Description
Strengthening access to medicines and vaccines has long been an important goal of global health governance. Indeed, the institutional architecture of global health is shaped by organisations that are mandated to facilitate the financing, development and distribution of medicines and vaccines, including some of the largest ones, like the Global Fund, Gavi and Pepfar, as well as a myriad of product development partnerships. But how did access to medicines and vaccines emerge as a key policy goal for global health? What created the perception that access to medicines and vaccines is a major problem to be addressed by global health governance? Existing literature has highlighted three main dynamics: disease outbreaks, notably HIV/AIDS, Ebola and Covid; the emergence of an international regime of intellectual property protection; and the perceived impact of infectious diseases on development and security. This paper contributes to this literature by taking a different analytical angle. It explores the role that technology has played in shaping the access problematique in global health. It will show how, at different times, technological advancements shaped how the problem of ‘access’ was understood and institutional responses devised. Drawing inspiration from Foucault’s concept of ‘problematisation’ as well as STS-inspired work on infrastructures, the paper examines three historical periods during which the problem of access was (re)defined on the global health agenda: the emergence of the Children’s Vaccine Initiative in the 1980s; the debates on Access and Benefit Sharing in the 2000s; and regional manufacturing in the 2020s.
