Blind Spot

Neoliberalism has been the defining paradigm in global health for the latter part of the twentieth century. What started as an untested and unproven theory that the creation of unfettered markets would give rise to political democracy led to policies in global health that promoted the belief that private markets were the optimal agents for the distribution of social goods, including healthcare. This case-study, set in post-Soviet Tajikistan's remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine the implementation of a "revolving drug fund" program - used by numerous non-governmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities - as a vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs. Provocative, accessible, and rigorous, Blind Spot offers a cautionary tale about the forces driving decision making in health and development policy today, illustrating how the privatization of health care can have devastating outcomes for some of the world's most vulnerable populations.