Future-proofing global health: Governance of priorities

Ilona Kickbusch's thought provoking editorial is criticized in this commentary, partly because she fails to refer to previous critical work on the global conditions and policies that sustain inequality, poverty, poor health and damage to the biosphere and, as a result, she misreads global power and elides consideration of the fundamental historical structures of political and material power that shape agency in global health governance. We also doubt that global health can be improved through structures and processes of multilateralism that are premised on the continued reproduction of the ecologically myopic and socially unsustainable market civilization model of capitalist development that currently prevails in the world economy. This model drives net financial flows from poor to rich countries and from the poor to the affluent and super wealthy individuals. By contrast, we suggest that significant progress in global health requires a profound and socially just restructuring of global power, greater global solidarity and the " development of sustainability. "

The Transformation of Global Health Governance, 2014

This chapter identifies how transformations in global health governance are reflected in the governances of specific health issues such as human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), pandemic influenza, tobacco control and access to medicines. It illustrates the importance of ideas such as security, rights, economics, development and bio-medicine in the formation and legitimisation of interests in global health. The chapter explains the link between global health governance and other areas of global governance. It also underscores the multisectoral nature of global health governance and how this is reflected in institutions and actors. Finally it suggests that the way forward in improving global health governance is to link health and other concerns both in the framing of issues and in institutional architecture.

International Politics Reviews, 2014

After ten years of unprecedented attention and funding for global health, and a simultaneous increase in the range and number of institutions involved in global health governance, we have arrived at what seems to be a watershed moment. This paper assesses the future of global health governance in this context. In particular, the financial crisis, the rise of middle- income powers, and changes in US domestic politics are all viewed as injecting new fault lines and dynamics into the existing system of governance. Although the impacts of these changes are likely to be profound, the paper argues that the private and hybrid public-private institutions that have become prominent in global health governance in the last decade will continue to play a central role in tackling a narrowly delineated range of global health problems, albeit with potentially fewer resources. Indeed the trend for a greater emphasis on ‘private’ forms of authority seems likely to become further entrenched by the financial crisis-engendered emphasis on the delivery of efficient global health interventions.

BRILL eBooks, 2023

This is an open access chapter distributed under the terms of the CC BY-NC 4.0 license.

The twenty-first century has seen a notable shift in how health issues are addressed by global governance polities. Health challenges, such as HIV/AIDS, SARS, the H1N1 flu, Ebola, and Zika, have been constructed increasingly through a discourse of security, and it is this fundamental shift in how health is framed which lies at the centre of this thesis. By adopting a constructivist approach, this thesis makes use of Copenhagen School’s securitisation theory to demonstrate the securitisation of antimicrobial resistance (AMR) by the United Nations High-Level Meeting on AMR in September 2016. Examining the speech acts from multiple actor categories by means of a qualitative content analysis, discursive themes are identified to support the claim of securitisation. Building on Thomas Kuhn’s conception of paradigms and paradigm shifts, the thesis makes a compelling case for the emergence of a new paradigm of global health, one which understands health as a security issue, thereby extending Keiko Inoue and Gili Drori’s health paradigm framework to include a fifth paradigm. As such, demonstrating the successful securitisation of AMR and arguing for a paradigmatic shift in the construction of health challenges are the two key contributions of this thesis to the academic debate.

The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and " the rise of the rest " will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals-the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health.

Fudan Journal of the Humanities and Social Sciences

The idea of this paper is inspired by the dismal experience and lessons from the initially ineffective global (WHO-led) response to the 2014-2016 West African Ebola virus epidemic. It charts the evolution of global health policy and governance in the post-World War II international order to the current post-2015 UN Sustainable Development Goals era. In order to respond adequately existing and emerging health and development challenges across developing regions, the paper argues that global health governance and related structures and institutions must adapt to changing socioeconomic circumstances at all levels of decision-making. Against the background of a changing world order characterised by the decline of US-led Western international liberalism and the rise of the emerging nations in the developing world, it identifies the 'Rising Powers' (RPs) among the emerging economies and their soft power diplomacy and international development cooperation strategy as important tools for responding to post-2015 global health challenges. Based on analysis of illustrative examples from the 'BRICS', a group of large emerging economies-Brazil, Russia, India, China and South Africa-the paper develops suggestions and recommendations for the RPs with respect to: (1) stimulating innovation in global health governance and (2) strengthening health systems and health security at country and regional levels. Observing that current deliberations on global health focus largely, but rather narrowly, on what resource inputs are needed to achieve the SDG health targets, this paper goes further and highlights the importance of the 'how' in terms of a leadership and driving role for the RPs: How can the RPs champion global governance reform and innovation aimed at producing strong, resilient and equitable global systems? How can the RPs use soft power diplomacy to enhance disease surveillance and detection capacities and to promote improved regional and international coordination in response to health threats? How can they provide incentives for investment in R&D and manufacturing of medicines to tackle neglected and poverty-related diseases in developing countries?