Blind Spot: How Neoliberalism Infiltrated Global Health
Neoliberalism has been the defining paradigm in global health since the latter part of the twentieth century. What started as an untested and unproven theory that the creation of unfettered markets would give rise to political democracy led to policies that promoted the belief that private markets were the optimal agents for the distribution of social goods, including health care.
A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan’s remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a "revolving drug fund" program—used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities. Provocative, rigorous, and accessible, Blind Spot offers a cautionary tale about the forces driving decision making in health and development policy today, illustrating how the privatization of health care can have catastrophic outcomes for some of the world’s most vulnerable populations.
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Aga Khan Foundation Aga Khan IV Ahmed AKF’s areas argued Badakhshan Bamako Initiative bank’s became Blind Spot Central Asia civil society Claquin collapse cost crisis cultural delivery democracy dental clinic diseases doctors donors Dushanbe economic empire equity essential drugs Ferranti financing Foucault global health Hayek health services health system hospital humanitarian assistance ideas ideological imam industrial institutions Isma’ili Kanji Keshavjee 1998 Keshavjee’s Khorog Kuhdeh living malnutrition Médecins Sans Frontières medicines ment Misha Mont Pèlerin mortality Navarro neoliberal NGOs nutrition ofthe outcomes Pamir Pamir Mountains patients Paul Farmer percent pharmaceuticals physicians political population post-Soviet poverty practice providing public health reform region response revolving drug fund role Rowden rural Russian social Soviet period Soviet Union Stein survey Tajik Tajikistan tion USAID user fees village World Bank World Health Organization ZdravReform zemstvo