Year: 2026
Type: article
Abstract: This paper argues that a persistent obstacle facing social analysis within global health institutions is not primarily prejudice, weak evidence, or scarce funding, but a form of paradigm incommensurability in Thomas Kuhn's sense. Kuhn's philosophy of science held that rival paradigms are not simply competing theories judged against a shared, neutral standard of evidence; each paradigm carries its own criteria for what counts as a legitimate problem, an adequate solution, and valid data, making genuine translation between paradigms difficult and, in the strongest cases, impossible. This paper extends that framework from the natural sciences, where Kuhn developed it, to the institutional setting of global health governance, arguing that the biomedical-economistic paradigm that dominates institutions such as the World Health Organization (WHO) and the socially grounded paradigm associated with Social Analysis do not merely disagree about facts; they operate with different criteria for what a fact is. Drawing on the historical rupture between comprehensive and selective primary health care, and on original institutional evidence of the WHO's architecture of vertical, disease-specific programmes, the paper shows how this incommensurability becomes structurally embedded rather than merely debated between individuals. It concludes that closing this gap requires deliberate institutional redesign, not further persuasion, since incommensurability, properly understood, cannot be resolved by evidence alone.
Author: Rakiya Mamman
Institution: National Open University
Language: English
Field: Social Sciences
Domain: Social Sciences
SDG: Reduced inequalities
Open Access status: bronze
OpenAlex ID: W7219790666