Global Governance of Health analysis + dialogue with multilateral actors



  • To summarize current institutional structures that support the achievement of the MDGs and challenges and opportunities these create for the future.
  • To propose changes to the present Global Governance of Health such that it holds governments and others more accountable for their responsibilities, enhancing the likelihood that the NHDGs will be achieved.
  • To clarify where in the Global Governance of Health landscape responsibilities for ensuring the affordability and accessibility of both new and existing essential medicines, building local research and production capacity, and ensuring financing of future research and development efforts should be discussed and agreed upon.


  • Review of literature on Global Governance of Health, including the literature on international political economy of global health, such as the reasons that richer states are willing (or unwilling) to support health efforts in poorer states, what might increase this willingness, how international health financing interacts with national structures and priorities, and the most promising practices to ensure genuine partnerships, improve accountability, and strengthen country ownership. A key part of this task is a summary of the current state of knowledge on Global Governance of Health addressing questions such as what are the existing global structures governing health or governing issues affecting health; who is the global polity in Global Governance of Health; who holds power and how is this power exerted; and what is the role of new actors, such as private foundations, in global governance.
  • WP4 will assess the consequences of the finding of other WPs for Global Governance of Health and formulate a proposal on how elements of the present Global Governance of Health architecture can be used to hold governments and other actors accountable for living up to their responsibilities, and what a future Global Governance of Health architecture could look like. Particular attention will be given to the role of the WHO and other key UN agencies involved with health. Larger questions to be examined include how to reconcile the trade-off between input (improved efficiency, accountability, representativeness) and output legitimacy (reduced morbidity/mortality) in choosing which actor to finance and support, whether the Global Governance of Health architecture should in general entail a looser structure involving different organisations competing to most effectively (in terms of input and output legitimacy) provide health financing and leverage their different strengths, or a more defined structure with clear coordination and delineation of functions; and specifically when competition or a more defined structure should be established – at what level (global, national, local), and in what areas (financing, innovation, implementation). This will be an essential part of a first draft of a NHDGs and a Global Social Contract.
  • The following task will involve obtaining feedback from multilateral actors to ensure that the proposed NHDGs are attuned to political realities and constraints. This would involve consultations with senior staff in the UN working on health such as in the WHO, the World Bank, and the United Nations Development Programme (UNDP) as well as with those working in the newer initiatives such as the Global Fund, the GAVI Alliance, and the Global Alliance for Improved Nutrition (GAIN).
  • Finally, WP4 will use the relationships it will have established to assess priorities for implementation with multilateral actors.