The second regime is the forms of knowledge and techniques associated with modern epidemiology. A collection of reporting routines, performance indicators, accounting firms and management experts, these cultures were progressively articulated in the twentieth century to govern commercial life before being redeployed to administer public life under the banner of New Public Management (Power, 1997 Shore & Wright, 2015). The first is contemporary cultures of audit. This new form of accountability is the result of the coming together of two regimes of expertise and practices that were hitherto kept separate. Specifically, the paper suggests that the growing involvement of philanthropists in global health has led to the emergence and spread of another, new form of accountability, which I term epidemiological accountability. 18, 157) call ‘democratic’ or ‘public accountability’, it would be a mistake to think that it has brought an end to all forms of accountability. It argues that while the re-emergence of foundations in world health might well have led to a decline in what Rushton and his colleagues ( 2011, pp. These critiques also stress how private foundations not only make little effort to engage in dialogue with experts and the public but actually actively discourage debate by promoting uncritical groupthink among global health specialists and officials. It also begs the question of what interests are being pursued by this small group of people, many of whom come from the pharmaceutical industry. This, they argue, is problematic given the growing power of foundations in global health. They point out how decisions about what should be funded and why are made by a small, restricted group of people behind closed doors. One particularly important concern for these critiques has been private foundations’ perceived lack of transparency and accountability. Others have been less sympathetic, levelling a range of critiques against the newcomers (e.g.
Bishop & Green, 2008 Moran & Stevenson, 2013). Many commentators have welcomed the arrival of these new actors, arguing that they bring with them much needed additional funding, a dynamic entrepreneurial spirit and innovative approaches from the business world (e.g. The shift from international to global health at the turn of the twenty-first century has been characterized by a private turn and the re-emergence of philanthropic foundations as major actors in world health, a trend symbolized by the Gates Foundation (Brown et al., 2006 Reubi, 2016a Rushton & Williams, 2011).
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