Contenu du sommaire : Santé et institutions dans les pays en développement

The market for antimalarial drugs, between regulation and failure Faced with the rise of resistance to monotherapies, the artemisinine-combination therapies (ACTs) have become the early 2000s, the golden standard in the fight against plasmodium falciparum malaria. Because of the need to substitute these therapies to older drugs and given the vastly more expensive ACTs, World Health Organization has established itself in global prescriber, enacting, on the one hand, health policy recommendations towards the endemic countries and organizing, on the other, a global supply chain. This article analyzes the disconnection that results from this model of governance, between the national and global levels and the consequences on the health status of malarious countries.

The revival of a biomedical conceptualization of malaria in international institutions We argue here that efforts against malaria are in line with a biomedical conception of the disease, which departs from the comprehensive and positive definition of health established at Alma-Ata in 1978. The use of community health workers and the use of rapid diagnostic tests illustrate this phenomenon. International institutions should consider malaria as the expression of a social, economic and environmental vulnerability rather than a parasitic infection that has to be eliminated.

Governance and AIDS in Africa: Instruments of international public action, from the example of the Global Fund This paper proposes a sociopolitical analysis of the Country Coordinating Mechanism (CCM) of the Global Fund against AIDS, Tuberculosis and Malaria (GFATM). It is based on the history of the Global Fund established in 2002 and the break which represents the emergence of the “New Funding Model” proposed by the Global Fund since 2014. From a diachronic approach (the historicity of the institutional answer to the AIDS in Africa from the intervention of the Global Fund) and synchronic (the analysis of the elaboration of the Concept Notes from countries to obtain the financing of the Global Fund), this paper aims to show the global institutional matrix within which the public action is making in Africa.

Public-private partnerships for health aid: Which conditions of effectiveness must be considered? One of the objectives of the Millennium Development Goals (MDG) adopted in 2000 is to develop public-private partnerships (PPP). In less than ten years, global partnerships have become key players in global health governance. However, to be effective, these partnerships must meet specific principles and conditions. Based on a literature review, this paper shows how ongoing thinking about the effectiveness of the PPP and the post-MDGs should check that the conditions of efficiency (identified in academic and or adopted at the institutional level) are taken into account by public-private partnerships in the health sector.

Global public-private health partnerships: spreading and embodiment of a norm of cooperation This article analyses how global health public private partnerships have been institutionalized since the 1990s. I show how the top-down formulation of a loose and imprecise norm of cooperation with businesses as part of a reform of the UN system, and its subsequent clarification with the Global Compact and the Millenium Development Goals, triggered a phase of diffusion, organized around the notion of ‘partnership', which was nonetheless vague enough to allow for various uses. Among them, I single out, define and analyze a specific institutional form, global health public-private partnerships.

Progress and Challenges for Three Major Reforms in the Chinese Health Care System Anning MA and Laurène PETITFOUR Since the early 2000s China has embarked on an ambitious and complex reform of its health system. This article focuses on three key elements of the reform process: the reform of the hospital sector and of the rural health insurance and the rebuilding of the price system of prescribed drugs in hospitals. Using case studies from Shandong province, it highlights some very positive effects of reforms while showing why they have led to an erosion of efficiency in the first level hospitals.

Private clinics in Algeria: logics of emergence and development strategies This article analyzes the context and the individual strategies which prevailed in the emergence of a private hospital sector in Algeria. It reveals that the development of the private clinics in Algeria took place in a constrained macroeconomic context and in a dysfunctional health system that have interacted with expectations and individual behaviors of the founders of these clinics. These founders have financial motivations but also objectives of professional autonomy. They combine various strategies in order to increase the number of patients, in particular the establishment of formal and informal networks.

The Chinese Trade-Union: a core institution of the wage-earning relationship The official Chinese Trade Union has gained strength during the reforms. It can now be considered as a central institution of the Chinese wage-earning relationship. As a quasi-governmental organization, it belongs to the evolutionary institutional design built by the Communist Party and must find solutions to the labour problems resulting from the reforms. Its creativity produces only organisational solutions far from achieving a real counter-movement in K. Polanyi's meaning.