Politics or Technocracy – What Next for Global Health?; Comment on “Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health”

Document Type : Commentary


Global Health Programme, Graduate Institute of International and Development Studies, Geneva, Switzerland


Politics play a central part in determining health and development outcomes as Gorik Ooms highlights in his recent commentary. As health becomes more global and more politicized the need grows to better understand the inherently political processes at all levels of governance, such as ideological positions, ideas, value judgments, and power. I agree that global health research should strengthen its contribution to generating such knowledge by drawing more on political science, such research is gaining ground. Even more important is – as Ooms indicates – that global health scholars better understand their own role in the political process. It is time to acknowledge that expert-based technocratic approaches are no less political. We will need to reflect and analyse the role of experts in global health governance to a greater extent and in that context explore the links between politics, expertise and democracy.


Main Subjects

  1. Taylor S. Political epidemiology: strengthening socio-political analysis for mass immunisation - lessons from the smallpox and polio programmes. Glob Public Health. 2009; 4(6):546-560. doi:10.1080/17441690701727850
  2. Forum on China –Africa cooperation. Spotlight: China, Africa map out strategic vision for win-win cooperation with practical action plan. http://www.focac.org/eng/zxxx/t1321742.htm. Accessed December 7, 2015. Published December 7, 2015.
  3. Ooms G. Navigating between stealth advocacy and unconscious dogmatism: the challenge of researching the norms, politics and power of global health. Int J Health Policy Manag. 2015;4(10):641-644. doi:10.15171/ijhpm.2015.116
  4. Shiffman J. Knowledge, moral claims and the exercise of power in global health. Int J Health Policy Manag. 2014;3(6):297-299. doi:10.15171/ijhpm.2014.120
  5. Barnes A, Parkhurst J. Can global health policy be depoliticized? A critique of global calls for evidence-based policy. In: Brown GW, Yamey G, Wamala S, edrs. Global Health Policy. London: Willey-Blackwell; 2014.
  6. Mackenbach J. Political determinants of health. Eur J Public Health. 2014; 24: 2.  doi:10.1093/eurpub/ckt183
  7. De Leeuw E, Clavier C, Breton E. Health policy–why research it and how: health political science. Health Res Policy Syst. 2014; 12: 55. doi:10.1186/1478-4505-12-55
  8. Fassassi A. How anthropologists help medics fight Ebola in Guinea. http:// www.scidev.net/global/cooperation/feature/anthropologists-medics-ebola-guinea.html.  Accessed November 10, 2015. Published September 24, 2014.
  9. Ottersen OP, Dasgupta J, Blouin C, et al. The political origins of health inequity: prospects for change. Lancet. 2014;383(9917):630-667. doi:10.1016/s0140-6736(13)62407-1
  10. Leopoldina. Akademien präsentieren Stellungnahme zu Public Health. http://www.leopoldina.org/en/press/press-releases/press-release/press/2315/. Accessed December 7, 2015. Published June 9, 2015.
  11. Fafard P. Beyond the usual suspects: Using political science to enhance public health policy making. J Epidemiol Community Health. 2015;69(11):1129-1132. doi:10.1136/jech-2014-204608
  12. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization; 2008.
  13. Smith K. Beyond evidence based policy in public health: the interplay of ideas. Palgrave Macmillan; 2013.
  14. Lee K. Revealing power in truth: Comment on "Knowledge, moral claims and the exercise of power in global health." Int J Health Policy Manag. 2015;4(4):257-259. doi:10.15171/ijhpm.2015.42
  15. Moon S, Sridhar D, Pate MA, et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. The Lancet 2015;386 (10009):2204-2221. doi:10.1016/s0140-6736(15)00946-0
  16. Hoffman SJ, Røttingen JA. Split WHO in two: strengthening political decision-making and securing independent scientific advice. Public health 2014;128(2):188-194. doi:10.1016/j.puhe.2013.08.021
  17. Bruen C, Brugha R. A ghost in the machine? Politics in global health policy. Int J Health Policy Manag. 2014;3(1):1-4. doi:10.15171/ijhpm.2014.59
  18. Slaughter AM. A new world order. New Jersey: Princeton University Press; 2004.
  19. Leftwich A. Bringing Agency Back. In: Politics and Human Agency in Building Institutions and States: Synthesis and Overview Report. Research Paper 06. York, UK: Developmental Leadership Programe; 2009.
  20. Kickbusch I.  The political determinants of health—10 years on. BMJ. 2015;350:h81. doi:10.1136/bmj.h81
  21. National Academy of Medicine. Global Health Risk Framework. http://nam.edu/initiatives/global-health-risk-framework/. Accessed November 8, 2015.
  22. Cliff C. Is Yet Another Ebola Report a Symptom of the Problem or the Solution? https://www.chathamhouse.org/expert/comment/yet-another-ebola-report-symptom-problem-or-solution. Accessed December 7, 2015. Published November 23, 2015.
  23. Ferrari GR, Griffith T.  Plato: 'The Republic'. Cambridge: Cambridge University Press; 2000.
  24. Minds like machines. The Economist Website. http://www.economist.com/node/21538698. Accessed November 10, 2015. Published November 19, 2011. 
  25. Kennedy D. Challenging expert rule: the politics of global governance. Sydney L Rev 2005; 27: 5.
  26. Barr MD. Beyond Technocracy: The Culture of Elite Governance in Lee Hsien Loong's Singapore. Asian Stud Rev. 2006;30(1):1-17.
  27. Bucchi M.  Beyond technocracy: Science, politics and citizens. New York, NY: Springer; 2009.
  28. Global health watch Website. Making WHO work better: an advocacy agenda for civil society. Civil Society Consultation Paper, August 2006. http://www.ghwatch.org/sites/www.ghwatch.org/files/MakingWHOWorkBetter.pdf. Accessed December 7, 2015.
  29. The White Ribbon Alliance Web site. The citizens hearing 2015. http://whiteribbonalliance.org/campaigns2/citizens-hearings-2015/. Accessed December 7, 2015.
  30. Moore R. Exploring Citizen Science. http://blogs.plos.org/citizensci/2014/08/01/exploring-citizen-science/. Accessed December 7, 2015. Published August 1, 2014.