Neoliberalism has been the defining paradigm in global health since the latter part of the twentieth century. What started as an untested and unproven theory that the creation of unfettered markets would give rise to political democracy led to policies that promoted the belief that private markets were the optimal agents for the distribution of social goods, including health care. A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan's remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a "revolving drug fund" program-used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities. Provocative, rigorous, and accessible, Blind Spot offers a cautionary tale about the forces driving decision making in health and development policy today, illustrating how the privatization of health care can have catastrophic outcomes for some of the world's most vulnerable populations.

List of Illustrations  Foreword  Paul FarmerPreface  Acknowledgments  1. Introduction: A World Transformed  Part I. The Beginning of the Encounter: The Soviet World Meets Its Global Counterparts2. Health in the Time of the USSR: A Window into the Communist Moral World  3. Seeking Help at the End of Empire: A Transnational Lifeline for Badakhshan  Part II. Life at the End of Empire: The Crisis and the Response4. The Health Crisis in Badakhshan: Sickness and Misery at the End of Empire  5. Minding the Gap? The Revolving Drug Fund  Part III. Transplanting Ideology: Village Health Meets the Global Economy6. Bretton Woods to Bamako: How Free-Market Orthodoxy Infiltrated the International Aid Movement  7. From Bamako to Badakhshan: Neoliberalism's Transplanting Mechanism  Part IV. The Aftermath: Neoliberal Success, Global Health Failure8. Privatizing Health Services: Reforming the Old World  9. Revealing the Blind Spot: Outcomes That Matter  10. Epilogue: Reframing the Moral Dimensions of Engagement  Notes  Bibliography  Index