Since its commencement in Rwanda in 2006, the study ofperformance-based financing (PBF) in Africa has focusedresearch attention on its effects regarding improving thehealth care system or achieving health-related MillenniumDevelopment Goals (MDGs). Similarly, critics of PBF haveconcentrated more on its inability to transform structuralindicators of the health system positively and sustainably.So far, the scientific literature has not sufficiently exploredthe implications concerning the ideological and operationalmutations that the PBF is operating. This study investigatesthese aspects of PBF in conception and operationalization ofpublic health intervention. The concept of depoliticization ofpublic health action is proposed in this analysis to describe thecapacity of the PBF to redraw health policy from the realmof political and State intervention, and from the primacy ofpublic sector to field of market-based competition betweenGovernment sponsored and non-State actors.Since its commencement in Rwanda in 2006, the study of performance-based financing (PBF) in Africa has focused research attention on its effects regarding improving the health care system or achieving health-related Millennium Development Goals (MDGs). Similarly, critics of PBF have concentrated more on its inability to transform structural indicators of the health system positively and sustainably. So far, the scientific literature has not sufficiently explored the implications concerning the ideological and operationalmutations that the PBF is operating. This study investigates these aspects of PBF in conception and operationalization of public health intervention. The concept of depoliticization of public health action is proposed in this analysis to describe the capacity of the PBF to redraw health policy from the realm of political and State intervention, and from the primacy of public sector to field of market-based competition between Government sponsored and non-State actors.