Jean-Paul Gaudillière: from international public health to global health

The research of Jean-Paul Gaudillière, head of the Center for research in medicine, science, mental health , and society (CERMES 3, Villejuif), concerns the globalization of health. He received an Advanced Grant from the European Research Council (ERC) to study this historical transformation.

How did your research project come about?

Jean-Paul Gaudilliere

Having initially trained in agricultural engineering and biochemistry, personal interest led me to the history of science and medicine. For a long time, I researched the development of biology and its interactions with clinical practice and medical research in postwar decades. Then I became interested in the question of medicines and pharmaceutical industry practices over the same period. For this work on the pharmaceutical industry, we developed a European network supported by the European Science Foundation. When the project came to an end, one way of sustaining the collaborations was to focus on the position of drug therapies in the regime of international public health, which has since become a regime of global health. So, I took the Globhealth project to the ERC, which agreed to fund it in 2013.

What does “global health” mean?

This expression encapsulates a major transition occurring between the end of the 1980s and the beginning of the 2000s in which  the health policy players, intervention targets, and tools have all changed. We’ve gone from policies to eradicate infectious diseases, led by the nation-states and WHO, to a regime that privileges market-driven regulations, public-private alliances, risk management, and chronic diseases.

How did you approach such a subject?

We chose to explore it from five fundamental angles. The first is the emergence of new players (the World Bank, which has become the primary investor in public health, the Gates foundation, etc.). The second is that, unlike the developed countries, the southern countries have not seen a shift from infectious diseases to chronic diseases but rather that both types are now rife. The third is the impact of the increased use of medicines. The fourth is the increasing space occupied by performance evaluation in health care strategies, and finally the fifth concerns the generalization of the paradigm of risk and risk assessment.

It’s certainly a vast subject!

Well, we've narrowed it down to four areas of investigation, which correspond to four globalization processes. One is the re-emergence of tuberculosis that began in the 1990s and which is being addressed in a standardized way worldwide. The second is the integration of traditional medicines from Asia (China and India), in which we’re seeing the emergence of a series of new localized markets. The third is the emergence of mental health and the fourth is the introduction of medical genetics. For all these subjects, we’ve chosen to focus on East Africa and Asia.

Tell us about your team

The team consists of historians and anthropologists. This means we can bridge a chronological "gap", since the historians are primarily interested in the pre-globalization period and the anthropologists focus on the present. They are also working at different levels: while the historians study international organizations, the anthropologists investigate the dynamics of local interventions (at such-and-such a hospital in such-and-such an African country, for example). Between analyzing the archives and the field work, a coherent whole is formed.

This project is funded until 2019. What do you think your next step will be?

Personally, I don’t intend to start any other major projects before I retire: there is already a lot to be done with the results from this one! However, one of the benefits of ERC funding is to have enabled the creation of a network of young researchers who will continue to work on global health, a subject which in continental Europe has received little attention to date, unlike in the US and UK.

Find out more about Jean-Paul Gaudillière and his research

Jean-Paul Gaudillière leads the Center for research in medicine, science, mental health, and society Centre de recherche médecine sciences santé mentale et société (Inserm unit 988/CNRS/EHESS, Villejuif) and the Globhealth project: “From International to Global: Knowledge, Diseases and the Postwar Government of Health.” He is also a member of Inserm’s History Committee.