Date of Award
Doctor of Philosophy (PhD)
The practice of medicine has become the prescribing of medicine. Reflecting a construct of health defined by Rationalism, individualism, and biomedical science, medicines (pharmaceuticals) are politically constructed to be the first – and sometimes only prescribed – line of defense against illness and disease. Pharmaceuticals also represent a highly desirable, ‘recession-proof’ component of many Nation-states’ (states’) export strategies, helping advanced economies, in particular, to maintain favorable trade balances and economic growth amidst the headwinds of deindustrialization.
Higher use and the overreliance on pharmaceuticals promote an outsized role for certain actors and ideas in the making of global health, referring to the systems of medical practice, the norms defining health subconsciously and consciously, the politico-economic relations and decisions that prioritize certain qualities and determinants of health, and interventions relating to health. Concentrations of power deepened under globalization, reinforcing and internationalizing specific, hegemonic ideas about health that reflect the ideas and interests of dominant actors. These dynamics further privilege certain actors and ideas in political and economic processes, which have the practical effect of predetermining outcomes. In this way, power sustains the global normative and politico-economic conditions that comprise modern health—power makes health.
This dissertation employs pharmaceuticals as a proxy to examine power asymmetries and market-oriented norms relating to health. The research examines the formative ideas and structuring role of power on the political salience, interests, values, and choices of the leading actors in global health. Rather than an exclusive focus on health’s visible outcomes, the research distinguishes the influence of power asymmetries expressed through norm formation and spread. It finds that health is a core issue of the 21st century global political economy and equitable scholarly focus and practical solutioning must be applied to the ideas, contexts, content, and processes that make health.
Winiarek, Claire W..
"The Politics of Medicine: Power, Actors, and Ideas in the Making of Health"
(2021). Doctor of Philosophy (PhD), Dissertation, , Old Dominion University, DOI: 10.25777/d1d5-6735