Historical Perspectives On Contemporary Issues

The Economization of Global Health: World Development Report 1993

A forum held online in collaboration with UMC Utrecht, CNRS, King's College London and McGill University on January 27, 2021. 

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This seminar in the Economization of Global Health series focuses on the origins, production and reception of one of the major moments in the economization of global health: the World Bank's World Development Report 1993: Investing in Health (WDR93). As well as reflecting the Bank's growing role in the funding of international and global health, the report offered a quantitative method for selecting problem, intervention and research priorities, by quantifying the burden of different diseases and then subjecting these numbers to cost-benefit and cost-effectiveness analyses. Unlike earlier efforts of this sort that were unable to fully operationalize such analyses, WDR93 provided a single, standardized epidemiological measure, the DALY (Disability Adjusted Life Years), that incorporated mortality and disability data and was amenable to economic analysis over a broad range of health problems and interventions.

Our speakers, both internationally recognized economists, played key roles in this venture: Dean T. Jamison was the lead author of the report, while Abdo Yazbeck was responsible for much of the technical work. In this seminar, the two discuss their work on the report and reflect on its origins and impact. 

The Economization of Global Health Seminar Series

Since the 1970s, economic concerns, concepts and tools have become central to and reconfigured the way global health is organized and managed. Often referred to as the economization of global health, this process—in which the World Bank played a key role—is hardly monolithic. It includes initiatives to problematize and restructure the financing of healthcare, from structural adjustment policies and attempts to reduce public health expenditures and encourage private forms of healthcare, to the identification of new funding mechanisms like user fees and the Global Fund. It also comprises efforts to rethink priority setting and resource allocation, from global burden of disease calculations to cost-benefit analyses and randomized control trials. Last but not least, the economization of global health also involves the multiplication of micro-economic devices that, like cash transfers and tobacco taxes, seek to improve people's quality of life by targeting individuals' preferences, aspirations and calculations rather than larger macro-economic aggregates.

Organized by UMC Utrecht, Le Centre National de la Recherche Scientifique, King's College London and McGill University, in collaboration with the Consortium, this seminar brings together social scientists and historians to explore—in conversation with economists—the process of economization of global health. Specifically, this seminar series will examine and discuss the following questions: What are the different concerns and tools that have informed the economization of global health and what are their genealogies? What critiques have social scientists articulated about the economization of global health and how have those critiques influenced and impacted this process? And how have economists and their social scientific critics reconfigured the field of global health? 

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To cite this content, please use footnote:

"The Economization of Global Health: World Development Report 1993," Consortium for History of Science, Technology and Medicine, accessed Month Day, Year, https://www.chstm.org/video/109. 


Insights from the Collections

The Consortium's collections provide many opportunities to learn more about the history of international and global health, economics and economization, and debates about public health and welfare economics. 

Our cross-institutional search tool allows researchers to investigate materials across multiple institutions from a single interface. With more than 4.4 million catalog records of rare books and manuscripts, the Consortium's search hub offers scholars and the public the ability to identify and locate relevant materials. 

Search the Consortium Search Hub.

Some archival materials related to this topic include:

China Medical Board Records, Rockefeller Archive Center

Lincoln Chen Papers, Rockefeller Archive Center

Population Council Records, Rockefeller Archive Center

Kenneth C. Smithburn Papers, Rockefeller Archive Center

Lewis W. Hackett Papers, Rockefeller Archive Center

Further resources and related publications:

Gaudilliere, J.P. and C. Gasnier (2020). From Washington DC to Washington State: The Global Burden of Diseases Data Basis and the Political Economy of Global Health. In S. Leonelli and N. Tempini (eds.), Data Journeys in the Sciences, Springer Open, 351-368. 

Pfeiffer J. and R. Chapman (2010). Anthropological Perspectives on Structural Adjustment and Public HealthAnnual Review of Anthropology 39, 149-165. 

Reubi, D. (2017). Rational Sin: How Chicago Economists Remade Global Public HealthLimn 9, 96-101. 

Ridde, V. (2015). From Institutionalization of User Fees to their Abolition in West Africa: A Story of Pilot Projects and Public PoliciesBMC Health Services Research 15 (Suppl. 3), S6. 

Weisz, G. and N. Tousignant (2019). International Health Research and the Emergence of Global Health in the Late Twentieth CenturyBulletin of the History of Medicine 93(3), 365-400. 

See also recent work from our fellows:

The State of the Poor: State Building and Public Health in Modern Brazil, 1834-1920, Maria Paula Andrade Diniz de Araujo

A History of Global AIDS and Health Activism in Brazil, Marcos Cueto 

Vital Cities: Public Health, Non-Human Life and Infrastructure in South Asian Cities, 1890-1970, Aditya Ramesh

Southeast Asia and the Beginnings of the Primary Health Paradigm, 1948-1978, Vivek Neelakantan

Enthroning Health: The National Negro Health Movement and the Fight to Control Public Health Policy in the African American Community, 1915-1950, Paul Braff

Epidemic Preparedness in the Age of Chronic Illness: Public Health and Welfare Politics in the United States, 1965-2000, George Aumoithe