Explores informal global health action and the importance of intentions of those who volunteer In the past two decades, medical missions have gained popularity among medical professionals, who view these excursions as important ethical interventions. Indeed, the notion of giving back by volunteering in rural or impoverished communities is celebrated as an ideal act of selflessness, one whose effects are unquestionably beneficial to those being served. Good Intentions in Global Health is a groundbreaking exploration of the growing realm of informal global health engagement, shedding light on the intricate interplay between intentions, emotions, and ethical considerations. Drawing on fieldwork in Guatemala, Nicole S. Berry investigates those who volunteer for short-term medical missions, revealing how the intent to do good shapes their everyday understandings of their own actions taken in the global health domain. Berry uncovers how the glorification of medical missions can obscure problems that stem from North American clinicians doctoring in places where they typically do not understand the context. The short-term nature of missions also means that volunteers are not privy to the long-term effects of their actions—the potential harms that may arise from a lack of sustained follow-up care or the utter absence of documentation that they were even there. By relying on gut instincts to reassure themselves that they are doing good, volunteers often bypass a comprehensive assessment of the ethical dimensions underlying their global health work. Good Intentions in Global Health shows why desires and emotions are increasingly important to contemporary global health. She makes the case that we must pay attention to volunteers’ perceptions of their work, however wrongheaded or naïve, in order to truly influence global health on the ground.

"Argues that incoherent social programs significantly contribute to poverty and little growth. Proposes converting the existing social security system into universal social entitlements. Advocates eliminating wage-based social security contributions and raising consumption taxes on higher-income households to increase the rate of GDP growth, reduce inequality, and improve benefits for workers"--Provided by publisher.

A sweeping history explores why people living in resource-poor areas lack access to basic health care after billions of dollars have been invested in international-health assistance. Over the past century, hundreds of billions of dollars have been invested in programs aimed at improving health on a global scale. Given the enormous scale and complexity of these lifesaving operations, why do millions of people in low-income countries continue to live without access to basic health services, sanitation, or clean water? And why are deadly diseases like Ebola able to spread so quickly among populations? In A History of Global Health, Randall M. Packard argues that global-health initiatives have saved millions of lives but have had limited impact on the overall health of people living in underdeveloped areas, where health-care workers are poorly paid, infrastructure and basic supplies such as disposable gloves, syringes, and bandages are lacking, and little effort has been made to address the underlying social and economic determinants of ill health. Global-health campaigns have relied on the application of biomedical technologies—vaccines, insecticide-treated nets, vitamin A capsules—to attack specific health problems but have failed to invest in building lasting infrastructure for managing the ongoing health problems of local populations. Designed to be read and taught, the book offers a critical historical view, providing historians, policy makers, researchers, program managers, and students with an essential new perspective on the formation and implementation of global-health policies and practices.

This volume's contributors evaluate the accomplishments, limits, and consequences of using quantitative metrics in global health. Whether analyzing maternal mortality rates, the relationships between political goals and metrics data, or the links between health outcomes and a program's fiscal support, the contributors question the ability of metrics to solve global health problems. They capture a moment when global health scholars and practitioners must evaluate the potential effectiveness and pitfalls of different metrics—even as they remain elusive and problematic. Contributors. Vincanne Adams, Susan Erikson, Molly Hales, Pierre Minn, Adeola Oni-Orisan, Carolyn Smith-Morris, Marlee Tichenor, Lily Walkover, Claire L. Wendland

A revolutionary approach to poverty that takes human irrationality into account-and unlocks the mystery of making philanthropic spending really work. American individuals and institutions spent billions of dollars to ease global poverty and accomplished almost nothing. At last we have a realistic way forward. Presenting innovative and successful development interventions around the globe, Dean Karlan and Jacob Appel show how empirical analysis coupled with the latest thinking in behavioral economics can make a profound difference. From Kenya, where teenagers reduced their risk of contracting AIDS by having more unprotected sex with partners their own age, to Mexico, where giving kids a one-dollar deworming pill boosted school attendance better than paying their families to send them, More Than Good Intentions reveals how to invest those billions far more effectively and begin transforming the well-being of the world.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Overseas volunteering has exploded in numbers and interest in the last couple of decades. Every year, hundreds of thousands of people travel from wealthier to poorer countries to participate in short-term volunteer programs focused on health services. Churches, universities, nonprofit service organizations, profit-making "voluntourism" companies, hospitals, and large corporations all sponsor brief missions. Hoping to Help is the first book to offer a comprehensive assessment of global health volunteering, based on research into how it currently operates, its benefits and drawbacks, and how it might be organized to contribute most effectively. Given the enormous human and economic investment in these activities, it is essential to know more about them and to understand the advantages and disadvantages for host communities. Most people assume that poor communities benefit from the goodwill and skills of the volunteers. Volunteer trips are widely advertised as a means to "give back" and "make a difference." In contrast, some claim that health volunteering is a new form of colonialism, designed to benefit the volunteers more than the host communities. Others focus on unethical practices and potential harm to the presumed "beneficiaries." Judith N. Lasker evaluates these opposing positions and relies on extensive research—interviews with host country staff members, sponsor organization leaders, and volunteers, a national survey of sponsors, and participant observation—to identify best and worst practices. She adds to the debate a focus on the benefits to the sponsoring organizations, benefits that can contribute to practices that are inconsistent with what host country staff identify as most likely to be useful for them and even with what may enhance the experience for volunteers. Hoping to Help illuminates the activities and goals of sponsoring organizations and compares dominant practices to the preferences of host country staff and to nine principles for most effective volunteer trips.

Over the past fifteen years, people in low- and middle-income countries have experienced a health revolution—one that has created new opportunities and brought new challenges. It is a revolution that keeps mothers and babies alive, helps children grow, and enables adults to thrive. Millions Saved: New Cases of Proven Success in Global Health chronicles the global health revolution from the ground up, showcasing twenty-two local, national, and regional health programs that have been part of this global change. The book profiles eighteen remarkable cases in which large-scale efforts to improve health in low- and middle-income countries succeeded, and four examples of promising interventions that fell short of their health targets when scaled-up in real world conditions. Each case demonstrates how much effort—and sometimes luck—is required to fight illness and sustain good health. The cases are grouped into four main categories, reflecting the diversity of strategies to improve population health in low-and middle-income countries: rolling out medicines and technologies; expanding access to health services; targeting cash transfers to improve health; and promoting population-wide behavior change to decrease risk. The programs covered also come from various regions around the world: seven from sub-Saharan Africa, six from Latin America and the Caribbean, five from East and Southeast Asia, and four from South Asia.

From the New York Times–bestselling author Stephen M. Walt, The Hell of Good Intentions dissects the faults and foibles of recent American foreign policy—explaining why it has been plagued by disasters like the “forever wars” in Iraq and Afghanistan and outlining what can be done to fix it. In 1992, the United States stood at the pinnacle of world power and Americans were confident that a new era of peace and prosperity was at hand. Twenty-five years later, those hopes have been dashed. Relations with Russia and China have soured, the European Union is wobbling, nationalism and populism are on the rise, and the United States is stuck in costly and pointless wars that have squandered trillions of dollars and undermined its influence around the world. The root of this dismal record, Walt argues, is the American foreign policy establishment’s stubborn commitment to a strategy of “liberal hegemony.” Since the end of the Cold War, Republicans and Democrats alike have tried to use U.S. power to spread democracy, open markets, and other liberal values into every nook and cranny of the planet. This strategy was doomed to fail, but its proponents in the foreign policy elite were never held accountable and kept repeating the same mistakes. Donald Trump won the presidency promising to end the misguided policies of the foreign policy “Blob” and to pursue a wiser approach. But his erratic and impulsive style of governing, combined with a deeply flawed understanding of world politics, are making a bad situation worse. The best alternative, Walt argues, is a return to the realist strategy of “offshore balancing,” which eschews regime change, nation-building, and other forms of global social engineering. The American people would surely welcome a more restrained foreign policy, one that allowed greater attention to problems here at home. This long-overdue shift will require abandoning the futile quest for liberal hegemony and building a foreign policy establishment with a more realistic view of American power. Clear-eyed, candid, and elegantly written, Stephen M. Walt’s The Hell of Good Intentions offers both a compelling diagnosis of America’s recent foreign policy follies and a proven formula for renewed success.

Neoliberalism has been the defining paradigm in global health since 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 that promoted the belief that private markets were the optimal agents for the distribution of social goods, including health care. A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan’s remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a “revolving drug fund” program—used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities. Provocative, rigorous, and accessible, 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 catastrophic outcomes for some of the world’s most vulnerable populations.