Are Existing Governance Structures Equipped to Deal with Today’s Global Health Challenges – Towards Systematic Coherence in Scaling Up

Devi Sridhar, Sanjeev Khagram, and Tikki Pang

The global financial crisis and a new political era shaped by the new US administration have led to a revival of interest in effective global health governance, and provide an opportunity to review existing mechanisms in the context of contemporary global health challenges. On the underlying premise that “global governance is actually global problem solving” it is proposed that the primary objective of good global health governance is to strengthen healthcare delivery systems in the developing world with an emphasis on the importance of primary health care. In order to achieve this objective, innovations which take into account new global political and economic realities are needed. A multi-level, multi-party and multi-purpose partnership framework of global health governance (global, regional, national) is put forward which includes all the key players and attempts to integrate the key functions needed to achieve an inclusive, equitable, flexible, democratic and sustainable mechanism. Based on shared values of solidarity, democracy and equity, and fully acknowledging the sovereignty of countries and other stakeholders, the proposed framework consists of a multilateral governance platform coordinated by the World Health Organization supported by highlevel political commitment and policy coherence, and ultimately operationalised by effective implementation mechanisms through global action networks (GANs). GANs are a mode of governance involving authoritative negotiations between state and non-state players which have interests and capacities to influence and shape outcomes in specific issue areas.