As in the days of the “robber barons,” today’s North American philanthro-capitalists have enormous influence over the global health agenda, convinced that a businesslike approach can resolve social problems more effectively than government or civil society, said Anne-Emanuelle Birn, Sc.D., professor and Canada Research Chair in International Health at the University of Toronto. Speaking to this year’s Downs Fellows in March, Birn said that philanthropic work has often promoted short-term, narrowly technical approaches that favored donor interests over local needs. A costly Rockefeller Foundation campaign to eradicate yellow fever in Mexico in the early 1920s, she said, was of minor local importance but eliminated a public health threat to ports in the United States.
Birn argued that global health efforts should not be separated from addressing poverty and social injustice. For example, in Sri Lanka, Cuba, and Costa Rica, maternal and child health improvements have been coupled with women’s empowerment, fair-wage movements, universal education, and other elements of a welfare state. “There is a reality that the philanthrocapitalists reject,” she said, “that health, well-being, and social justice are inextricably integrated.”