Global Health and Its Limitations: An Historical Perspective.

Abstract

Humanitarian themes, such as rights and entitlements to universal well-being, feature prominently in narratives of global health, even as many recent authors have pointed to systematic imbalances of power, unfair governance structures, and unwanted influences as evidence of ongoing colonial interference in the health affairs of many low- and middle-income countries. This article employs an historical perspective to analyze major forces that have shaped the development of global health, and which remain as obstacles to its objectives. These include macroeconomics, geopolitics, and the activism and resources of the HIV/AIDS pandemic that led to global health in its current form. Through an examination of this history and its effects, I argue that the humanitarian goals of global health will not be realized without dramatic changes to the field. Particularly in the failure to engage economic relationships and trade policy, global health limits its attention to downstream consequences of resource inequalities, where its goal of a more egalitarian, more healthy world is difficult, if not impossible, to achieve.