Public–private partnerships (s) in global health: the good, the bad and the ugly

Global Health Partnerships (ghps) have become ubiquitous within global health governance (ghg). Even before the onset of the global financial crisis public–private partnerships (ppps) were an omnipresent policy tool in global health and in the current austerity climate ppps have been heralded as an effective way to address a growing resource gap in ghg. Despite their omnipresence, ghps have not received adequate attention from critical scholars; few efforts have been made conceptually and theoretically to grasp how ppps are transforming the logic of ghg. We argue that ghps have contributed to the emergence of a complex global health governance architecture in which private solutions (market mechanism) are generally privileged over public approaches. Drawing on Gramscian conceptualisations of public/private, we suggest that the reshaping of the private and public realm inherent to ppps represents a further deepening of the neoliberal management of individuals and populations, allowing private interest to become more embedded within the public sphere and to influence global and national health policy making. This undermines the attempt to improve global health results as the inequitable distribution of social determinants of health, especially poverty and social exclusion, remain the main barriers to achieving health for all.