Epidemiological Accountability: Philanthropists, Global Health and the Audit of Saving Lives

There has been concern about the recent private turn and re-emergence of philanthropies in world health, with many worrying about these philanthropies’ perceived lack of transparency and accountability. In contrast, I argue that while the private turn might have led to a decline in democratic or public accountability, it did not bring an end to all forms of accountability. Specifically, I suggest philanthropists’ involvement in global health has led to the spread of another, new form of accountability: epidemiological accountability. The latter is a combination of two regimes of expertise and practices hitherto kept separate: audit and epidemiology. To substantiate this argument, I draw on my research on the Bloomberg Initiative – a global effort to reduce tobacco use spearheaded by the Bloomberg and Gates foundations.