Middlemen in Global Health: Markets, Hospitals and Consultancies in North India

Middlemen are essential to various transactions that happen in the delivery of public health globally. They inform the ways in which regulations are played out at micro levels, making pertinent ethical and political choices in the systems of health delivery. Despite being fundamental to the workings of commercial life of health delivery globally, the role of middlemen do not have professional designations, are under-determined and not much scholarly attention is paid to how they work on ground. I will examine through a 5-year multi-sited ethnographic research project how middlemen make possible the workings of everyday systems of public health delivery in India through an ethnography of markets and marketplaces. This project on middlemen will unravel various notions about quality, risk, standards and security that exist in the global health markets and that these emerge from an implicit understanding of work systems that are prevalent in different parts of the world. Fundamentally, I will examine, what does a story about middlemen in global health tell us about the shifts from commercialization to financialization of global health and how on ground incremental risks are being lumped up in global financial markets in favor of larger players in global health.