Innovation in Global Health Governance: Critical Challenges and Key Issues in addressing Contemporary Health Crises in the World
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1 Innovation in Global Health Governance: Critical Challenges and Key Issues in addressing Contemporary Health Crises in the World Warwick Q-Step Spring School st April 2016 Franklyn Lisk, PAIS/CSGR
2 OVERVIEW Concept of global governance: system, institutions, objectives, rules, cooperation, partnerships, authority and power relationships International health risks and challenges: infectious diseases and pandemics; non-communicable diseases; access to medicines The present global order for preventing and responding to global health risks: institutional mechanism; civil society; gaps and weaknesses Governing the global health security domain: right to health; dynamics and complexity of contemporary global health challenges; globalisation and health policies Governance challenges in global health: sovereignty vs. international rules; consensus on policy and action; global shared responsibility; finance Innovation in global health governance: need, priorities, principles and global agenda Assessing impact of governance innovation: information and data needs for assessing a dynamic challenge-response-innovation framework Indicators of success in global health governance: knowledge and resources for fighting biggest health challenges; health for all notion
3 Recent and Current Global Health Challenges and Crises HIV/AIDS, SARS, Avian influenza, Ebola, Zika virus Cholera, Malaria, Typhoid, TB, Small Pox Polio Tobacco Non-communicable diseases: cancer, diabetes, cardiovascular and heart disease, obesity, dementia Access to affordable medicines in a globalised world Treatment for neglected tropical diseases Biological warfare agents and bioterrorism ( e.g. anthrax, toxic bacteria) Illicit and harmful drugs ( e.g. Heroin)
4 Governance of global health risks and crises: Framework, gaps, weaknesses and challenges Instruments and institutions involved in global health governance: International Health Regulations (IHR); Global health institutions and multilateral organisations (e.g. WHO, UNAIDS, World Bank, WTO, ILO, WFP, UNEP, UNICEF); Informal institutions (G7/8, G20 Summits and Health Ministers Meetings); Multi-stakeholders initiatives (e.g. GAVI, GFATM, Roll Back Malaria, Gates and Clinton Foundations): Regional organisations (EU, ASEAN, AU, PAHO); Emergency WHO summits (e.g. SARS, Ebola, Zika) Institutional coordination and policy harmonisation: global health inequalities; incorporating health concerns in international development objectives (MDGs and SDGs); aid effectiveness; capacity-building The politics of global health governance: leadership of global health; global health diplomacy; health sovereignty; power relationships Financing global health: funding of global health institutions; global health donors; global shared responsibility Need for innovation in global health governance: creating new opportunities to respond to existing and new health challenges
5 Innovations in global health governance: Type and direction Institutional Innovations: WHO (Commissions on macroeconomics and health, and on the social dimensions of health; Framework Convention on Tobacco Control; data collection and monitoring (e.g. UNAIDS); Global Outbreak Alert and Response Network; UN and World Bank (HIV/AIDS); G8 (GFATM); Multi-stakeholder initiatives, foundations (GAVI, Stop TB, Roll Back Malaria) Instrumental Innovations: International law (revision of international health regulations); adoption of policies with specified targets and timetable; health policy coherence (AIDS and Ebola) Informal techniques and spontaneous actions: Health summits; mobilising and leveraging resources (e.g. Ebola); civil society pressure groups, social movements and networks Promoting a global health revolution: global awareness and action campaigns; large-scale regional and national level programmes; improved surveillance and response to infectious disease outbreaks
6 Appropriateness and effectiveness of innovations in global health governance The Challenge-Response-Innovation Framework (Cooper, Kirton and Lisk) Action: actors, targets, process, pathway System responsiveness: suitability, efficacy System transformation: change, relevance
7 Applying Systems Thinking to global health governance innovation Systems thinking concept: identify and reveal underlying characteristics and relationships of systems Applying systems thinking perspective to global health governance: comprehensive set of tools to map, measure and understand the dynamics of global health challenges and complexity of global health system architecture in real world settings Anticipate how an innovation might flow through, react and impact on health governance system to create opportunity in a constructive way Estimate investments and interventions required for increasing the effectiveness of global health governance Undertake empirical studies ( research and analysis) of innovation, governance and policy complexities to validate operational significance
8 Indicators of success in global health governance innovation: Areas of focus Finance: adequately-funded and efficient global health institutions - leadership, resource mobilisation, aid architecture Institutional structure: legitimacy, transparency and accountability International law and practice: global health diplomacy: international health regulations and shared responsibility Collaboration: interactions between global health initiatives and country health systems, country ownership, innovative and transformative global partnerships Rolling out of new medicines and technologies: intellectual property rights and pharmaceutical pricing policy; research and development Access to health services: health for all, especially in low and middleincome countries Population-wide behaviour change: global campaigns to decrease health risks (e.g. tobacco; obesity; family planning) Nexus of health and environment: incorporate issues of climate change, ecology and clean energy within integrated global governance framework
9 Useful General Readings Dodgson, R., K. Lee and N. Drager 2002, Global health governance: A conceptual review (WHO and LSHTM) Fidler, D. 2004, SARS: Governance and the globalisation of disease (Palgrave Macmillan) Fidler, D. 2007, Architecture amidst anarchy: Global health s quest for governance. Global Health Governance, vol.1, no. 1 Garrett, L. 2007, The challenge of global health. Foreign Affairs Cooper, A., J. Kirton and T. Schrecker (eds.) 2007, Governing global health: Challenge, response, innovation (Ashgate) Poku, N., A Whiteside and B. Sandkjaer (eds.) 2007, AIDS and Governance (Ashgate) 2007Cooper, A., B. Hocking and W. Maley (eds.) 2008, Global governance and diplomacy: World apart? (Palgrave Macmillan Cooper, A. and J. Kirton (eds.) 2009, Innovation in global health governance (Ashgate) Harman, S. and F. Lisk (eds.) 2009, Governance of HIV/AIDS: Making participation and accountability work (Routledge) F. Lisk 2010, Global institutions and HIV/AIDS; Responding to an international crisis (Routledge) Kirton, J. A. Cooper, F. Lisk and H. Besada (eds.) 2014, Moving health sovereignty in Africa: Disease, governance and climate change (Ashgate) A. Sehovic 2014, HIV/AIDS and the South African state: Sovereignty and responsibility to respond (Ashgate) Kirton, J. 2015, G20 Governance for a globalised world (Ashgate) Larionova, M. and J. Kirton (eds.) 2015, The G8-G20 relationship in global governance (Ashgate)
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