Blind spot : how neoliberalism infiltrated global health by Salmaan Keshavjee

By Salmaan Keshavjee

Neoliberalism has been the defining paradigm in international wellbeing and fitness because the latter a part of the 20th century. What began as an untested and unproven conception that the construction of unfettered markets could supply upward thrust to political democracy ended in regulations that promoted the idea that personal markets have been the optimum brokers for the distribution of social items, together with overall healthiness care.

A bright representation of the infiltration of neoliberal ideology into the layout and implementation of improvement courses, this example examine, set in post-Soviet Tajikistan’s distant japanese province of Badakhshan, attracts on wide ethnographic and old fabric to envision a “revolving drug fund” program—used by way of a number of nongovernmental corporations globally to handle shortages of fine quality prescription drugs in terrible communities. Provocative, rigorous, and available, Blind Spot deals a cautionary story in regards to the forces using choice making in future health and improvement coverage this present day, illustrating how the privatization of healthiness care may have catastrophic results for many of the world’s so much susceptible populations.

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In Badakhshan, there was no need for any success beyond imposing the reform, just as had been the case in Bamako. This uncoupling of interventions (“reform”) and assessment of their effectiveness in improving health, or at least in preventing catastrophe, is often pathognomonic of dogma over data. We’ve met some of those who served up dogma to the hungry and the sick, but who cooked up the dogma? Keshavjee introduces us to some of the people he believes were injured by neoliberalism but also tries to identify the mechanisms of the injury, and why some are spared.

Claims of the effectiveness of this system prior to its erosion are suspect. In the years of Keshavjee’s fieldwork, which began in 1995, this collapse was followed by the chaotic proliferation of what were termed, in developmentspeak, “civil society institutions” with very different and competing agendas. In the mid-1990s, disparities and asymmetries of all sorts—public-private, center-periphery, urban-rural, mountains-lowlands, practitioner-patient, foreign-local—abounded and were growing. Above all, and quite new, was the gulf between the tottering public health system and the well-resourced aid agencies and nongovernmental organizations (NGOs) new to the region.

It has redefined how we help others, including the most vulnerable in society, and has reshaped our social world by penetrating our “common sense” about what is right and wrong. In the case of global health and development, it has led to blind spots—referred to in this book as neoliberal realms of programmatic blindness—that have contributed to poor outcomes for individuals and communities. The second belief is that nongovernmental organizations (NGOs) are, de facto, the best institutions to provide social services to the poor.

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