In this paper, we draw upon and build on three presentations which were part of the plenary session on ‘Structural Drivers of Health Inequities’ at the National Conference on Health Inequities in India: Transformative Research for Action, organised by the Achutha Menon Centre for Health Science Studies in Trivandrum, India. The three presentations discussed the influential role played by globalisation and neoliberalism in shaping economic, social and political relationships across developed and developing countries. The paper further argues that the twin process of globalisation and liberalisation have been important drivers of health inequities. The first segment of the paper attempts a broader conceptualisation of neoliberalism beyond the economic realm. Using Stephanie Lee Mudge’s conceptualisation (Soc Econ Rev 6:703–3, 2008) we have analysed how the political, bureaucratic and intellectual domains of neoliberalism have intersected and redefined the role of state and commercialised health services leading to inequities. Neoliberal ideas have reconfigured the role and changed the priorities of non-governmental organisations resulting in a fracture within this movement. n the second segment, we focus on the rise of American philanthro-capitalism, and how the two major foundations, the Rockefeller Foundation (early twentieth century) and the Bill and Melinda Gates Foundation (twenty-first century), have shaped the ideology of institutions engaged in international health and influenced the global health agenda. We discuss how the activities of philanthro-capitalists have transformed the architecture of health governance through their top-down organisational culture and deficit of structures to ensure accountability. The third and final segment of the paper focuses on how neoliberalism as a political project and cultural movement has forged alliances with conservative politics and religious fundamentalisms, resulting in negative consequences for women and other marginalised groups. These alliances have resulted in the control of women’s bodies and contributed to the reversal of hard-won rights for health and gender justice in many parts of the world.
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机译：在本文中，我们借鉴并借鉴了三个演讲，这些演讲是由Achutha Menon卫生中心组织的印度全国卫生不平等问题全国会议：“卫生不平等的结构驱动因素”全体会议的一部分：行动的变革性研究印度特里凡得琅的科学研究。这三场演讲讨论了全球化和新自由主义在塑造发达国家和发展中国家之间的经济，社会和政治关系方面所起的重要作用。该论文进一步指出，全球化和自由化的双重过程是造成健康不平等的重要驱动力。本文的第一部分试图在经济领域之外对新自由主义进行更广泛的概念化。使用斯蒂芬妮·李·马奇（Stephanie Lee Mudge）的概念化方法（Soc Econ Rev 6：703–3，2008年），我们分析了新自由主义的政治，官僚和知识领域如何相交并重新定义了导致不平等的国家和商业化医疗服务的作用。新自由主义的思想改变了角色，改变了非政府组织的工作重点，导致这一运动破裂。在第二部分中，我们关注美国慈善资本主义的兴起，以及洛克菲勒基金会（二十世纪初）和比尔和梅琳达·盖茨基金会（二十一世纪）这两个主要基金会如何塑造了从事国际卫生并影响全球卫生议程的机构。我们讨论了富裕资本家的活动如何通过其自上而下的组织文化和结构不足以确保问责制改变了卫生治理架构。本文的第三部分也是最后一部分将重点放在作为政治计划和文化运动的新自由主义如何与保守的政治和宗教原教旨主义结成联盟，从而给妇女和其他边缘化群体带来负面影响上。这些联盟导致了对女性身体的控制，并为世界许多地方逆转了来之不易的健康和性别正义权利。
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