Bullshit Bingo

Not all global health buzzwords are empty - but some were designed to be

Artwork by Canva

Global health policy language has become fluent, even elegant. Declarations read smoothly. Commitments sound earnest. The vocabulary is familiar enough that seasoned readers can anticipate entire paragraphs before reaching the end of the sentence. This has given rise to the reflexive game of “bullshit bingo,” also called “buzzword bingo”, where the appearance of words like integration, resilience, or equity is taken as evidence that nothing of consequence will follow.

That instinct is understandable, but it is incomplete. Not all ambiguous language is empty, and not all buzzwords are bullshit. In health diplomacy, ambiguity can be both, a tool of progress or a shield against it. The difference matters.

Diplomatic language evolves under constraint. Multilateral agreements must survive veto players, asymmetric power, and incompatible interests. Precision forces decisions; decisions create losers; losers block consensus. As a result, policy language is selected not for clarity, but for elasticity. Words survive because they can be read in more than one way. They carry double meaning: one that reassures in public, and one that stabilises the system in practice.

This is where many readers lose patience. Double meaning feels evasive. Yet without it, many agreements would never exist at all. Ambiguity, in this sense, is not a bug. It is infrastructure.

The problem begins when ambiguity stops being a bridge and becomes a destination. Consider this sentence:

“We commit to strengthening integrated, people-centred health systems through whole-of-society partnerships to ensure equitable and sustainable outcomes for all.“

This is a classic bullshit-bingo sentence. It sounds impressive, but it does no work. There is no implied decision, no narrowing of options, no hint that any actor will have to behave differently tomorrow. Every word is positive; none are constraining. The sentence cannot fail, because it cannot be tested.

Now compare it with a superficially similar sentence:

“We commit to integrating prevention services into primary health care by revising national benefit packages and aligning financing mechanisms accordingly, beginning with pilot implementation in selected districts.“

The vocabulary overlaps. Integration is still there. So is commitment. But the sentence now points somewhere. It implies disruption. Someone will have to revise a benefit package. Budgets will have to move. The ambiguity has not disappeared completely, but it has been put on a leash. The double meaning is temporary. The difference is not tone. It is consequence.

The same distinction appears with resilience, one of the most overused and misunderstood terms in global health. A bingo version reads like this:

“We will build resilient health systems capable of withstanding future shocks and stresses.“

This sentence performs concern while normalising exposure to harm. It subtly shifts attention away from prevention and towards endurance. It reassures donors and institutions that systems will cope, without asking why they are so frequently required to do so.

A diplomatically serious version might read:

“We will invest in surge capacity and supply chain redundancy for essential services, prioritising regions with repeated emergency exposure.“

Here, resilience is no longer an attitude. It is an investment choice. The sentence still leaves room for negotiation, but it creates pressure. If the investment does not happen, the failure will be visible.

Equity offers an even sharper contrast. A pure bingo sentence:

“We reaffirm our commitment to advancing equity and leaving no one behind.“

No one disagrees. No one is threatened. No resources are implicated. The sentence functions as moral alignment, not as policy. A more meaningful diplomatic sentence:

“We commit to reducing inequities in service coverage by reallocating domestic and external financing toward underserved populations, with progress reviewed annually.“

The word equity is doing real work now. Redistribution is implied, even if the details remain negotiable. The double meaning is productive: countries can agree on the direction while contesting the scale.

Sometimes the distance between those two versions is visible in a single sentence. A recent high-level global health declaration included this convoluted commitment:

“We commit to ensuring to promote that advances in science, in a reformed global health architecture, are increasingly accessible globally to ensure health for all, rooted in an evidence-based approach.“

Not to ensure. To ensure to promote. That phrase is not a typo. It is a negotiation scar. Somewhere between drafts, ensure became ensure to promote - a visible downgrade from commitment to disposition, legible in the syntax of the final text. It is the diplomatic equivalent of a contract that promises to try to try. This is what the watering-down process looks like when it forgets to clean up after itself.

The pattern repeats across the vocabulary of global health. Whole-of-society can mean genuine coordination across sectors, or it can mean dissolving responsibility into a fog of participation. Country ownership can signal autonomy, or it can be used to offload accountability while retaining upstream control. Evidence-informed can anchor policy in reality, or it can be a polite way of excluding inconvenient knowledge.

More recently, the vocabulary has upgraded. Health sovereignty has entered the lexicon, implying genuine national control over priorities and resources - a stronger claim than ownership. But the upgrade is often cosmetic. When health sovereignty appears alongside phrases like “among other objectives” or “in accordance with national context and priorities”, the stronger term inherits the same escape hatches as its predecessors. A fundamental shift hedged by “among other objectives“ is not a fundamental shift. It is a direction of travel with no obligation to arrive.

The words themselves are not the problem. Their architecture is.

Functional diplomatic language usually does at least one of three things. It signals a future moment when ambiguity will end. It narrows the range of acceptable outcomes over time. Or it embeds a friction point that someone will eventually have to confront.

Bullshit bingo avoids all three. It is timeless, frictionless, and immune to falsification. Its function is not to move systems forward, but to allow them to remain where they are without appearing stagnant.

What makes this consequential is that the documents and reports generating the most bingo rarely arise in comfortable times. The most elaborate performances of commitment tend to appear precisely when the gap between what is needed and what is politically possible is widest. When fiscal space is shrinking, when aid is declining, when systems are under pressure - that is when language works hardest to paper over the distance. The diagnostic sections of these documents are often clear-eyed, even courageous. The prescriptive sections are where the retreat happens. That gap between honest diagnosis and empty commitment is not neutral. It absorbs political energy that might otherwise produce decisions.

This distinction matters because global health has become very good at talking about its own shortcomings. It names inequity, complexity, and power more clearly than it did a decade ago. That is progress. But when language becomes self-referential, when recognition replaces redistribution and consultation replaces decision, eloquence starts to work against reform.

Calling all diplomatic language bullshit is a mistake. It confuses constraint with bad faith. But failing to distinguish between functional ambiguity and empty performance is worse. It allows systems to hide behind words that sound like movement while ensuring that nothing moves.

The task, then, is not to ban buzzwords or demand technocratic bluntness. It is to read policy language with care: to ask whether ambiguity is being used as a bridge or as a refuge. Words that matter tend to make someone uncomfortable, eventually. Words that do not are usually doing exactly what they were designed to do.

Bullshit bingo is real. So is diplomatic craft. The challenge is knowing when you are looking at one, and when you are looking at the other.