Addressing global health governance challenges through a new mechanism:
the proposal for a Committee C of the World Health Assembly
Ilona Kickbusch, Wolfgang Hein, Gaudenz Silberschmidt
forthcoming in Special issue of the Journal of Law, Medicine and Ethics on global health governance, 2010
Committee C JLME 2010 Final Draft Feb 2010
Available online PDF [32p.] at: http://bit.ly/cAVW8f
“…………There has been much discussion about improving global health governance and even calls for a new global health architecture2. Some authors continue to see WHO in the center of such a new configuration, others see it as one organization amongst many others and some consider it outdated. But the role of the organisation can only be determined if there is greater clarity about the various domains of global health and its role in relation to them.
One problem is that in debating the need for better governance and coordination in global health many analysts focus exclusively on one part of the global health governance picture: the complex landscape of health in development. It is in this arena of global health that the actors have increased exponentially and visibly – disease by disease - over the last twenty years and it is here that many new governance mechanisms and institutions were developed.
The explosion of actors and activities in this domain of global health is due in particular to a widening resource base for mainly vertical health activities. Funding for global health initiatives has quadrupled in less than two decades to almost $22 billion, boosted in particular by
But the realm of global health governance is much broader. Governance according to Krasner4 includes “implicit or explicit principles, norms, rules and decision making procedures” according to which the international actors operate.
Today these clearly emerge in a more complex manner than when the World Health Organization was the only health game in town. As the environment gets more complex a new need for coherence and coordination in global health governance is recognized5. In the crowded landscape this is clearly an empty space - a governance void - which WHO should fill. WHO’s responsibilities lie exactly – in concordance with its constitution - in the establishment of principles, norms and rules according to which the wide range of global health actors should shape their actions, be they member states, donors, foundations or private public partnerships.
The critical difference at the beginning of the 21st century lies in the decision making procedures of how these principles, norms and rules are developed. They call not only for the involvement of the broad range of global health actors but also for increased transparency and accountability
Three strategic pathways emerge for the organization, all of which imply a new relationship with member states, with other international bodies and organisations, with civil society and with the private sector:…………….”
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