Medicine and public health have played important roles in imperialism. With the emergence of the United States as an imperial power in the early twentieth century, interlinkages between imperialism, public health, and health institutions were forged through several key mediating institutions. Philanthropic organizations sought to use public health initiatives to address several challenges faced by expanding capitalist enterprises: labor productivity, safety for investors and managers, and the costs of care. From modest origins, international financial institutions and trade agreements eventually morphed into a massive structure of trade rules that have exerted profound effects on public health and health services worldwide. International health organizations have collaborated with corporate interests to protect commerce and trade. In this article we clarify the connections among these mediating institutions and imperialism.
Although medicine and public health have played important roles in the growth and maintenance of the capitalist system, conditions during the twenty-first century have changed to such an extent that a vision of a world without an imperial order has become part of an imaginable future. Throughout the world, diverse struggles against the logic of capital and privatization illustrate the challenges of popular mobilization. In addition to these struggles, groups in several countries have moved to create alternative models of public health and health services. These efforts—especially in Latin America—have moved beyond the historical patterns fostered by capitalism and imperialism…. All the struggles that we describe remain in a process of dialectic change and have continued to transform toward more favorable or less favorable conditions. However, the accounts show a common resistance to the logic of capital and a common goal of public health systems grounded in solidarity, not profitability.
In December 1999, Archbishop Desmond Tutu, Nobel Peace Prize winner from South Africa, gave the keynote address for an important conference in Miami Beach: the International Summit of Managed Care. The price for attending this conference, excluding travel, room, and meals, was $1395. The conference was sponsored by the American Association of Health Plans and the Academy for International Health Studies, and was targeted at “chief executive officers, presidents, board chairs, chief financial officers, directors of marketing, and business development officers.” In addition to Tutu, ostensibly progressive participants at the meeting included former Congressman Ron Dellums, whose legislative efforts for a U.S. national health service have inspired health activists since the mid-1970s. Dellums took part in his new role as president of Healthcare International Management