The global health complex

Abstract

In February 2009, Andrew Witty, the Chief Executive of GlaxoSmithKline (GSK) announced that GSK would slash the prices of its medicines in low-income countries, and, more surprisingly, raised the idea of a patent pool, where holders of intellectual property rights would share discoveries in order to stimulate neglected diseases research (Lancet, 2009; McNeil, 2010). The announcement generated cautious praise from non-governmental organizations (NGOs) such as the Medicins Sans Frontieres (MSF) and the Drugs for Neglected Diseases Initiative, the latter suggesting that GSK has emerged as the ‘most innovative’ pharmaceutical company to tackle the persistent problem of how to encourage the private sector to pour RD see also Lexchin, 2010). Behind the apparent selflessness of GSK’s strategy lies much contestation and controversy over the economic motivations and unintended consequences of recent attempts to address disparities in access to medicines and health care. Using the complex matrix of global health initiatives as an anchor, contributors to this special issue explore the underlying contention behind actions such as GSK’s, examining how industry moves such as priceslashing in developing regions and calls for patent sharing relate to wider concerns about the tensions between private and public investment in health care; the nature of what Marcel Mauss once referred to as the ‘in fact obligatory and interested’ character of philanthropy and gift-giving; and the national security objectives embedded in bilateral and multilateral global health initiatives (Lakoff and Collier, 2008; Mauss, 1990).