Context
margauxfThe Global Burden of Disease (GBD) study that the authors reference and model their call to action around is the worlds' largest scientific effort to quantify trends in health. It is lead by the Institute foe Health Metrics and Evaluation (IHME) at the University of Washington. It began in 1990 as a World Bank-commissioned study and is known for having introduced the disability-adujusted life year (DALY) as a new metric to quantify the burden of disease, injuries, and risk factors (or determinants), and enable comparisons.
The 1990s were a turning point for global health structures of governance and knowledge production, which the GBD study exemplifies. Global health experts began increasingly reframing health and healthcare in technical terms like DALY, removing health from public governance in ways that complemented and bolstered structural adjustment policies that were introduced in the 1980s (Janes 2004). As a result of these policies, the size, scope and reach of healthcare delivery and public health services were steadily reduced and downgraded. Anthropologists have been critical of these processes and other perceived failures in global health: the collapse of primary care initiatives fostered at Alma Ata in 1978, the resurgence of selective forms of primary care and vertical public health programs, and the ascendency of the World Bank as the principal health policymaking institution (Janes 2004, 2009).
Janes, Craig R (2004). "Going global in century XXI: medical anthropology and the new primary health care." Human Organization 63, no. 4: 457-471.
Janes, C. R., & Corbett, K. K. (2009). Anthropology and global health. Annual Review of Anthropology, 38, 167–183. doi:10.1146/annurev-anthro-091908-164314