
































Taking Control of Your Health: Communicating Neoliberalism’s 

Pseudoscientific Claims to Health 

Review by David Fazzino

Neoliberal Health Organizing: Communication, Meaning, and Politics

by Mohan J. Dutta

Left Coast Press, 2015

In a very readable and accessible format Dutta, Provost’s Chair Professor and Head of the Department

of Communications and New Media at  the National  University of Singapore,  analyzes the various

components of neoliberal strategies in defining and delivering health care to a variety of publics. He

draws from his own experiences and recent literature to provide an indictment of neoliberal health

organizing  and  neoliberalism,  more  generally,  as  a  pseudo-science.  Dutta  (p.  87)  notes  that,

“neoliberalism is founded on a spirit of anti-evidence and information inequality while at the same time

it uses this language of evidence, accountability, and transparency to consolidate power in the hands of

transnational capital. Claims of economic growth facilitated by neoliberal policies are not borne out.”

Although written from a communications rather than an anthropological perspective, anthropologists

will  nonetheless  recognize  many  of  the  themes  from  critical  medical  anthropology  and  the

anthropology of development literature.  Neoliberal Health Organizing is suitable for use in advance

undergraduate anthropology courses and provides an excellent overview/review of many of the issues I

addressed this  past  semester  in  a  medical  anthropology course.  It  shows that  current  theorizing in

critical medical anthropology, as summarized in Singer and Baer (2012), aligns closely with the work

of other fields and hence demonstrates the value of drawing from other disciplines and working in

multi-disciplinary teams to provide critical analysis of, and appropriate responses to, the ever-extending

reach of neoliberalism.



The book has eight chapters, the majority of which directly address the current state of affairs with the

dominance  of  neoliberal  hegemony  and  the  resultant  disparities.  Dutta  begins  Chapter  1,

“Neoliberalism and Health,” by taking neoliberal discourses of “freedom” and “choice” to task for its

attempt to rest responsibility for health on individuals as consumers of health. The health as commodity

approach is yet another attempt to minimize responsibility for “externalities” of growth and production

while  maximizing profits  by creating  new desires  via  advertising,  public  relations  campaigns,  and

medicalization of “other” bodies. Dutta works to draw out the interconnections of those working to

promote dis-ease with the self in various industries, governments, and in academia. In the realm of

communication he introduces the terms he uses throughout his text:  communicative inversions, “the

deployment  of  communication  to  circulate  interpretations  that  are  reversals  of  the  material

manifestations.” (p. 12); communicative inequality “the unequal access to sites of discourse, discursive

processes, and discursive articulations.” (p. 12); and structures as “frameworks of organizing material

resources that both enable as well as constrain access to these resources. Structures of health constitute

resources such as hospitals, education, food, employment, work, and so on, that reflect the ambit of

global health inequalities.” (p. 15).

Dutta  approaches  health  in  holistic  fashion  by  considering  the  impact  of  neoliberal  ideologies  of

privatization,  individualism,  and commodification  encoded in  policies  which further  disenfranchise

people  who are  already marginalized,  in  a  variety  or  arenas  including:  land  tenure,  displacement,

worker’s rights, food systems, gender, violence, and education. Hence health is not merely about the

delivery of healthcare for Dutta,  but the sociocultural,  economic and political  environments within

which communities and individuals are situated.

Dutta  concentrates  on  specific  aspects  of  his  arguments  in  chapter  2-7.  Chapter  2,  “Development

Communication  and  Imperialism,”  examines  the  interconnections  between  development  and

imperialism. Dutta argues that proponents of development define development in opposition to the

undeveloped or those that  are lacking (technology and rationality).  For Dutta,  the existence of the

development  project,  including  its  various  projects  (including  those  of  the  body)  to  increase  the

rationality  and global  economic participation of  undeveloped countries  and persons may make the

claim to benevolence and good will, but through an imperial logic it reifies evolutionary and racist

hierarchies  wherein  those  who are  to  be  developed are  not  rational  enough to  be  involved in  the

development process. This ideology justifies unequal participation in the development process as a

matter of the supposed innate capacities of “experts” and “locals” who possess a static culture that



inhibits development (see p. 52). Dutta explains how these development ideologies play out in the

increasingly  privatized  projects  of  population  control  and  agricultural  development  wherein

“empowerment” and “participation” refer to how well community members can be mobilized to assist

in the implementation of a plan of action crafted by experts.

Chapter 3, “Foundations as Neoliberal Health Interventions,” discusses the role of foundations, such as

the Bill and Melinda Gates Foundation and the Clinton Foundation, in encouraging privatization and

“shaping the global policy agendas” thorough what Dutta refers to as “philanthrocapitalism” or the

“powerful role of capitalism in ending extreme poverty” (p. 93). Chapter 4, “Transnational Capital and

Health,” looks at the role of the State in efforts which enable privatization, including various State-

private  sector  relationships  including  state  support  for  neoliberalism  through  law  and  policy  and

explicit  public-private  partnerships.  Chapter  5,  “NGOs,  Health  Communication  and  Democracy,”

discusses the role of NGOs as sites of local dissemination of global health communication. Here, Dutta

furthers  his  arguments  of  co-optation  of  civil  society  in  order  to  advance  neoliberal  agendas  by

undercutting resistance through tropes of “community participation” and “democracy,” giving specific

examples of the USA’s democracy promotion in Chile, the World Food Program’s framing of hunger as

a  brand to  be  confronted  with  technological  solutions,  and  Avahan  HIV/AIDS campaign  in  India

focusing  on  individual  decision-making.  The  vision  of  democracy  and  democratic  participation

espoused in these settings is “deeply intertwined with the commoditization of individual subjectivity,

where the acknowledgment of the citizen is tied to his/her ability to participate in the market as a

consumer and to his/her position as a property-bearing subject” (p. 155, see also Lipsitz 2006). Larger

structural and causal considerations of environmental contamination and health impacts remain absent

from “community” concerns as articulated by NGOs associated with extractive industries which offer

development  projects  in  the  realm  of  environmental  sustainability,  health,  and  educational

programming. Dutta concludes the chapter by noting that communities and NGOs might also serve as

sites of resistance to neoliberal visions, potentially holding NGOs to greater levels of accountability at

the local level.

Chapter 6, “Health as Security: Crisis, Surveillance, and Management,” presents the neoliberal vision

of  health  as  a  series of global  security  threats  and the subsequent  militaristic  responses,  including

governance and violence, which prioritize security of the neoliberal order, including resources flows

via extractive industries, over health as a human right. Dutta notes that the violence of war renders

moot  all  of  the  promoted  individual  exercise  and  dietary  shifts,  in  so  doing  he  highlights  the



communicative inversions that take place in justifying war as a necessary intervention in maintaining

global security and well-being. Chapter 7, “Communication Technologies and Health,” reiterates much

of  Dutta’s  earlier  arguments  through  focusing  on  technological  determinism  in  the  context  of

development  of  the “primitive” towards adoption of (health)  technologies  that  would mark one as

“modern.”

In his concluding chapter, “Epilogue: Neoliberal Health and Alternatives,” Dutta offers alternatives of

neoliberal approaches to health, suggesting that global communication technologies and processes may

be utilized by a variety of actors, including those publics who are otherwise marginalized in dominant

health care delivery systems. Of particular interest he takes on the concept of culture and its utilization

in neoliberal  health  organizing,  wherein culture is  viewed as something which is  bounded, can be

discerned at a distance, and must be thought around using the multi-cultural expertise of experts in

faraway conference rooms. Culture is a barrier  to be overcome in neoliberal health organizing and

those that assumedly possess culture cannot be trusted to effectively participate in neoliberal health

organizing, rather local knowledge and peoples are neglected, dismissed as irrelevant, or obstacles to

expert  knowledge. Hence the value of coming to know communities through effective channels of

communication  is  co-opted  and  it  used  as  a  conduit  to  communicate  expert,  technological,  and

scientific knowledge in order to “educate” localized others.

Dutta uses a vignette in the concluding chapter where he highlights the creation and maintenance of

international expertise from afar, aside from this we get little on how his positioning in neoliberal

health organizing moved from one of facilitation to critique. This would have potentially elucidated the

complex  interrelationships  between  business,  government,  industry,  local  elite,  and  NGOs  further,

adding depth to  his  analysis.  Nonetheless,  Neoliberal  Health Organizing provides  a  solid  point  of

departure for critically examining the ways that health is conceptualized and acted upon through a

neoliberal  lens  resulting  in  the  commodification  of  health.  Thorough  Dutta’s  analysis  we  see  the

questionable ethical and moral ramifications of communicative inversions in the context of structures

within which neoliberal healthcare is delivered, but also the potential of enacting alternatives in the

world. As such Dutta’s work should be considered by those who feel moral indignation in the face of

slights  of  neoliberalism  and  a  sense  of  responsibility  to  act  on  these.  This  would  include

anthropologists teaching undergraduates who seek to situate the anthropological approach in relation to

a  communications  perspective  of  conveying  alternatives  to  neoliberalism.  In  this  context,  pairing

Dutta’s  Neoliberal Health Organizing: Communication, Meaning, and Politics with the literature of



critical medical anthropology and the anthropology of development would demonstrate to students a

broader,  multi-disciplinary,  critique  of  neoliberalism,  and  examples  of  how  there  are,  in  fact,

alternatives, including alternative conventions of critique.

References Cited

Lipsitz, George.

2006.  Learning  from  New  Orleans:  The  Social  Warrant  of  Hostile  Privatism  and  Competitive

Consumer  Citizenship.  Cultural  Anthropology 21(3):  451–468

http://onlinelibrary.wiley.com/doi/10.1525/can.2006.21.3.451/epdf

Singer, Merrill, and Hans Baer.

2012.  Introducing Medical  Anthropology:  A Discipline  in  Action.  Second Edition.  Lanham,  MD:

AltaMira Press.

David Fazzino, Assistant Professor of Anthropology at Bloomsburg University of Pennsylvania, is a

cultural anthropologist trained in law and agro-ecology. His research interests include environmental

anthropology,  structural violence,  intellectual property rights, food and energy policy, and medical

anthropology.

© 2016 David Fazzino


