The Domestic Agenda of the New "Global Health" Curriculum

It has become commonplace to state that in today’s global health village, “global health” is a planetary endeavour going beyond aiding poor countries. Yet, hardly anyone takes note of what the new global health agenda means for and does in the Global North. In this paper, I argue that this is an important omission, and show that the ongoing and massive mobilization for global health is also a struggle over the right medicine for rich countries. It is a (renewed) attempt to strengthen public health and social medicine against the dominance of the so-called biomedical professions.

I develop this argument through an analysis of the emerging global health curriculum in the (Anglo-)West, where universities and medical and public health schools are experiencing a veritable “epidemic” of global health study programs. Especially in the US, the number of degrees and certificates in “global health” is dramatically rising and mobilizing an entire generation of students. Likewise, the share of medical students gaining clinical and/or research experience in developing countries has increased from about 6% in 1984 to about 29% in 2014. New institutions such as the US-centred Consortium of Universities for Global Health, founded in 2008 with the help of the Bill and Melinda Gates and the Rockefeller Foundations and counting almost 140 member institutions, nowadays seek to standardize the mission and skills of the new global health professionals.

Substantiated by a content analysis of university websites and the professional literature for global health educators, I will argue that the domestic agenda of global health education can be read from the design of and evaluative standards for “global health electives”: the kind of practice experience offered to students who want to become global health professionals. I show that the primary mission of these electives is not to produce health expertise for the South. Rather, they are designed to sensitize young, still idealist people, to the importance of social determinants of health, and to motivate them to choose careers in primary care and public health in the North. This agenda of harnessing “global health” ideals against doctors’ corruption by professional privilege is not only evident in the types of “global health electives” offered within the North, namely electives in rural health, health equity or community health. It also shows in the sizeable body of literature on international health electives in the South, which gauges the value of these experiences in terms of students’ growing public health awareness and resultant career choices at home.

Combining insights from medical history and sociology and the transnational sociologies of law and economics, this paper transcends the monolithic “medicalization” accounts of global health that dominate the International Relations literature. It shows how health aid abroad is mobilized in deep-seated professional conflicts at home. The paper also goes beyond the critical anthropological literature, which exposes the neo-colonial dominance and exploitation of the South through global health practices, but pays little attention to the repercussions of globalized medicine in its western metropolis.