Shrinking Spaces for the "Public' in Contemporary Public Health

This contribution joins the debate on the politics of global health, and specifically inequality in health. Focusing on three recent and pertinent reports, it examines two opposing perspectives for dealing with this inequality. Driven by the global financial crisis, one perspective attempts to validate the intervention of global capital through markets, technology and research funding in global health; it promotes a uniform model of universal health care based on medical care through insurances, public-private partnerships and a dominant private sector. The other perspective arises from the specific historical experiences of nation states in which health has been treated as a commodity. It highlights the negative impacts on global health of neoliberal reforms, such as reductions in welfare and increasing inequalities, and critiques the optimization of profits from health services, which undermines the government's role in health care. The article analyses the historical evolution of these perspectives and the two kinds of movements that emerged across the globe. Using the case of India, the authors argue that where neoliberalism prevails, health movements must link up with broader democratic and political movements that work for the realignment of structural inequalities and policy shifts for the well-being of the majority.