Rebels, vigilantes and mavericks: heterodox actors in global health governance

Abstract

COVID-19 has exposed profound governance challenges that demand more diverse and creative approaches to global health governance moving forward. This article works towards such a pluralization of the field by foregrounding the vital role played by heterodox actors during the pandemic. Heterodox global health actors are backgrounded actors who improve health in different parts of the world, but who remain politically marginalized – and epistemically invisibilized – because they depart in crucial respects from the liberal orthodoxy pervading the field of global health governance. The article analytically foregrounds those heterodox actors through an architectural inversion – a relational approach to the study of global health governance that builds upon recent methodological insights from postcolonial studies, infrastructure studies, and science and technology studies. The article then harnesses that methodological approach to empirically investigate the COVID-19 activities of three different heterodox actors: rebel groups providing public health in the borderlands of Myanmar, a women’s vigilante movement stitching face masks in the Czech Republic, and a maverick scientific platform for the international sharing of viral sequence data. Performing that architectural inversion begins to loosen the dominance of the liberal episteme within the practice and study of global health governance. It further visibilizes how that field is continually co-produced by the background activities of many such heterodox actors. It also lays conceptual foundations for a more heterodox future research agenda on global health governance – and arguably global governance more broadly – in response to the numerous unresolved challenges revealed by COVID-19.