Between Philanthropy and Big Business: The Rise of mHealth in the Global Health Market

ABSTRACT With more than 7 billion mobile connections in 2017, mobile phones have become the most widespread communication technology worldwide. From appointment reminders to mobile glucometers, healthcare systems are increasingly using mobile technologies to improve healthcare. These programmes, called ‘mHealth’, contribute to the present shift in international health described by many scholars as ‘global health’. The dynamics of globalization and commodification associated with global health are used to justify and encourage the spread of technical devices such as mHealth in the global South. Deployed by global players to respond to global challenges, mHealth engages strong participation by private actors. Based on the ethnography of an mHealth programme implemented in Africa and Asia, this article analyses the broader impact of mHealth initiatives on the contours of public health systems. It focuses specifically on power dynamics, philanthropic and market interests underlying the expansion of these new technical artefacts in the global South. It shows that advocates of mHealth play a major role in the commodification of health by addressing health issues as marketing cases and considering developing countries as untapped markets. It highlights how mHealth contributes to the creation of private health markets at the bottom of the pyramid in the global South that benefit the Northern digital economy.