1 Trials and tribulations of a global heath investment : the advance market commitment for pneumococcal vaccines

Interventions in global health utilizing overseas aid budgets have increasingly been characterized by a narrative of investment. This paper argues that in order to understand what makes a global health investment and its return on investment, we need detailed consideration of the financial, policy and advocacy work through which they are accomplished. Calculative devices, standards and protocols, the movement and presentation of evidence, and demonstration of specific effects, each require study. We introduce the notion of evaluative situations in this paper to explore how this array of activity is arranged in and across various times and locations in order to make a case for investment, authorize investment and deliver a return. We focus on one particular global health initiative: the advance market commitment for pneumococcal vaccine.