Cermes3, Campus CNRS, 7 rue Guy Mo?quet 94800 Villejuif 21/06/2017,
10:00 | Introduction
Jean-Paul Gaudillie?re, Guillaume Lachenal
10:30 | Public-private partnerships in global health and the value of
absent evidence
Linsey McGoey, University of Essex, UK
This paper draws on the history of ideas in order to investigate early
20th-century shifts in economic thought that have led to widespread
21st-century assumptions about the effectiveness of private-sector actors
in improving health outcomes. Through a critical analysis of Hayekian ideas
on the diffusion of knowledge in social life, I situate the emergence of
public-private partnerships in global health in a longer historical debate
over the efficacy of private actors in allocating resources efficiently. I
then suggest that the evidence-base attesting to the economic and social
benefits of subsidizing private-sector actors to help realize global health
goals is far weaker than proponents of increased PPPs typically
acknowledge. Lastly, I argue that this apparent weakness ? the difficulty
in obtaining empirical evidence of private-sector efficacy and
cost-effectiveness ? functions as a rhetorical asset for private actors
rather than, as might be expected, a liability.
11:30 | Indirect and Diffuse Philanthropy in (British) Colonial Africa
Between the Wars
Helen Tilley, Northwestern University, USA
Philanthropies are, by definition, institutions that donate money, mobilize
resources, and, in turn, influence (health) policies. Studying their
grant-making patterns can thus help us understand which regions and topics
have been a priority and which have been neglected. Yet actual revenue
streams tell us only part of the story and can sometimes distract us from
understanding both the significance and impact of philanthropic activities.
This is especially true in places such as sub-Saharan Africa, where U.S.
and European philanthropies did comparatively little direct work until the
second half of the twentieth century. This paper takes up these questions
by considering the myriad effects of indirect philanthropy within British
Africa between the wars, focusing largely on the activities of the
Rockefeller Foundation and the Carnegie Corporation and their grants to the
League of Nations Health Organization and the African Research Survey
(1931-1939). It also examines a number of smaller projects funded by the
Rhodes Trust (in Oxford, England) and the Colonial Development Fund
(managed by Britain?s Colonial Office), which
operated at times as quasi-philanthropic and quasi-governmental
institutions. Taking this approach allows us to see the diffuse effects of
large-scale metropolitan projects and smaller-scale initiatives within
British Africa. It also reveals the broad definitions of health and
medicine in play, such that intelligence tests, medical ethnographies, and
agro-ecological surveys were all part and parcel of the picture. Because
global health specialists and even social activists often describe much of
Sub-Saharan Africa as a neglected or overlooked region of the world ? even
in terms of the work of health philanthropies ? these multifaceted
approaches to well-being are often erased, as if they never existed, or
condemned and criticized given their colonial roots and uneven application.
My analysis of philanthropies? hidden histories is meant to challenge
simplistic notions that funders failed to do much in colonial Africa by
focusing on the ripple effects relatively small sums of money had.
12:30 | Repas / lunch break
14:00 | Humanitarian medicine and pharmaceutical capitalism: the alliance
between the DNDI and Sanofi in the malaria field
Maurice Cassier, Cermes3, CNRS, France
The Drugs and Neglected Diseases Initiative (DNDI) is a foundation and a
laboratory without walls created in 2003 at the initiative of MSF, to
compensate for the shortcomings of the innovation property rights model in
the field of so-called neglected diseases. MSF used the grant it received
as Nobel Peace Prize laureate in 1999 to set up a ?not-for-profit
pharmaceutical laboratory? (Jacques Pinel, MSF). The NGO?s aim was to use
its therapeutic activism not only to appeal for access to medicines, but
also to set up R&D projects and industrial alliances. In this respect the
DNDI is the heir of the Tropical Diseases Research (TDR) group launched by
the WHO, the World Bank, UNICEF and the UNDP in 1975 to make up for the
lack of therapeutic research on tropical diseases. The TDR was moreover a
founding member of the DNDI. Finally, the DNDI engages the services of
research and public health institutions in countries of the South: Fiocruz,
the Indian Council of Medical Research, the Kenya Medical Research
Institute, the Malaysian Ministry of Health, and the Pasteur Institute in
France. In 2015 the Bill and Melinda Gates Foundation contributed one
quarter of the DNDI?s budget, while government institutions contributed a
little over half, and MSF 17%. The idea is to balance public- and
private-sector contributions and to preserve the Foundation?s independence.
I will pay particular attention to the partnership formed with Sanofi in
2004 to industrialize and distribute an artemisinin-based combination
therapy, the artesunate and amodiaquine combination, that accounts for one
quarter of the global ACT market, based on a ?no profits no loss? model.
15:00 | Mobile (for) development: cellphones as philanthropic tools for
global health
Marine Al Dahdah, CEPED, Universite? Paris Descartes, France
With more than 7 billion mobile phone users in 2017, mobile phones became
the most widespread communication technology worldwide. From appointment
reminders by SMS to mobile glucometers, healthcare systems are increasingly
using mobile technologies. However, the use of mobile technologies for
health called « mHealth » or « mobile health » has not been well
documented so far, especially in the Global South. Through the study of a
global mHealth program on maternal health implemented in Western Africa and
South Asia, our research offers a first glance at those devices. This
communication will focus especially on power relations, philanthropic and
market interests underlying the expansion of those new technical artifacts
in the Global South.
Mobile operators, cellphone manufacturers or private foundations from the
digital sector consitute core stakeholders of mHealth programs. All
newcomers on the scene of international health, they are major players in
digital development projects. The high proportion of private investors and
public-private partnerships characterize mHealth and reflect the
fragmentation and commodification of public health already associated with
Global Health programs. This evolution has mostly been studied through
partnerships with pharmaceutical companies. The case of mHealth embodies a
different convergence of interests between public health actors and private
actors from the digital industry.
This communication will first examine the public-private partnership on
which the studied Gobal mHealth program is based and how the philantropic
foundations involved in it have influenced the trajectory of the program.
From philanthropic grants to the commercialization of the device, its
itinerary echoes the notion of "philanthrocapitalism", the meeting between
generosity and commercial interests. This communication will discuss this
dual philanthropic and commercial dimension and show how mHealth is part of
a strategy for developing new markets in the Global South. It will detail
mechanisms by which those technological and market-based partnerships
perpetuate imperialist dynamics and North-South inequalities.
16:00 | The  in global health 
Anne-Emanuelle Birn, University of Toronto, Canada
The power wielded by philanthropists in channelling profits from their
business and investment interests into shaping the global health agenda
toward particular ends (technical, market-oriented...) is accompanied by an
even larger marshalling of the public purse to this same agenda and modus
operandi. How have philanthrocapitalists so deftly corralled public
resources to their vision of global health? This talk explores the
narrative approach employed by global health philanthropists past and
present, particularly the way in which the « royal we » is invoked to
explain (and take credit for) a trajectory of population health
improvements (defined in ways that aggrandize the role of ).
Finally, and fittingly ?given our proximity to the setting of the
quintessential monarchic overthrow? what does this account tell us about
the possibilities for resisting  in global health?
Seminar series outline
The framing of health as a global issue over the last three decades has
carved out an intellectual, economic and political space that differs from
that of the post-war international public health field. This older system
was characterised by disease eradication programs and by the dominance of
nation states and the organisations of the United Nations. The actors,
intervention targets and tools of contemporary global health contrast with
previous international health efforts. The construction of markets for
medical goods takes a central place in this new era, as does regulation by
civil society actors. Global health can also be characterized by
co-morbidities between chronic and infectious diseases, the stress on
therapeutic intervention, risk management, health as an instrument of
'community' development and the deployment of new modes of surveillance and
epidemiological prediction. This emerging field takes on a radically
different appearance when examined at the level of its infrastructures
(such as the WHO, the World Bank or the Gates Foundation) or at the level
of the knowledges and anticipatory practices generated by its practices and
local instantiations.
This seminar will combine historical, sociological and anthropological
approaches to examine this globalized space and the assemblages that
constitute it: public-private partnerships, foundations, local
'communities', cancers, 'non-communicable diseases', risk prevention,
monitoring and evaluation, etc. Particular attention will be given to the
infrastructures and the contemporary dynamics of knowledge production,
insurance techniques and diagnostic interventions, therapeutic
'innovations' in their diverse geographies, including Africa, Asia or Latin
America. These often differ widely from transfer schemes between the global
north and the global south that insist on technological dependency. The
seminar will examine the myriad local forms that global health takes in
everyday practices.
Organized by Claire Beaudevin (CNRS-Cermes3), Fanny Chabrol
(Inserm-Cermes3), Jean-Paul Gaudillie?re (Inserm-Cermes3), Fre?de?ric Keck
(CNRS-LAS/Muse?e du Quai Branly), Guillaume Lachenal (Universite? Paris
Diderot), Vinh-Kim Nguyen (Colle?ge d'Etudes Mondiales), Laurent Pordie?
(CNRS-Cermes3), E?milia Sanabria (E?cole Normale Supe?rieure de Lyon)
This lecture series is supported by the ERC project « From International
Public Health to Global Health » (Cermes3, Paris & University of Oslo) and
the chair for Anthropology and Global Health (Colle?ge d?Etudes Mondiales,
FMSH, Paris).
For updated practical information: http://enseignements-2016.ehess.fr/2016/ue/969/