This article examines the changing dynamics of development in India, focusing on partnerships between civil society organisations (CSOs)1 and the state in the area of rural health. Drawing on ethnographic perspectives of CSO work, we examine the shifting meaning of these partnerships for the institutions involved and how they function given their differing institutional cultures and values. We argue that the adoption by the state of a global language of rights and its efforts to integrate civil society language, practices and representatives in the policy and implementation of health programmes point to collaborationist models which support the creation of an ‘activist’ state, as they simultaneously strengthen as well as weaken the role of CSOs as mediators in development.
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