# Abstract To what extent does the Brazil, Russia, India, China and South Africa (BRICS) bloc constitute a paradigm shift in global health and development? This paper interrogates the concept of paradigm shift with the help of a framework familiar to scholars working in the field of International Relations. It distinguishes between the BRICS’ material capabilities, institutions and ideas, and assesses the extent to which the BRICS contribution represents ‘a potentially transformative’ source of new resources and innovation for global health and development. [[It has been argued that the BRICS bloc champions a qualitatively different development discourse from industrialised countries that has made possible a progressive set of development practices]]. ==The BRICS discourse and praxis gives weight to the claim that a paradigm shift in global health is underway. However, the extent to which such discourse will be effective in improving global health will depend on the bloc making greater use of institutions and further deploying its material capabilities==. # Conclusion We started our analysis with a question: does the phrase ‘shifting paradigm’ accurately describe the BRICS bloc’s engagement with global health? To focus our analysis, we utilised a framework familiar to International Relations scholars that distinguishes between material capabilities, institutions and ideas in order to compare different historical structures or ‘frameworks for action’. From this framework we were able to hypothesise that if the BRICS was indeed challenging or shifting the dominant paradigm of global health, the key features of which we described above, then we would be able to detect, two years after the first meeting of BRICS’ Health Ministers, a quantitatively or qualitatively different configuration of the three categories of the framework – or at a minimum some attempt to ‘set about doing so’ in the words of MccGwire. Underpinning both the material capabilities and institutional innovations of the individual BRICS countries and the BRICS bloc is s a set of ideas that are qualitatively different from those expressed through what has hitherto been the dominant, ‘Western’, development paradigm. In the context of global health we acknowledge that there are grounds for scepticism: ==collectively, the BRICS bloc appears long on rhetoric and short in practice==. Our response to that criticism is twofold. First, the rhetoric is powerful: time and again commitment to partnership, access and empowerment, imbue formal statements, communique ́s and declarations of BRICS Health Ministers. Second, as their support for TRIPS flexibilities; R&D into new drugs, products and technologies; and response to non-communicable diseases illustrates, the ==BRICS has adopted an approach to global health that is progressive==. The potentially transformative discourse employed by the BRICS bloc thus gives weight to the claim that a paradigm shift in global health is underway. If so, as the history of the [[Non-Aligned Movement (NAM)]] illustrates, that shift has been a long time coming. But discourse will only likely have effect if institutions are leveraged to support BRICS’ continued engagement with global health, and if material capabilities are further deployed.