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As small government and austerity campaigns continue to wreak havoc on health services worldwide, there is increasing interest in capital market instruments designed to ‘make suffering profitable.’ The aim is to recruit private investors – high-wealth individuals and institutional investors – to mitigate the funding gaps created by government drawdowns implemented since the 1970s. In rich and poor countries alike, ‘impact’ instruments are being introduced to tackle difficult health, education, and social challenges.

This talk will focus on the growth of financial instruments for health. It will present the logics of a new financial instrument for emergency pandemic response promoted by the World Bank and the World Health Organization, the colloquially named ‘Ebola Bond’. Based on multi-sited ethnographic research in global financial institutions as well as on-the-ground with mobile enumerators in Sierra Leone,  the spaker will show how serious health risk management decisions are now actively informed by investor sensibilities. Catastrophic health forecasting, re-insurance, and extreme mortality modeling are now central to the financing of pandemics.

Additionally,  it will be explained how health data plays a key role in financial payout, constituting the ‘trigger’ that either fund a response or make money for investors. Long-held notions of using data for project and program account-ability are still operative but invest-ability has become an adjuvant and decidedly more lucrative use of health data, continuing a trend first sparked in 2010 by the Gates Foundation. Analyzing these financial instruments may well assist us in assessing desirable and undesirable global health financing futures. What kind of global health financing do we want? With what kind of financing will we be complicitous in the future?

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