From AIDS to swine flu: the politicization of global health

For more than a decade now, the focus of global health has been on exceptional events, whether HIV, SARS or pandemic influenza. An accepted orthodoxy has emerged that something new has occurred: that new infectious diseases/outbreak events pose new risks; that these problems are global not local; and that they require a more political response, up to and including global health governance. This orthodoxy however is not simply a passive reflection on what has changed; rather it constitutes a narrative, which constructs and shapes our understanding of what is happening. This paper proposes to deconstruct this narrative and identify the work it is doing. Crucially it asks the question: whose interests are being served by this narrative? In so doing the paper will suggest that, far from the narrative opening up questions of whether foreign/security policy and global health can co-operate or are in competition to each other, what the narrative actually does is privilege a set of interests which are shared by Western health and foreign and security. In particular it suggests that the new ‘outbreak narrative’ is a narrative of the powerful privileging the West, established medical disciplines and multinationals (drugs, but also through their exception food and tobacco), rather than the expected privileging of global health needs.