Secrets from Whom? Following the Money in Global Health Finance

Clandestine financial dealings are at the core of new forms of philanthropic venture capitalism in global health. Worldwide, organizing principles of state-centric pastoral and clinical health care have given way to speculative, market-driven approaches to health. Because global finance is a normatively secretized social space, the increasing use of private financial instruments in health spaces previously publicly funded raises important questions about the remaking of global welfare processes, global public health incentives, and abandonments. Anthropological research shows that market value does not always link up with improved health outcomes. This article explores a related point: what are the relationships between financial secrecy and care? When the stakes are life and death, how much secret knowledge and private action is tolerable? Increasingly in global health finance, new forms of exclusion are emerging; disenfranchised people and nation-states participate in world systems but as compromised financial subjects. Asking "Who knows what?" and "What benefits whom?" opens up all manner of difference and differential stakes in well-being-financial and corporeal-and provides analytical traction on both new systems of advantage and recent intensifications of old systemic global inequalities.