This article analyses the emergency governance of international organizations by combining securitization theory with legal theory on the state of exception. Our main argument is that where issues are securitized as global threats, exceptionalism can emerge at the level of supranational bodies, endowing them with the decisionist authority to define emergencies and guide political responses. We theorize the 'emergency trap', which is triggered when the emergency powers of international organizations reduce the obstacles to, and increase the incentives for, the securitization of further issues. Based on the idea that the emergency trap functions as an institutional driver of securitization, we also highlight the importance of the constitutional containment of emergency competencies as an alternative to discursive desecuritization strategies. We illustrate this security-emergency dynamic in a case study of the recent empowerment of the World Health Organization (WHO) in the governance of global health emergencies. The article shows how WHO's exceptional response to the 2003 severe acute respiratory syndrome (SARS) crisis paved the way for an institutionalization of emergency powers within the organization and contributed to securitizing the 2009 swine influenza outbreak as a global pandemic. However, WHO's crisis governance has also triggered internal and external processes of constitutional contention.

This research note discusses limitations of principal-agent (PA) analysis in explaining gradual change in international organisations (IOs). It suggests that historical institutionalism (HI) can fill important gaps left by the PA approach and identifies scope conditions for both approaches. For this purpose, a distinction is made between two sources of state power that PA usually treats as synergistic -namely the formal control of IO decisions and material power resources. While PA analysis is best applicable where reform coalitions of like-minded member states control both formal and material resources, in many contexts there exist frictions between material and formal power in IOs. In these constellations recent HI-inspired works on gradual modes of change such as 'layering' and 'drift' are of particular relevance. This research avenue is illustrated with empirical examples from a variety of international organisations.

The article puts forward a historical institutionalist account of how international organizations are 'designed.' I argue that deliberate institutional design is circumscribed by path-dependent power dynamics within international organizations. Power-driven path dependence is used to explain that organizations lock in and reinforce historical privileges of international organization subunits. Early winners in the international organization lock in their privileges with the support of member-state allies, and reap increasing returns from their positions over rounds of reform. They thereby amplify features of international organization design that reformers would otherwise change later on. The argument is illustrated with a historical case study of the World Health Organization's unique federal design, which grants the regional offices near autonomy from headquarter oversight. Vocal criticisms of the World Health Organization's regionalization and repeated centralization attempts notwithstanding, the powers of the regions have increased over time. The case study retraces the path-dependent struggles over the World Health Organization's federal design since its creation in the 1940s. While the literature on international organizations tends to reserve inertia and path dependence for constructivist analysis, this article offers a rationalist account of inertia in international institutions.

In 1990, the World Health Organization (WHO) started to downsize its renowned Global Programme on AIDS, despite continued donor and member state support. This turnaround has decisively contributed to WHO's loss of leadership in HIV/ AIDS politics. From the viewpoint of both rationalist and constructivist theories of international organisation (IO) agency, an IO engaging in 'mission shrink' is a striking irregularity. In order to account for such apparently self-defeating behaviour, this article adopts an open systems view of IOs and identifies trans-organisational coalitions as important agents of IO change. I argue that subunit dynamics rather than systemic conditions drive IO behaviour, in particular where member states' material power and their formal control of organisational veto positions do not coincide. This approach will be used to retrace the changes in subunit coalitions that drove WHO's erratic HIV/AIDS programme and thus to solve this puzzle of 'mission shrink'. On the basis of insights from the WHO case, the article concludes by offering a heuristic of trans-organisational coalitions and the types of IO change associated with them.

No abstract

Effective argumentation in international politics is widely conceived as a matter of persuasion. In particular, the ‘logic of arguing’ ascribes explanatory power to the ‘better argument’ and promises to illuminate the conditions of legitimate normative change. This article exposes the self-defeating implications of the Habermasian symbiosis between the normative and the empirical force of arguments. Since genuine persuasion is neither observable nor knowable, its analysis critically depends on what scholars consider to be the better argument. Seemingly, objective criteria such as universality only camouflage such moral reification. The paradoxical consequence of an explanatory concept of arguing is that moral discourse is no longer conceptualized as an open-ended process of contestation and normative change, but has recently been recast as a governance mechanism ensuring the compliance of international actors with pre-defined norms. This dilemma can be avoided through a positivist reification of valid norms, as in socialization research, or by adopting a critical and emancipatory focus on the obstacles to true persuasion. Still, both solutions remain dependent on the ‘persuasion vs. coercion’ problem that forestalls an insight into successful justificatory practices other than rational communication. The conclusion therefore pleas for a pragmatic abstention from better arguments and points to the insights to be gained from pragmatist norms research in sociology.

This article explores the professional construction of the space of Global Health. I argue that the growth of Global Health as a field of practice does not merely indicate an intensification of North-South intervention. It is also a professional project of reimporting lessons from the South to countries in the North. I focus on the emerging didactic regime for Global Health in US medical education and the deterritorialized “global” lessons that students are taught in poor countries. By rescaling these lessons to precarious settings at home, the space of Global Health is reterritorialized as a Global Medical South stretching into the United States, reinforcing the perception that health is not a right but a privilege. The analysis is based on a content analysis of university websites and didactic handbooks and a sample of sixty-four articles evaluating the education effects of study abroad experiences. It reveals an emerging canon of Global Health virtues and the construction of domestic scales for Global Health practices, which are based on ethnic and socioeconomic categories. This analysis of professional projects as spatial projects sheds new light on the geography of Global Health and of professional globalization more generally.

The article analyzes the contested concept of global health through the lens of orders of worth. Drawing on pragmatist political and social theory, especially the work of Boltanski and Thévenot, I conceptualize orders of worth as moral narratives that connect visions of universal humankind to ideas about moral worth and deficiency. They thereby differ from the self/other narrative of political identity that is emphasized in International Relations scholarship. Orders of worth do not pitch a particularistic identity against foreign identities, but tie collective identity to a higher common good. They provide tools for moral evaluation and the justification of hierarchy. I use this heuristic to reconstruct four main conceptions of health in global politics: The order of survival, the order of fairness, the order of production, and the order of spirit. Each of them articulates a distinct political identity, as ‘we species’, ‘we liberals’, ‘we bodies’ and ‘we souls’, and implies different notions of virtuous and selfish conduct in the global community. These orders are derived from scholarly writings and the policies of global health institutions. Finally, I discuss the nature of compromises between the four orders regarding contested issues such as health emergencies or digital medicine.