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ABSTRACT
This article explores how the role of religion is evaluated in global health institutions, focusing on policy debates in the World Health Organization (WHO) and the World Bank. Drawing on Luc Boltanski and Laurent Thévenot’s pragmatist approach to justification, I suggest that religious values are creative and worldly performances. The public value of religion is established through a two-pronged justification process, combining generalizing arguments with particularizing empirical tests. To substantiate the claim that abstraction alone does not suffice to create religious values in global public health, I compare the futile attempts of the 1980s to add ‘spiritual health’ to the WHO’s mandate with the more recent creation of a ‘faith factor’ in public health. While the vague reference to some ‘Factor X’ inhibited the acceptance of spiritual health in the first case, in the second case, ‘compassion’ became a measurable and recognized religious value.
Acknowledgements
I thank Uriel Abulof, Markus Kornprobst, Rebecca Majewski and two anonymous reviewers for their helpful comments on previous versions of this paper, and Pavel Satra for research assistance.
Disclosure statement
No potential conflict of interest was reported by the author.
Notes on contributor
Tine Hanrieder is a senior researcher at the WZB Berlin Social Science Center, Research Unit Global Governance. She has published the monograph International Organization in Time (Oxford University Press, 2015) and articles on global health politics, international theory and institutional change in journals including International Theory and the European Journal of International Relations.
Notes
1. ‘Global’ health governance is usually distinguished from a presumably preceding world of ‘international’ health governance, to indicate the growing importance of non-state actors in addition to purely interstate institutions such as the WHO. In this contribution, I will use the more encompassing term ‘global health governance’ for the entire spectrum of cross-border health cooperation.
2. Other attempts to create religious health values might be found in biomedical circles, where, for example, the concept of ‘religious coping’ has gained considerable traction (see Pargament, Koenig, & Perez, Citation2000).
3. The Act allowed for welfare service delivery by faith-based organizations, and enabled them to receive government funding (Clarke, Citation2007, p. 82).
4. Evidently, the concepts of ‘public’ and ‘private’ are themselves not stable but take on different meanings in different contexts (cf. Casanova, Citation1994, pp. 40–66). In this article, I adopt an institutional perspective and consider that public values are those that are accepted in multilateral institutions.
5. See also Birnbaum (Citation2015) on techniques of making religion measurable (or ‘recognizable’) in the case of postcolonial nation-building.
6. Of course, the use of devices can also fail and they do not automatically stabilize normative agreement. To borrow from Maria Birnbaum's terminology, they help to make values ‘recognizable’ (or acceptable), yet they do not guarantee their acceptance (Birnbaum, Citation2015).
7. On the origins and substance of PHC cf. Cueto (Citation2004) and Litsios (Citation2002).
8. The proponents of the resolution were Bahrain, Botswana, Chile, Democratic Yemen, Egypt, Kenya, Kuwait, Malawi, Mauritania, Morocco, Oman, Qatar, Saudi Arabia, Somalia, Sudan, Swaziland, Syrian Arab Republic, Tunisia, United Arab Emirates, Venezuela, Yemen, and Zambia (Al Khayat, Citation1997, p. 221). Curiously, India was not a co-sponsor, but participated in the WHA debates about the draft resolution, see below.
9. Of 113 members present and voting on the decision to postpone the matter, 80 voted for, 33 against, and 12 abstained (CitationWHO ROEM, 1996, p. 274).
10. I thank an anonymous referee for raising this important question about the general prospects for a spiritual health campaign in the 1980s’ constellation.
11. See http://www.irhap.uct.ac.za/about_history.php (retrieved 27 May 2015).
12. The term ‘religious entities’ refers not only to formal religious organizations, but also to self-organized groups and, in some cases, individuals (cf. CitationARHAP, 2006, p. 43).
13. This publication complemented the WHO’s (Citation2008) World Health Report Primary health care – now more than ever (Schmid et al., Citation2008), which sought to revive the PHC concept 40 years after the Alma Ata conference.
14. Among other assets, partnerships with FBOs were, for example, conceived as means to complement government services, bring in external donor money, or tap community resources and capacities (CitationWHO, 2008, p. 19).
15. An overview of general effectiveness studies is provided in (CitationWFDD, 2012, pp. 56–64).
16. Notably, this idea of using intrinsic motivation and commitment for public tests of religious values is similar to the tests of ‘inspiration’ that Boltanski and Thévenot (Citation2006, p. 88) describe in their reflections on the inspired order of worth: Inspired actors here are those who do not strive for mundane rewards and not even ‘recognition from others’, but who pursue their ideals ‘without concern for other people's opinion’. While the preparedness to work below market wage is not the same as renouncing any social recognition, it nevertheless points to a person's source of inspiration outside established remuneration schemes. In a sense, it refers to the ‘spiritual health’ of the health providers and their above-average altruism.