The Making of Global Health Governance: China and the Global Fund to Fight AIDS, Tuberculosis, and Malaria PDF
Preview The Making of Global Health Governance: China and the Global Fund to Fight AIDS, Tuberculosis, and Malaria
The Making of Global Health Governance This page intentionally left blank The Making of Global Health Governance China and the Global Fund to Fight AIDS, Tuberculosis, and Malaria NicoleA.Szlezák themakingofglobalhealthgovernance Copyright©NicoleA.Szlezák,2012. Softcover reprint of the hardcover 1st edition 2012 Allrightsreserved. Firstpublishedin2012by PALGRAVEMACMILLAN® intheUnitedStates—adivisionofSt.Martin’sPressLLC, 175FifthAvenue,NewYork,NY10010. WherethisbookisdistributedintheUK,EuropeandtherestoftheWorld, thisisbyPalgraveMacmillan,adivisionofMacmillanPublishersLimited, registeredinEngland,companynumber785998,ofHoundmills, Basingstoke,HampshireRG216XS. PalgraveMacmillanistheglobalacademicimprintoftheabove companiesandhascompaniesandrepresentativesthroughouttheworld. Palgrave®andMacmillan®areregisteredtrademarksintheUnited States,theUnitedKingdom,Europeandothercountries. ISBN 978-1-349-43755-9 ISBN 978-1-137-02083-3 (eBook) DOI 10.1057/9781137020833 LibraryofCongressCataloging-in-PublicationData Szlezák,NicoleA.,1972– Themakingofglobalhealthgovernance:Chinaandtheglobalfundto fightAIDS,tuberculosis,andmalaria/NicoleA.Szlezák. p. cm. ISBN978–1–137–02082–6(hardback) 1. Worldhealth. 2. Publichealth—Internationalcooperation. 3. Medicalpolicy. 4. AIDS(Disease)—Socialaspects. 5. Tuberculosis—Socialaspects. 6. Malaria—Socialaspects. I. Title. RA441.S962012 362.1—dc23 2012011136 AcataloguerecordofthebookisavailablefromtheBritishLibrary. DesignbyIntegraSoftwareServices Firstedition:September2012 10 9 8 7 6 5 4 3 2 1 PrintedintheUnitedStatesofAmerica. Contents ListofTables vii Author’sNote ix AbbreviationsandAcronyms xiii 1 GlobalizingPublicPolicy:TheHealthSector 1 2 PublicHealthintheTwenty-FirstCentury:Beyondthe MultilateralInstitutions 11 3 TheGlobalFundExperiment 43 4 HowtheFundOperatesintheGlobalDomain 75 5 TheLocalandtheGlobal:HIV/AIDSinChina 91 6 TheFund’sImpactonChina’sHIV/AIDSPolicy 119 7 PublicHealthPolicyMakingintheGlobalDomain 145 Notes 153 Bibliography 161 Index 185 This page intentionally left blank List of Tables 6.1 TheChinaCCM2004(CountryCoordinatingMechanism inChina2004) 135 6.2 TheChinaCCMin2006(CountryCoordinating MechanisminChina2006) 136 This page intentionally left blank Author’s Note My motivation for writing this book goes back a long way. A physician by training,Iworkedintropicalmedicineresearchforabriefperiodofmylife, conducting biomedical research on malaria at the Albert Schweitzer Hospi- tal in Lambaréné, Gabon. The work provided me, for a short time, with the humbling opportunity to be part of an entirely different world. I was struckbythecontrastbetweenthedailyrealityofmymalariapatients,mostly primary school children, who lacked the most basic things including clean water and basic pediatric services, and the reality of a European biomedical researcher, contributing to a global body of knowledge about malaria, who couldstepintothatworld,andoutagain,atherowndiscretion. A number of questions stirred my interest, which form the underlying structureofthisbook.Whoseproblemsgettheworld’sattention,andwhy? Howdopolicyissuescometoberegardedasglobal?Howdonewapproaches to solving them gain currency and become accepted, financed, and imple- mented?Anddonewwaysofframingthingsreallyleadtodifferentwaysof engagement? My search for intellectual tools to help me grapple with these questions led me to pursue a PhD at Harvard University’s John F. Kennedy School of Government. Drawing on the multiple disciplinary perspectives inhabiting the School, I found myself drawn to study the emergence of the global, or the transnational; to observe its taking form as a set of rules and institutions; to follow its deployment into the real world; and to study its engagementwiththelocal. InthisbookIexplorethesethemesthroughafocusontheGlobalFund to Fight Aids, Tuberculosis and Malaria and its interaction with one of its largestgrantrecipients,China.Inordertoaccomplishthistask,Ineededto followawiderangeofdiversethreads,suchastheemergenceofHIV/AIDS as a global issue, changing paradigms driving international health coopera- tion, the evolution of ethical norms for global clinical trials, the emergence of trade and intellectual property regimes in the context of global pharma- ceutical policy, the controversies around AIDS denialism, the emergence of
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