Over the past two decades, global health has undergone a profound transformation. As public funding for international health and development has become increasingly unpredictable, private philanthropy has largely stepped in to fund global programmes.

It is well known that large foundations, such as the Gates Foundation, Bloomberg Philanthropies, or the Chan Zuckerberg Initiative, to list a few, now largely contribute to the budgets of the World Health Organization (WHO), a number of public-private partnerships, or initiate private initiatives.

What is less visible though is the way philanthropic organisations are increasingly producing the data, research, and knowledge infrastructures through which global health problems are known, prioritised and eventually governed. This shift is often presented as pragmatic, in the face of constrained budgets and an urgent global health crisis. Yet the expanding epistemic presence of philanthropic actors in global health is interrogating, when it shapes the very frameworks though which health issues are understood.

When philanthropic foundations produce global health data

Philanthropic foundations have, in recent years, widely invested in the production of metrics on the “burden” of specific health conditions and the “costs” and “returns” of given health interventions.

These metrics, while necessary, do not only describe reality, but define what counts as a health problem and what kinds of interventions are deemed valuable.

In 2007, the Gates Foundation (formerly known as the Bill & Melinda Gates Foundation) created the Institute of Health Metrics and Evaluation (IHME) to provide “timely, relevant, and scientifically valid evidence to improve health policy and practice” (IHME........

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