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Making Health and Development Policy in a Ski Resort

It seems ridiculous to discuss policies that affect the poorest members of society in a Swiss ski resort. Economic questions in Davos itself tend to revolve around whether or not Moon Boots are on sale. So why are do world leaders meet there to discuss “real” economic issues—including many relating to health and development?

The World Economic Forum’s annual meeting was held in Davos, Switzerland from the 25th to the 29th of January. Health-related highlights include:

  • The 10th Anniversary of the Global Fund to Fight AIDS, Tuberculosis and Malaria.  The Global Fund has delivered anti-retrovirals to about 3.3 million people to date and funds about 70% of HIV/AIDS medications in low and middle-income countries.  However, it is experiencing a funding crisis at the moment.  It was thus very welcome when Bill Gates expressed his continued commitment to the Fund by pledging an additional $750 million.
  • The 12th Anniversary of the GAVI Alliance.  Formally known as the Global Alliance for Vaccines and Immunisation, the GAVI Alliance is a public-private-partnership that aims to increase access to immunisations in poor countries.  As of 2010, it was estimated that the Alliance’s efforts had helped avert over five million deaths
  • A new initiative discussed this year is the matching fund.  The British have pledged to match up to £50 million pounds ($79 million) and the Bill & Melinda Gates Foundation has pledged to match up to $50 million in private-sector donations.

So why are these things discussed in Switzerland, which has the second-highest life expectancy in the OECD?

In the ethnographic classic, The Forest of Symbols, Victor Turner describes various aspects of ritual amongst the Ndembu of Zambia. Turner was also keen on Arnold van Gennep’s ideas around liminality.  In short, this is the idea that the “action” of rites of passage takes place in a setting that is outside of normal social life.  For example, during a coming-of-age rite, a person might be sequestered outside of the village whilst transitioning from a child to an adult.

And I would argue that the policy-makers in Davos are not so different than the Ndembu.  The diplomat, businessperson or leader is separated from his or her home “tribe” and sequestered in a ski resort.  He or she emerges a week later, hopefully transformed with new ideas or policies.  And policies themselves are transformed – as we saw with new funding commitments. Turner also described “communitas” which consists of the temporary relationships amongst people during this liminal, or transition phase.  The World Economic Forum (WEF) and other international fora, are dependent on interpersonal connections made in situ.

And instead of a feast, after the WEF rituals, world leaders go for fondue.

Switzerland, as a whole, is a bit of a liminal space.  It is “betwixt and between,” to use Turner’s words.  It is physically in the heart of Europe, but a place unlike any other country.  It is both neutral and an example of extreme federalism.  And when one is up in the mountains one is really outside of time and reality.   I am not justifying the cost of holding these – or other discussions, negotiations and institutions – in one of the world’s most expensive countries.  But it actually makes sense to remove key players in policy and business from their normal lives.

So, this year, raise a glass of Swiss chablais or chasselas to toast the GAVI Alliance and the Global Fund.  And then get back to work. There is still a lot to be done when it comes to improving global health outcomes.