Accountability in global health systems

Beginning in 1996, Purdue Pharmaceuticals (Purdue) knowingly mislabeled and mass marketed OxyContin (oxycodone), an opioid painkiller, catalyzing the opioid crisis which has been responsible for more than 600 000 deaths in and beyond North America. This case is an extreme example of how transnational pharmaceutical companies prioritize shareholder profits over public wellbeing. As such, the field of global health faces the critical challenge of better understanding how transnational pharmaceutical companies, like Purdue, can be held to account for the harms they cause. Within the framework of Actor-Network Theory, a sociomaterial approach to analyzing complex networks, this case study uses key informant interviews (n = 18) to examine how accountability is taken up in and by global health systems in response to the harms caused by Purdue. Findings highlight the multiple co-existing versions of accountability enacted within global health systems organized as three separate but interrelated networks: social accountability, political accountability, and legal accountability. Though often interconnected, these diverse networks mobilized distinct tools, resources, and strategies, such as news articles, scholarly literature, and policy guidelines, to construct and stabilize enactments of accountability. Through this in-depth examination of the complex interactions involved in global health and pharmaceutical systems, this study offers a nuanced understanding of the diverse actors mobilized and the unique strengths leveraged within and by accountability networks. Further, in examining these networks' differences, interconnectedness, and peculiarities, we broaden the scope of how accountability is defined, conceptualized, and operationalized in global health systems

Accountability · Epistemology · Global health · Health services research · Operationalization · Political science · Public health · Public relations · Sociology · Law · Medicine · Opioid Use Disorder Treatment · Pharmaceutical Economics and Policy · Pharmaceutical industry and healthcare · Health Policy

• Holding Power to Account

  Open Access•Richard Mulgan•Holding Power to Account•2003

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• Responding to the opioid crisis in North America and beyond

  Open Access•Keith Humphreys, Chelsea L Shover et al.•The Lancet•2022

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• Widgets or Watchdogs?

  Anuradha Joshi, Peter P Houtzager•Public Management Review•2012

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• Global Accountabilities

  Open Access•Ngaire Woods, Randall Germain et al.•Global Accountabilities•2007

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• Laboratory Life

  Bruno Latour, Steve WooIgar et al.•Laboratory Life•2013

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• A concept in flux

  Open Access•Carlos Bruen, Ruairi Brugha et al.•Globalization and Health•2014

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• Defining the global health system and systematically mapping its network of actors

  Open Access•Steven J Hoffman, Clarke B Cole•Globalization and Health•2018

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• Reassembling the Social

  Bruno Latour•REASSEMBLING THE SOCIAL: AN…•2005

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• The Zimbabwe Bush Pump

  Open Access•Marianne De Laet, A Mol•Social Studies of Science•2000

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• Social Accountability

  Open Access•Jonathan Fox, Jonathan A Fox•World Development•2015

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• The Promotion and Marketing of OxyContin

  Art Van Zee•American Journal of Public Health•2009

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• The Body Multiple

  A Mol, Barbara Herrnstein Smith et al.•The Body Multiple•2002

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