHA plenary, by member states alone.

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  • Kirton, John J., Julia Kulik, and Caroline Bracht. “Generating Global Health Governance through BRICS Summitry.” Contemporary Politics 20 (2014): 146–162.

    DOI: 10.1080/13569775.2014.907990Save Citation »Export Citation » Share Citation »

    Political scientist Kirton is a leading researcher on the G7/G8. Here he and colleagues argue that as health has slipped off the agendas of the G8 and G20, summits of the BRICS are playing an increasingly important role in the governance of global health.

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  • Smith, Richard, Robert Beaglehole, David Woodward, and Nick Drager, eds. Global Public Goods for Health: Health, Economic, and Public Health Perspectives. Oxford: Oxford University Press, 2003.

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    The concept of public goods has emerged as central to (some) thinking about global health and avoidance of crises; market institutions will always underproduce public goods (market failure). Contributors demonstrate that when defined rigorously according to economic theory, there are few true global public goods for health, although regional public goods are more abundant.

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Role of the International Financial Institutions

The World Bank’s role in promoting a particular version of health sector “reform” was discussed above under the heading of the global politics of health systems; Lee and Goodman 2002 offers an account of where the Bank fit into policy networks. The role of individual protagonists (and their shared assumptions and career trajectories) emerges as important, as it does, in somewhat different ways, in the discussion of selective primary health care in Cueto 2004 (cited under Historical Perspectives on Health, Disease, and Health Policy). Lee and Goodman 2002 suggests that global health is shaped by elites operating within policy networks that often cross formal organizational lines, an important area for future research. The most contentious intersection of health and the IFIs involved the structural adjustment conditionalities attached to loans from the IMF and World Bank, starting c. 1980, to enable indebted LMICs to restructure their debts while protecting creditor interests and—according to many observers—to advance the project of economic integration more generally. By 1987, the Adjustment with a Human Face study (Cornia, et al. 1987) had established, on a preponderance of the evidence, the destructive consequences for child well-being, yet the conditionalities in question persisted for another decade or more. Baker 2010 provides a well-grounded argument that they persist to this day, albeit in different guises, such as the expenditure ceilings that limit recruitment of health workers in the public sector, and Haddad, et al. 2008 gives more detailed evidence from several countries. Babb 2005 offers a multidisciplinary summary of evidence on social effects, using structural adjustment to refer to the broader project of restructuring societies along market lines rather than solely to policies undertaken in response to the IMF. Conversely, Breman and Shelton 2007, in a summary of work undertaken for the Commission on Macroeconomics and Health, concludes that direct evidence of negative effects on health outcomes (except in sub-Saharan Africa) is equivocal. This work, counterposed against Baker 2010 in particular, raises at least two issues. First, what is the appropriate standard of proof, based on what kind of evidence (the central question raised in Pfeiffer and Chapman 2010, and one that has much broader relevance to assessing the health impacts of economic and social policy)? Second, what is the appropriate counterfactual? A continuation of business as usual, which most observers agree could not have been sustained in the contexts where structural adjustment programs were applied, or what might be called an egalitarian alternative (Cornia, et al. 1987) to the neoliberalism that has been promoted as a dominant development model over the past few decades?

  • Babb, Sarah. “The Social Consequences of Structural Adjustment: Recent Evidence and Current Debates.” Annual Review of Sociology 31 (2005): 199–222.

    DOI: 10.1146/annurev.soc.31.041304.122258Save Citation »Export Citation » Share Citation »

    Although not focused on health, this multidisciplinary literature review provides a valuable overview of the (often negative) economic and social effects of structural adjustment programs and the more general shift toward market-oriented social programs that they exemplify. Babb uses the term “structural adjustment” to describe this larger shift rather than simply the particular set of policy nostrums promoted by the IFIs.

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  • Baker, Brook. “The Impact of the International Monetary Fund’s Macroeconomic Policies on the AIDS Pandemic.” International Journal of Health Services 40 (2010): 347–363.

    DOI: 10.2190/HS.40.2.pSave Citation »Export Citation » Share Citation »

    Baker argues that IMF policies have contributed to economic and social conditions that facilitate the spread of HIV infection, and that despite some reform initiatives IMF policy prescriptions for the post-crisis world will have a similar effect. His analysis is applicable more generally to the role of the IMF as an inhibitor rather than facilitator of poverty reduction, social protection, and public investment.

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  • Breman, Anna, and Carolyn Shelton. “Structural Adjustment Programs and Health.” In Globalization and Health. Edited by Ichiro Kawachi and Sarah P. Wamala, 219–233. Oxford: Oxford University Press, 2007.

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    Authors offer a useful conceptual framework for analyzing the issue. Based on extensive although not exhaustive literature review, they claim that “empirical” studies are equivocal on the health impacts of structural adjustment, but concede that studies of sub-Saharan Africa find predominantly negative outcomes.

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  • Cornia, Giovanni Andrea, Richard Jolly, and Frances Stewart, eds. Adjustment with a Human Face. Vol. 1, Protecting the Vulnerable and Promoting Growth. Oxford: Clarendon, 1987.

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    This ten-country study concentrating on economic adjustment’s effects on children and youth was one of the first large-scale demonstrations of the negative impacts of economic adjustment on what would now be called social determinants of health. Authors argued that key macroeconomic objectives could be achieved while protecting the vulnerable, but necessary policies were not being followed in most study countries.

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  • Haddad, Slim, Enid Baris, and Delampady Narayana, eds. Safeguarding the Health Sector in Times of Macroeconomic Instability: Policy Lessons for Low- and Middle-Income Countries. Trenton, NJ: Africa World Press, 2008.

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    Multidisciplinary assessment of effects of structural adjustment specific to the health sector, focusing on Burkina Faso, Colombia, India, Mexico, and Thailand. Includes important chapters on methodological issues and a broader literature review.

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  • Lee, Kelley, and Hilary Goodman. “Global Policy Networks: The Propagation of Health Care Financing Reform since the 1980s.” In Health Policy in a Globalising World. Edited by Kelley Lee, Kent Buse, and Suzanne Fustukian, 97–119. Cambridge, UK: Cambridge University Press, 2002.

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    The authors describe “a ‘revolving door’ of career progression that has facilitated the movement of individuals” among key institutions, of which the World Bank is among the most powerful. They conclude that health reform “worldwide has been fostered by the emergence of a policy elite” and identify many of its members c. 2000.

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  • Pfeiffer, James, and Rachel Chapman. “Anthropological Perspectives on Structural Adjustment and Public Health.” Annual Review of Anthropology 39 (2010): 149–165.

    DOI: 10.1146/annurev.anthro.012809.105101Save Citation »Export Citation » Share Citation »

    Important contrast between epidemiological and anthropological standards of proof with respect to the social consequences of structural adjustment, which is directly relevant to the assessment of findings like those in Breman and Shelton 2007.

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Development Assistance and/for Health

Development assistance for health (DAH) is the most visible health-relevant transfer of resources across national borders, and its providers will continue to play a substantial role, for better or worse, in the health system choices of many countries that rely on such assistance; Sridhar 2010 cites one estimate that twenty-three countries rely on donors for more than 30 percent of their health budgets. DAH roughly quadrupled in value between 1990 and 2010; the financial crisis created considerable uncertainty about the future, but as Institute for Health Metrics and Evaluation 2014 points out, initial apprehensions were not fully justified. The dangers of future cutbacks and disproportionate reliance on a few aid providers remain. The increase in the value of DAH has been accompanied by a proliferation of new institutions and delivery mechanisms, as noted in Balabanova, et al. 2010 and Biesma, et al. 2009. Richard, et al. 2011 and Sridhar 2010 adopt distinctive, but complementary, approaches to the recurring question of how to improve the effectiveness of DAH. Like many authors in this field, both are, in my view, too deferential to “country ownership in health” and too polite about the real motivations not only of donors but also of some recipients, but both raise critical questions. Sridhar and Gómez 2010 raises the important question of whether the actors outside some countries’ borders can have an impact on health priorities that functions independently of DAH. This is clearly true with respect, for example, to the IMF and international capital markets; the authors suggest that a broader range of (arguably less visible) influences is at play as well. It could be argued that the presumption that health spending should be allocated on a basis roughly proportional to the disease burden is itself problematic, at least without further qualification, but the point cannot be explored further here. Jamison, et al. 2013 offers a set of prescriptions for future aid priorities that owe much to the Investing in Health report (World Bank 1993, cited under Global Politics of Health Systems), while contrasting with approaches that reflect the political economy perspective exemplified in Birn, et al. 2009 (cited under Textbooks).

  • Balabanova, Dina, Martin McKee, Anne Mills, Gill Walt, and Andy Haines. “What Can Global Health Institutions Do to Help Strengthen Health Systems in Low Income Countries?” Health Research Policy and Systems 8 (2010): 22.

    DOI: 10.1186/1478-4505-8-22Save Citation »Export Citation » Share Citation »

    An overview not only of the new set of institutions involved with delivering and coordinating development assistance for health, but also of the key challenges for improving health care against a background changing patterns of disease. Like Feldbaum, et al. 2010 (cited under Globalizing Health Governance), this source will be especially useful to readers relatively new to the field of global health.

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  • Biesma, Regien G., Ruairí Brugha, Andrew Harmer, Aisling Walsh, Neil Spicer, and Gill Walt. “The Effects of Global Health Initiatives on Country Health Systems: A Review of the Evidence from HIV/AIDS Control.” Health Policy and Planning 24 (2009): 239–252.

    DOI: 10.1093/heapol/czp025Save Citation »Export Citation » Share Citation »

    Review of literature assessing the impact of the Global Fund, the World Bank’s AIDS Program, and the US President’s Emergency Program for AIDS Relief (PEPFAR) on national health systems. Both positive and negative impacts are found; the article provides a research agenda and a set of policy recommendations potentially relevant to a variety of new institutions for providing and delivering development assistance.

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  • Institute for Health Metrics and Evaluation. Financing Global Health 2013: Transition in an Age of Austerity. Seattle, WA: Institute for Health Metrics and Evaluation, 2014.

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    The latest in an annual series of reports documenting the value and changing composition of development assistance for health. Importantly, this edition points out that initial apprehensions about a decline in DAH following the financial crisis of 2008 were largely unfounded.

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  • Jamison, Dean T., Lawrence H. Summers, George Alleyne, et al. “Global Health 2035: A World Converging within a Generation.” The Lancet 382 (2013): 1898–1955.

    DOI: 10.1016/S0140-6736(13)62105-4Save Citation »Export Citation » Share Citation »

    Lead authors of this Lancet commission report both have a long history with the World Bank. Authors argue for a package of (mostly) biomedical interventions, defined with reference to cost-effectiveness and economic returns, aimed at reducing burden of infectious diseases and some noncommunicable diseases worldwide to the levels now found in high-performing middle-income countries. In direct contrast to Ottersen, et al. 2014 (cited under Social Determinants of Health and Globalization), social determinants of health are dismissed in one paragraph.

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  • Richard, Fabienne, David Hercot, Charlemagne Ouédraogo, et al. “Sub-Saharan Africa and the Health MDGs: The Need to Move beyond the ‘Quick Impact’ Model.” Reproductive Health Matters 19 (2011): 42–55.

    DOI: 10.1016/S0968-8080(11)38579-5Save Citation »Export Citation » Share Citation »

    Describes how donor priorities for GHIs organized around the Millennium Development Goals (MDGs) have led them to support “quick win” approaches that may not be the most effective route to longer-term improvements in health status. Noteworthy for focusing on donor as well as recipient actions as influencing the success of specific programs.

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  • Sridhar, Devi. “Seven Challenges in International Development Assistance for Health.” Journal of Law, Medicine & Ethics 38 (2010): 459–469.

    DOI: 10.1111/j.1748-720X.2010.00505.xSave Citation »Export Citation » Share Citation »

    Sridhar critiques the proliferation of new institutions while acknowledging their role in remedying institutional shortcomings, and points out the tension between the power of donors and the lack of accountability and the ongoing problems of linking health to national security interests. Like Balabanova, et al. 2010, this article will be especially valuable to those relatively new to health and development.

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  • Sridhar, Devi, and Eduardo J. Gómez. “Health Financing in Brazil, Russia and India: What Role Does the International Community Play?” Health Policy and Planning 26 (2010): 12–24.

    DOI: 10.1093/heapol/czq016Save Citation »Export Citation » Share Citation »

    The countries studied do not rely on development assistance for health, yet Brazil and India, in particular, spend a disproportionate amount on HIV/AIDS relative to its contribution to the domestic burden of disease. The authors identify international influences on domestic priorities that are unrelated to development assistance, including the strength of AIDS advocacy and the role of the pharmaceutical industry.

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Social Determinants of Health and Globalization

The concept of social determinants of health is not new; it can be traced back to 19th-century public health pioneers like Rudolf Virchow. It achieved new prominence through the work of the Commission on Social Determinants of Health (2008), chaired by Sir Michael Marmot, which began its report with the observation that “[s]ocial injustice is killing people on a grand scale” as “the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics” (p. 1). All but two of the sources annotated here (Szreter 1999 and Ottersen, et al. 2014) arise from the Commission’s activities. Benach, et al. 2010 and Labonté, et al. 2009 report on the work of, respectively, the “knowledge networks” on employment conditions and on globalization that supported the Commission. Cornia, et al. 2008 reports on an econometric study of globalization’s health impacts carried out for the globalization knowledge network. Marmot, et al. 2012 is the most recent of several reflections on political responses to the Commission’s work by its former chair, Sir Michael Marmot, and his research staff. (Marmot was also a member of the team that generated Ottersen, et al. 2014.) In addition to reminding us that large-scale social dislocations go along with rapid growth, Szreter 1999 raises the provocative question of whether that growth can be translated into widely shared improvements in population health in the absence of at least semi-democratic institutions like those of 19th-century England and Wales. James Riley (Riley 2008, cited under Historical Perspectives on Health, Disease, and Health Policy) would probably argue the affirmative on this; Szreter 1999 is more skeptical, and the issue remains critical for future research on globalization and health.

  • Benach, Joan, Carles Muntaner, Orielle Solar, Vilma Santana, and Michael Quinlan. “The Role of Employment Relations in Reducing Health Inequalities.” Special Section: International Journal of Health Services 40 (2010): 195–322.

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    A collection of articles generated by one of the knowledge networks supporting the Commission on Social Determinants of Health; the authors adopt a broadly social democratic perspective on the relations among income, working conditions, and health.

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  • Commission on Social Determinants of Health. Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health: Final Report of the Commission on Social Determinants of Health. Geneva, Switzerland: World Health Organization, 2008.

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    Report of a multinational commission established in 2005 by a former director-general of WHO, who died suddenly shortly afterward. Chaired by social epidemiologist Sir Michael Marmot, the Commission organized its work around the concepts of health equity and the ubiquity of socioeconomic gradients in health of the kind found by Marmot in two English studies of civil servants (the Whitehall studies).

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  • Cornia, Giovanni Andrea, Stefano Rosignoli, and Luca Tiberti. Globalization and Health: Impact Pathways and Recent Evidence. WIDER Research Paper 2008/74. Helsinki: World Institute for Development Economics Research, 2008.

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    Authors report findings from an econometric exercise designed to assess the effects of globalization on health when measured against a counterfactual in which relevant trends between 1960 and 1980 were simply extrapolated over the period 1980–2000, when the Washington Consensus dominated development policy. A shorter version appears in Labonté, et al. 2009.

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  • Labonté, Ronald, Ted Schrecker, Corinne Packer, and Vivien Runnels, eds. Globalization and Health: Pathways, Evidence and Policy. New York: Routledge, 2009.

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    Perspectives on the relations between health equity and global economic processes that range from centrist to Marxist. Topics include labor markets, health worker migration, health systems, and how “policy space” is limited by trade and investment agreements. Now in softcover, and selected chapters are freely available online.

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  • Marmot, Michael, Jessica Allen, Ruth Bell, and Peter Goldblatt. “Building the Global Movement for Health Equity: From Santiago to Rio and Beyond.” The Lancet 379 (2012): 181–188.

    DOI: 10.1016/S0140-6736(11)61506-7Save Citation »Export Citation » Share Citation »

    The chair of the Commission and colleagues reflect on the politics of responses to the Commission’s report and on prospects for the future. Overly optimistic, in some respects; see Marmot’s commentary, written shortly after the 2011 World Conference on Social Determinants of Health, for a less sanguine perspective.

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  • Ottersen, Ole Petter, Jashodhara Dasgupta, Chantal Blouin, et al. “The Political Origins of Health Inequity: Prospects for Change.” The Lancet 383 (2014): 630–667.

    DOI: 10.1016/S0140-6736(13)62407-1Save Citation »Export Citation » Share Citation »

    Authors of this Lancet commission report emphasize that: “With globalisation, health inequity increasingly results from transnational activities that involve actors with different interests and degrees of power” (p. 630). Seven case studies—the financial crisis, intellectual property and pharmaceuticals, investment treaties, food security, the conduct of transnational corporations, irregular migration, and armed conflict—illustrate the point and show the scale of the challenges for equity-oriented policy and governance. Contrast between this perspective and that of Jamison, et al. 2013 (cited under Development Assistance and/for Health) is dramatic.

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  • Szreter, Simon. “Rapid Economic Growth and ‘the Four Ds’ of Disruption, Deprivation, Disease and Death: Public Health Lessons from Nineteenth-Century Britain for Twenty-First-Century China?” Tropical Medicine and International Health 4 (1999): 146–152.

    DOI: 10.1046/j.1365-3156.1999.00369.xSave Citation »Export Citation » Share Citation »

    Szreter is a historian who has documented life expectancy trends in industrial England and Wales during the 19th century: a sharp decline was followed by slower improvement post-1836. He argues that fast-growing developing economies should learn from that experience the importance of state action to invest in public health infrastructure, but emphasizes the need for political institutions that can ensure the necessary accountabilities.

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Ethics of Global Health Crises

Contemporary health ethics is preoccupied with micro-level phenomena, and the study of ethics in international relations tends too often to drift into abstract debates about concepts like cosmopolitanism. Beitz 2005 provides a guide that will be helpful to nonphilosophers. The sources included here focus, like the work of the Commission on Social Determinants of Health, on the inseparability of health ethics (in the Commission’s words, health equity) from distributions of political power and material resources. Farmer 2004 and Farmer and Campos 2004 argue that the inequality of those distributions and the consequent suffering are sufficiently extreme to warrant description as structural violence. The argument of Pogge (see Pogge 2007 and Pogge 2010) about ethical responsibility for those unequal distributions is especially intriguing, because the author grounds it not in the “positive duty” to provide assistance, but rather in the “negative duty” to avoid causing harm—which, the work argues, is a duty clearly violated by many of those who make and endorse choices about the direction of the global economy. This is a central argument in any consideration of global health justice, and Pogge’s position is more relevant than ever in the aftermath of financial crisis, making the connections between health ethics and political economy in Benatar and Brock 2011 especially valuable.

  • Beitz, Charles. “Cosmopolitanism and Global Justice.” Journal of Ethics 9 (2005): 11–27.

    DOI: 10.1007/s10892-004-3312-0Save Citation »Export Citation » Share Citation »

    Beitz provides a roadmap to recent academic work on global justice, most of which will be intelligible to nonphilosophers. Useful in the context of global health and its social determinants because it engages directly with Thomas Pogge’s work (and others’) on responsibility for poverty (see citations in this section).

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  • Benatar, Solomon, and Gillian Brock, eds. Global Health and Global Health Ethics. Cambridge, UK: Cambridge University Press, 2011.

    DOI: 10.1017/CBO9780511984792Save Citation »Export Citation » Share Citation »

    The first edited academic book in English that explicitly connected the ethics and political economy of globalization’s effects on health, with chapters by many leading researchers from both traditions. A fine introduction for a variety of teaching purposes, although a few chapters will be rough going for readers with no background in philosophy.

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  • Farmer, Paul. “An Anthropology of Structural Violence.” Current Anthropology 45 (2004): 305–325.

    DOI: 10.1086/382250Save Citation »Export Citation » Share Citation »

    Structural violence (a concept “intended to inform the study of the social machinery of oppression,” p. 307) is a key concept for physician and anthropologist Farmer, who focuses here on the historical context of extreme poverty in Haiti, where he has worked extensively. Reprinted in Labonté, et al. 2011 (cited under Reference Works).

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  • Farmer, Paul, and Nicole Gastineau Campos. “Rethinking Medical Ethics: A View from Below.” Developing World Bioethics 4 (2004): 17–41.

    DOI: 10.1111/j.1471-8731.2004.00065.xSave Citation »Export Citation » Share Citation »

    Authors use the concept of the view from below to critique contemporary medical ethics for its consistent lack of attention to the choices and distributions of power that deprive many of resources for treatment that are routinely available to the wealthy. They argue for the “resocializing” of ethics to address these disparities.

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  • Pogge, Thomas, ed. Freedom from Poverty as a Human Right: Who Owes What to the Very Poor? Oxford: Oxford University Press, 2007.

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    Before Pogge became engaged with access to medicines, he wrote extensively on extreme poverty as a human rights violation, organizing his critique around poverty’s status as the outcome of international institutional arrangements that could be more equitable. His intellectual leadership on this topic is beyond dispute, and Pogge’s long introductory chapter is the clearest synthesis of his demanding work; it is followed by commentaries, many of which will be of interest mainly to philosophers.

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  • Pogge, Thomas. Politics as Usual: What Lies behind the Pro-Poor Rhetoric. Cambridge, MA: Polity, 2010.

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    Valuable compilation and revision of Pogge’s previously published work on global justice and politics. Chapters 3 and 4 are salutary reminders that international institutions will try to camouflage the inadequacy of progress toward objectives like (in this case) the Millennium Development Goals through subtle changes in the design of indicators and metrics.

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Health and Human Rights

Since human rights is the last theme in the periodization of Inoue and Drori 2006 (cited under General Overviews), it is fitting that it conclude the bibliography. Most of the world’s nations are parties to the major human rights treaties (the United States is a conspicuous exception); human rights language has become increasingly visible in health politics, and (as Hogerzeil, et al. 2006, note) in an increasing number of national statutes and constitutions. Gauri and Brinks 2008; Langford 2008; White and Perelman 2011; and Zuniga, et al. 2013 all combine legal and political theory with multiple empirical studies of the legal entrenchment of economic and social rights including not only access to health care, but also various social determinants of health. Schrecker, et al. 2010 argue the importance of human rights as what Yamin 2010 calls an “insurrectional discourse” that challenges the values of the marketplace, pointing out the conspicuous contrast at the international level between the mechanisms available (for instance) for enforcing the provisions of trade treaties and the weakness of accountability for economic and social rights. Vindication of such rights remains, for the moment, dependent on circumstances and institutions at the nation-state level. Yamin also raises the question of what human rights obligations states have regarding the health of those outside their borders. For example, how should such obligations affect the votes of state representatives on the governing bodies of the World Bank and IMF? See also Yamin, et al. 2011. Langford, et al. 2013 raises the closely related issue of how development policy should reflect an emphasis on human rights.

  • Gauri, Varun, and Daniel M. Brinks, eds. Courting Social Justice: Judicial Enforcement of Social and Economic Rights in the Developing World. Cambridge, UK: Cambridge University Press, 2008.

    DOI: 10.1017/CBO9780511511240Save Citation »Export Citation » Share Citation »

    Study of health and education rights in South Africa, Brazil, India, Nigeria, and Indonesia is cautiously upbeat about the effectiveness of legalizing such rights, while recognizing the scope of the challenges. Concluding analytical chapter is especially useful.

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  • Hogerzeil, Hans V., Melanie Samson, Jaume V. Casanovas, and Ladan Rahmani-Ocora. “Is Access to Essential Medicines as Part of the Fulfilment of the Right to Health Enforceable through the Courts?” The Lancet 368 (2006): 305–311.

    DOI: 10.1016/S0140-6736(06)69076-4Save Citation »Export Citation » Share Citation »

    On the basis of extensive review of then-available data, authors find that access to essential medicines is most effectively advanced by litigation when the right to health is incorporated into national legislation or (ideally) constitutions, either directly or by explicit reference to key international treaties.

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  • Langford, Malcolm, ed. Social Rights Jurisprudence: Emerging Trends in International and Comparative Law. Cambridge, UK: Cambridge University Press, 2008.

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    A strong historical introduction is followed by case studies from thirteen low- to high-income countries and six regional jurisdictions, reaching a broader range of conclusions than Gauri and Brinks 2008. Also includes a section on international human rights procedures.

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  • Langford, Malcolm, Andy Sumner, and Alicia Ely Yamin, eds. The Millennium Development Goals and Human Rights: Past, Present and Future. Cambridge, UK: Cambridge University Press, 2013.

    DOI: 10.1017/CBO9781139410892Save Citation »Export Citation » Share Citation »

    The diversity of disciplines and foci in the twenty-two chapters ensure that it will be relevant long after the 2015 end point of most of the MDGs. The authors, many of them also cited elsewhere in this article, offer a retrospective critique of the MDG goal-setting process and, perhaps more importantly, of contemporary development policy’s conceptual and political limitations. Many of these are directly relevant to health.

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  • Schrecker, Ted, Audrey Chapman, Ronald Labonté, and Roberto de Vogli. “Advancing Health Equity in the Global Marketplace: How Human Rights Can Help.” Social Science & Medicine 71 (2010): 1520–1526.

    DOI: 10.1016/j.socscimed.2010.06.042Save Citation »Export Citation » Share Citation »

    Authors argue that economic and social rights offer a challenge to the “market fundamentalism” at the core of economic globalization, explicate the relevance to social determinants of health, and review weaknesses of existing domestic and international mechanisms for realizing health-related human rights. They conclude by identifying three directions for future comparative research.

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  • White, Lucie E., and Jeremy Perelman, eds. Stones of Hope: How African Activists Reclaim Human Rights to Challenge Global Poverty. Stanford, CA: Stanford University Press, 2011.

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    African case studies address resistance to forced evictions in Tanzania and Nigeria as well as South Africa’s Treatment Action Campaign (on access to antiretroviral therapy) and access to health care in Ghana. Contributors are less concerned with the short-term effectiveness of litigation than with how human rights can function as a basis for advocacy and political mobilization.

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  • Yamin, Alicia Ely. “Our Place in the World: Conceptualizing Obligations beyond Borders in Human Rights-Based Approaches to Health.” Health and Human Rights 12.1 (2010): 3–14.

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    Overview of the philosophical and legal literature on economic and social rights obligations across national borders—in particular, the obligations of the “developed” world to the rest—that explicitly contrasts charity and human rights models. Author asks, e.g., about the human rights implications of the fact that capital flight more than offsets the total annual value of development assistance.

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  • Yamin, Alicia Ely, and Siri Gloppen, eds. Litigating Health Rights: Can Courts Bring More Justice to Health? Cambridge, MA: Harvard University Press, 2011.

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    Focus is specifically on health rights, with case studies from Argentina, Brazil, Colombia, Costa Rica, India, and South Africa. Includes important comparative analyses of the effectiveness of litigation, inequalities in the ability to use litigation, and how transnational influences and actors become involved in domestic health rights litigation.

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  • Zuniga, José M., Stephen P. Marks, and Lawrence O. Gostin, eds. Advancing the Human Right to Health. Oxford: Oxford University Press, 2013.

    DOI: 10.1093/acprof:oso/9780199661619.001.0001Save Citation »Export Citation » Share Citation »

    Overview essays by leading scholars in the field are followed by case studies from Haiti, Ghana, India, South Africa, the Philippines, China, Brazil, Mexico, the United Kingdom, Japan, and the United States. A final, crosscutting section deals with “challenges and opportunities” including nutrition, prisoners’ rights, gender, and financing. Some case studies contain little political analysis, while others are more critical.

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