Will capitalism drive the future of global health?

Yesterday the institute co-sponsored (with Kenan-Flagler Business School) a lecture by Steven Phillips, the Medical Director for Global Issues and Projects at ExxonMobil, titled “Saving lives through the power of partnerships.”

I think the very notion of business solutions to global health problems raises some eyebrows, particularly when you’re talking about an international mega-corporation like ExxonMobil.  Besides the obvious ethical questions, good basic science and sound public health practice just seem to run in direct conflict with profit motive.

To address the accuracy and validity of such assumptions and concerns would take volumes, so I’ll just highlight a few interesting points raised during his talk.

At one point Phillips was talking about fighting malaria in Africa and said something to the effect of “the battle is not against the mosquito and the parasite; the battle is getting uncooperative entities to work together.”  In other words, the problem is not how to prevent and treat malaria–that’s the easy part–the real challenge is people and institutions (bureaucracies), both of which are resistant to change, slow to implement change, and reluctant to relinquish power and authority.  Add to that the cultural tension created when a (usually) Western entity tries to apply foreign solutions to local problems. Suddenly developing a malaria vaccine seems like walk in the park (with insect repellent, natch).

Phillips thinks that business has a thing or two to teach the change averse.  Phillips spoke of the increasing “businessification” of  malaria programs among NGOs and other non-profits and claimed that employing a “business toolkit”–program management, goal-setting, metrics, etc.–led to improved outcomes (he didn’t give any numbers).

During the question and answer period, Phillips posed a question to the audience, which was made up of approximately 75%  public health, 20% medicine, and 5% business students and faculty.  He asked, “What is the primary motivator or objective of global public health?” (1) humanitarian (2) application of standard public health principles and practices in a global context or (3) development–public health being but one spoke on wheel, others being  infrastructure, adequate workforce, economic growth, political stability, property ownership, quality of life, etc.

Not a single person raised her hand for #1, while nearly everyone chose #3.  And if #3 is the “right” answer, then perhaps business and corporations do have a role to play in global health.

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