Buying In, Edging Out: Perspectives on Contemporary Global Health Financing among Thailand’s Malaria Community

Abstract

The first signs of an unprecedented form of drug resistance, identified along the Thai–Cambodia border, have reawakened scientific interest in the discovery of new anti-malarial treatments. Innovation in malaria financing policy geared to promote wider access to effective and safe malaria drugs through coordinated investment practices of large global health donors has significantly contributed to invigorate international product research and development (R&D). This article seeks to explore the elementary question of what the increment in global funding for malaria control and elimination has done, not for, but to the Thai malaria policy and research community. Drawing on ethnographic research, it first examines how public–private partnership arrangements in this bioscientific and biomedical field have helped close the product innovation cycle of a non-profit-based drug developer. Second, it asks in what ways the successful resolution of an earlier disjunction between drug safety and efficacy studies and drug discovery has impinged on the working relationships between two local communities of practice. I set out my notion of ‘disconnected connectivities’ to analyze this dynamic between the global and the local to elucidate how the global inclusivity that collaborative financing instruments and mechanisms provide spurs unanticipated forms of exclusion within the international malaria science enterprise.