In the 1970s, the WHO embarked on an ambitious project to promote primary health care worldwide. The Expanded Programme on Immunization (EPI) was one of the most successful parts of that effort, yet some national EPIs struggled to increase vaccination coverage while others were very successful. Drawing on documentary sources from the WHO Archives and Library, this paper traces the historical development of global EPI policy and compares the development of two programs: the high-performing EPI in Malawi and the low-performing one in Cameroon. Global advisers’ rigid adherence to then-current global policy and blindness to local conditions and historical legacies exacerbated problems faced by Cameroon's EPI, helping explain that program's weakness. In Malawi, in contrast, the similarity of global policy and local practices helped strengthen the EPI. Greater flexibility in pursuing program goals and attention to historical legacies could help future programs avoid similar counterproductive dynamics.

Throughout the 2000s, donor organizations successfully argued for the inclusion of men who have sex with men (msm) in the global response to HIV/AIDS. These efforts have had unintended consequences for msm and lesbian, gay, bisexual, and transgender (lgbt) populations in sub-Saharan Africa. Focusing on Malawi and Senegal, we find that donors’ emphasis on msm provided new urgency and sources of support for nascent lgbt- and msm-identified groups to organize around sexual identities and disseminate prevention strategies to their communities. These interventions increased the visibility of msm and lgbt populations in both countries; however, this new visibility also positioned msm and lgbt organizations between Western donors and political elites, contributing to political backlash against lgbt Malawians and Senegalese by the late 2000s. Further, while some msm- and lgbt-identified organizations in Malawi and Senegal ultimately expanded their activism to include lgbt rights, other HIV organizations working with msm to gain access to new donor funding did not advocate for the rights of lgbt populations. We discuss the implications of these processes for development initiatives and argue for a more expansive definition of health in HIV and development work to address a broader set of community concerns.

Sociologists have much to contribute to the study of global health and development. Our discipline's fundamental concerns with power and inequality uniquely position us to leverage theoretical, conceptual, substantive, and empirical insights for the understanding of engines, outcomes, and processes of global health and development. This special issue highlights the diversity and depth of sociological engagements with the topics of global health and development. In this introduction to this special issue, I briefly outline how sociologists have approached the study of global health and development despite the fact that this is a nascent and not yet fully coalesced field. While medical sociologists and political sociologists have historically studied these topics, they have also marginalized them. Exciting sociological research is, however, underway. The challenge is in ensuring that scholarship on global health and development is in conversation across subfields in order to propel research on global health and development forward, both substantively and theoretically.

Over the past two decades, a sociology of global health has emerged. While this new subfield takes up some themes and issues that are familiar to the discipline as a whole—among them organizations, social movements, and the social construction of illness—it has also posed new questions and opened new research pathways by formulating and testing theory in environments radically different from the United States. This work has forced sociologists to confront the ethnocentrism of research paradigms that are grounded in the American experience and to consider classical assumptions and constructs in fruitful new ways. Notable recent literature reviews have taken up the issue of HIV/AIDS in sub-Saharan Africa, comparative healthcare systems, and the sociology of development. However, this review is the first to outline the contours of a coherent sociology of global health. It addresses several questions: What issues are being taken up in this emergent subfield? What added value comes from turning scholarly attention beyond our borders? And what new research agendas lie on the horizon?