James Pfeiffer Mark Nichter for the Critical Anthropology of Global Health Special Interest Group What Can Critical Medical Anthropology Contribute to Global Health? A Health Systems Perspective The flow of international aid from wealthier to poorer countries has increased dramatically over the last decade. This is attributable in part to the efforts of health activists, including medical anthropologists, who have rendered bare the realities of health disparities and human suffering. We are now facing an unprece- dented moment in the history of global health, in which infectious diseases such as HIV/AIDS, malaria, and tuberculosis are no longer peripheral concerns but primary targets of bilateral aid programs, philanthropy, and research. Emergent health prob- lems range from antibiotic resistance to tobacco use to SARS and avian flu to the flow of health professionals from developing to developed countries. These prob- lems demand global solutions, challenge the internal sovereignty of nation states, and involve new sets of actors, networks, partnerships, and transnational health initiatives. There have been dramatic increases in funding from the U.S. President’s Emer- gency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Gates Foundation; the Doris Duke Charitable Foundation; the Clinton Foundation; and myriad other philanthropies dedicated to health problems in the developing world, transforming the way in which high-priority health prob- lems are being addressed, in what has been termed the politics of the possible. As engaged medical anthropologists, we have fought to keep the health and health care problems of the world’s poor on the radar screen of wealthier nations by calling attention to issues involving both social justice and enlightened self-interest in the face of these mounting crises. We celebrate the recent emphasis on funding global health initiatives, yet at the same time we remain alert to major concerns related to governance, oversight, and the impact of high-profile public health efforts on state health care systems. As social scientists, we are sensitive to deepening divisions in the global health community over the way forward, in addition to the manner in which injecting massive resources into vertical health interventions deflects attention away from the management of other health problems. We are also sensitive to recent trends that threaten to undermine the remarkable potential of this historic moment. We are concerned by reports of wasteful spending, poor planning, and uncoordinated 410 MEDICAL ANTHROPOLOGY QUARTERLY, Vol. 22, Issue 4, pp. 410–415, ISSN 0745- 5194, online ISSN 1548-1387. C  2008 by the American Anthropological Association. All rights reserved. DOI: 10.1111/j.1548-1387.2008.00041.x