Abstract
Without much attention to local context, global health policy experiments are being conducted on vulnerable indigenous populations. This article details the history of a development-bank-funded experiment to contract out public health services in Cambodia's north-eastern province of Ratanakiri. The case study highlights the difficulties that flow from improper planning and implementation, as well as the distorting effects that narrowly defined contract performance measures can have on the health of the population as a whole. Progress in global health will not be possible if local context and voices continue to be underappreciated.