Paper short abstract:

This paper examines how Bolivian policy actors are striving to forge alternatives to global, neoliberal models of health and development. Tracing practices of collaboration, negotiation, and debate, it explores how Bolivians both challenge and reproduce dominant configurations of “global health.”

Paper long abstract:

Recent, state-led efforts to overhaul the healthcare system in Bolivia explicitly reject dominant, global models of health and development. Policies like the 2008 Family, Community, and Intercultural Healthcare law propose a socialized healthcare system that relies on the active participation of indigenous and labor movements. For policymakers, this new law presents a vital shift away from the neoliberal politics of care that characterize international development projects. Yet, due to resource shortages, Bolivian policymakers often end up forging pragmatic alliances with transnational institutions to implement this policy. They engage in a delicate balancing act, invoking the state's project of "de-neoliberalization" while also utilizing the resources and discourses of global health. This paper examines the tensions and collaborations that emerge as Bolivian policymakers, healthcare workers, and NGO officials strive to make health policy work in a rural municipality. How do these various groups draw on national and transnational discourses to make policy implementable? How do their practices both challenge and re-inscribe dominant configurations of "global health"?