Markets, Governments, and Global Health

This chapter is the first of three on the roles of markets, the private sector, and governments in global health. It provides an overview of principles and unresolved issues of relevance to the practice of global health. Discussions about markets and governments often evoke strongly held beliefs and positions, particularly on appropriate roles of the private sector and public policy. The strengths of these beliefs and positions come from varying combinations of theoretical doctrines, empirical evidence, anecdotes, ideologies, and grand myths. These combinations have practical consequences for global health, as they help explain the origins of health systems in different parts of the world and the dynamics of Development Assistance for Health (DAH). It is important to look at — and beyond — the failures of governments and markets, with attention to just what it is that decision makers are optimizing for. Doing so paves the way for measured considerations of equity of access to technologies and services, and for careful distinctions between means and ends.