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Into the Machine: Economic Tools, Sovereignty, and Joy in a Global Health Institution
1Johns Hopkins University.
Medical Anthropology Quarterly
|May 29, 2019
Summary
Global health institutions promote economic tools for health spending in developing nations but often fail to implement them. This gap highlights power dynamics and political factors influencing health governance.
Area of Science:
- Global Health
- Health Economics
- Development Studies
Background:
- International financial institutions like the World Bank and Inter-American Development Bank have promoted economic tools for health spending prioritization in low-income countries since the 1990s.
- Despite advocating economic management for health improvement, these institutions frequently neglect their own policies mandating the use of economic tools in health project planning.
Purpose of the Study:
- To analyze the complex deployment and non-application of economic tools within development bank networks.
- To investigate how these tools become sites of tension concerning sovereignty and professional satisfaction for economists.
- To understand the production of affect and power through the use and non-use of economic tools in global health.
Main Methods:
- Qualitative analysis of policy implementation and institutional practices within development banks.
- Examination of the discourse and application of economic tools in global health project planning.
- Exploration of the political and power dynamics influencing expert practices in international finance.
Main Results:
- Economic tools are inconsistently applied, often existing beyond practical decision-making in health project planning.
- The use and non-use of these tools generate tensions related to national sovereignty and create specific professional dynamics for economists.
- Economic tools are shown to be productive of both emotional responses (affect) and power relations within the institutions.
Conclusions:
- The inconsistent application of economic tools in global health governance reveals underlying political considerations embedded in expert practices.
- Addressing these frictions is crucial for developing more equitable and just global health governance frameworks.
- Greater attention to the political dimensions of economic tool implementation is needed for effective health policy in developing countries.
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