COVID-19 Exposes Warped Global Health Power: The System Needs a Course Correction

Kashyap, Aruna; Knight, Kyle; Wurth, Margaret

doi:10.1017/bhj.2021.38

Bus. and hum. rights j.

2021

DOI: 10.1017/bhj.2021.38

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COVID-19 Exposes Warped Global Health Power: The System Needs a Course Correction

Aruna Kashyap¹,

Kyle Knight²,

Margaret Wurth³

Abstract: Just three weeks after the World Health Organization (WHO) recognized COVID-19 as a global pandemic, novelist Arundhati Roy wrote: ‘Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next.’1

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Power across the global health landscape: a network analysis of development assistance 1990–2015

Fergus

2022

Health Policy and Planning

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Power distribution across the global health landscape has undergone a fundamental shift over the past three decades. What was once a system comprised largely of bilateral and multilateral institutional arrangements between nation-states evolved into a varied landscape where these traditional actors were joined by a vast assemblage of private firms, philanthropies, non-governmental organizations, public-private partnerships. Financial resources are an explicit power source within global health which direct how, where, and to whom health interventions are delivered, which health issues are (de)prioritised, how and by whom evidence to support policies and interventions is developed, and how we account for progress. Financial resource allocations are not isolated decisions, but rather outputs of negotiation processes and dynamics between actors who derive power from a multiplicity of sources. The aims of this paper are to examine the changes in the global health actor landscape and the shifts in power using data on disbursements of development assistance for health (DAH). A typology of actors was developed from previous literature and refined through an empirical analysis of DAH. The emergent network structure of DAH flows between global health actors and positionality of actors within the network were analysed between 1990 and 2015. The results reflect the dramatic shift in the numbers of actors, relationships between actors, and funding dispersal over this time period. Through a combination of the massive influx of new funding sources and a decrease in public spending, the majority control of financial resources in the DAH network receded from public entities to a vast array of civil society organisations (CSOs) and public-private partnerships (PPPs). The most prominent of these were the Bill and Melinda Gates Foundation (BMGF) and the Global Fund for AIDS, TB, and Malaria (GFATM), which rose to the third and fourth most central positions within the DAH network by 2015.

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Power across the global health landscape: a network analysis of development assistance 1990–2015

Fergus

2022

Health Policy and Planning

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COVID-19 Exposes Warped Global Health Power: The System Needs a Course Correction

Cited by 1 publication

References 3 publications

Power across the global health landscape: a network analysis of development assistance 1990–2015

Power across the global health landscape: a network analysis of development assistance 1990–2015

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