Constructing Success: The World Bank, Onchocerciasis Control, and What Lies Beneath Triumphalist Global Health Narratives

Journal article

Using a historical case study of the World Bank and World Health Organization (WHO)'s Onchocerciasis Control Programme (OCP, 1972-2002), I explore how success is conceptualised in global health and why it matters for policy and priority-setting. First, I summarise the 'dominant' OCP success narrative that has emerged since the 1980s, which is based on public health, socio-economic and humanitarian justifications for the programme's effectiveness. Next, I analyse how socio-economic metrics linking the programme's disease control to increased labour productivity and agricultural land availability evolved in the 1980-90s. This alternative analysis of the OCP demonstrates how metrics, particularly when divorced from their assumptions and political context, are pliable and constructible. I argue that the OCP's success was actively constructed by the World Bank and that moving beyond triumphalist, programme-level 'lessons-learned' approaches within global health requires disruption of the epistemic, institutional and discursive power that 'lies beneath' success narratives.

Authors: Winters, J

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: Social History of Medicine
• Volume: 38
• Issue: 3
• Pages: 547-575
• Publication date: 2025-03-01
• DOI: 10.1093/shm/hkae064
• EISSN: 1477-4666
• ISSN: 0951631X, 0951-631X
• Pmid: 41079891
• Language: English
• Keywords: Global Health History; Constructivism; World Bank; Onchocerciasis Control; Metrics Production