Book Review Health for Some: The Political Economy of Global Health Governance S.J. MacLean, S.A. Brown and P. Fourie (eds.) Palgrave Macmillan, Houndmills, UK & New York, USA, 2009, 278pp., ISBN: 978-0230 224247

European Journal of Development Research (2010) 22, 589–590. doi:10.1057/ejdr.2010.25

This anthology’s point of departure is the conclusion by the 2005-set Commission on the Social Determinants of Health of the World Health Organization (WHO) that global socio-economic inequities define populations’ health and wellbeing. This reference lays down an understanding of global health centered not just in function of a sum of leading individual epidemics (HIV/AIDS, tuberculosis or malaria), but also in an evolving complex linking intercontinental travel to viral transmission, or consumption of nutritionally poor food to augmentation of coronal diseases in poor countries, notably. The title – ‘Health for Some’ – captures the negative outcome in terms of health inequities associated with the contemporary paradigm of neo-liberal-led economic relations, and appears in opposition to the promises of the WHO agenda of ‘Health for All until 2000’ launched in 1978 in the former Soviet city of Alma-Ata. According to the editors, ‘the contributors to this volume approach the issue of global health from different methodological frameworks and theoretical perspectives [yet] united in a common concern to highlight the health inequalities [and] how political economy factors are both contributing to current global health problems and supporting governance arrangements that produce inadequate solutions’ (p. 16). The book is divided into three sections. They reflect on (1) the linkages between globalization, state and global health; (2) the shift from international to global health governance; and (3) governance of global health research and product access. In the first essay, ‘The G8, Globalization, and the Need for a Global Health Ethic,’ Ted Schrecker concentrates on the policy consequences of the group of the world’s most industrialized countries for health in the rest of the world, from debt relief initiatives to development assistance. For the author, despite pledges of ‘making poverty history,’ rich countries’ policies lag much behind what has been promised. Therefore, he appeals to a renewed ethics in foreign policy and international relations of the major world powers. The second contribution, by Rodney Loeppky, ‘The Accumulative Nature of the US Health Complex,’ offers a detailed description of the historic private, highly profit-seeking health industry of the United States, based on an entangled web of private and public players: biomedical corporations, governmental protection and the US public. Given the high influence of the United States in global health through a number of major bilateral initiatives (HIV/AIDS and malaria, more prominently), the author warns that ‘global health, modeled on the US complex of production-provision-profit, will turn out poorly for the overwhelming majority of populations who cannot afford such heightened costs’ (pp. 51–52). In turn, Colleen O’Manique’s ‘Palliative Interventions: Canadian Foreign Policy, Security and Global Health Governance’ discusses the ‘social-democratic’ character of human security policies of the Canadian government in light of concurrent world trade measures and other inward-looking, status quo-maintaining tactics. The first section’s last contribution aims at settling the academic ‘dispute’ in Political Science and r 2010 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 22, 4, 589–590 www.palgrave-journals.com/ejdr/

Book Review related fields on whether HIV/AIDS causes state fragility. Pieter Fourie concludes that ‘there is little reliable evidence to suggest that HIV by itself causes state fragility or collapse’ (p. 82), although it certainly adds to the vulnerability experimented under longerlasting social and political problems among hard-hit societies. The second section is devoted to neo-liberal age labor division models of global provision of health services. The first essay by Wolfgang Hein and Lars Kohlmorgen, ‘Transnational Norm-Building in Global Health: The Important Role of Non-State Actors in Post-Westphalian Politics’ is essentially a theoretical piece that applies to the realm of health the ‘famous’ mid-1990s theory of norms-building in a radically transformed postCold War order. Carmen Huckel Schneider moves forward in Hein and Kohlmorgen’s explorations by discussing the new features of public-private partnership (PPP) models of intervention, namely the role of epistemic communities and orientation toward specific goals. Michael Moran’s contribution also focuses on PPPs, notably the prominent Rockefeller Foundation and IAVI (International AIDS Vaccine Initiative) and their roles as policy entrepreneurs and norm-setters. Sonja Bartsch’s contribution, ‘Southern Actors in Global Public-Private Partnerships: The Case of the Global Fund’ addresses the power relations reproduced under the auspices of PPPs, notably Northern and Southern governments, but also NGOs. Often, PPPs work as transmission belts for agendas of parties involved, which permit the evasion of traditional, formal politically based organizations such as the WHO. Although located in the next section, Sherri Brown’s ‘The Partnership Prescription: Access to HIV/AIDS and Public-Private Partnerships’ addresses similar issues. This section ends with Siri Bjerkreim Hellevik’s ‘‘‘Making the Money Work’’: Challenges towards Coordination of HIV/AIDS Programmes in Africa,’ which discusses the ulterior problem of national horizontal coordination of different donor programs. The third section begins with Sandra J. Maclean and David R. Maclean’s appreciation of the ‘The Political Economy of Global Health Research.’ Important points made by the authors concern two aspects. On the one hand, they highlight the overemphasis on the access to drugs (explored by Valbona Muzaka ahead in the same section in ‘Dealing with Public Health and Intellectual Property for Pharmaceuticals at the World Trade Organization’) by analysts of social inequities at the expense of prevention research (p. 175). On the other, they denounce the difficulty of pursuing research agendas that do not necessarily stand for corporate profits (p. 179). Shree Mulay, Eowynne Feeney and Daya R. Varma’s study ‘Patents, Policies and Pricing: Access to Medicines for Vulnerable Populations in a Global Economy’ presents an interesting incursion into a pharmaceutical company of a less-developed country, Indian Ranbaxy, and its views on incentives to be granted in order to produce cost-effective drugs for people with little or no access to them. The conclusions the editors come to echo the assembly of perspectives by the generality of the authors: ‘Planning and investments for health must be a key priority of governments, and, supported by a strong, sustainable and committed multilateral strategy, the emphasis must be on achieving a fundamental shift towards a social determinants of health approach to create a healthier, wealthier world for all’ (p. 236). Despite its honesty, this conclusion reifies the dead-end analyses that global (health) governance finds itself trapped in, and unable to grasp beyond the critique of the current liberal system. Ricardo Pereira Centre for Social Studies, University of Coimbra, Coimbra 590

r 2010 European Association of Development Research and Training Institutes 0957-8811 European Journal of Development Research Vol. 22, 4, 589–590

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