Unequal ‘Partners’. AIDS, Academia, and the Rise of Global Health

The last decade has seen the proliferation of “global health” departments, centers, programs, and majors across top research universities in North America and Europe. This trend has been particularly pronounced in the United States, where it is connected to America′s new role as a major sponsor of HIV treatment in Africa. This paper describes the rise of “global health” as a research, funding, and training priority within U.S. academic medicine, and the increasing desirability of “global health partnerships” with institutions in sub-Saharan Africa. Leading spokespersons emphasize that “partnership” with poor nations is central to the mission of global health, an ethic that distinguishes it from older, more paternalistic traditions of international health and tropical medicine. However, at the same time, the field of academic global health depends on steep inequalities for its very existence, as it is the opportunity to work in impoverished, low-tech settings with high disease burdens that draws North American researchers and clinicians to global health programs and ensures their continued funding. This paradox – in which inequality is both a form of suffering to be redressed and a professional, knowledge-generating, opportunity to be exploited – makes the partnerships to which global health aspires particularly challenging.