Global health discourse

Is quite often

Global health nonsense

One of the most salient features of early 21st century global health discourse is that there is so much nonsense. Spin, hyperbole, meaningless buzzwords, and technocratic jargon have become common fare. Nonsense is not necessarily marked by a will to deceive. Rather, it is characterised by a “lack of a connection to a concern with truth—[an] indifference to how things really are.”1

This kind of discourse is marked by its “unclarifiable unclarity”2 and tends to be “pointless, unnecessary, or pernicious.”3 Whatever the intention behind nonsense may be, it usually underinforms or misinforms its audience, without thereby relying on lies.

Attempts to govern global health according to the goals, actors, modalities, and concepts of financialised markets are partially to blame for the spread of nonsense.4 Short term competitive funding rounds, the fetishisation of performance metrics, and a focus on returns on investment increase pressure to constantly project success.5 As a result, global health’s leading agencies routinely refer to “accelerators,” “catalysts,” and “investment cases,” emulating the hyperbolic self-praise of Silicon Valley.

Several observers have picked up on this trend and made the case for more meaningful and self-aware discourse. They provide sometimes humorous rejections of vacuous global health speak67 alongside serious reflection on the way language recapitulates and reinforces existing power hierarchies.8Nevertheless nonsense seems to be proliferating, perhaps because so many of us are implicated in producing it. Taking global public-private partnerships in the response to the covid-19 pandemic as examples, three main forms of global health nonsense are obfuscation, misrepresentation, and the omission of relevant information. We must call out nonsense because it stifles efforts to understand, critically assess, and improve global health governance.