Policy processes sans frontières: interactions in transnational governance of global health

Abstract

National policy on global health (NPGH) arenas are multisectoral governing arrangements for cooperation between health, development, and foreign affairs sectors in government policy for global health governance. To explore the relationship between national and global processes for governing global health, this paper asks: in what forms of interaction between NPGH arenas and global health governance are learning and networking processes present? In a multiple case study of Norwegian and Swiss NPGH arenas, we collected data on intersectoral policy processes from semi-structured interviews with 33 informants in 2014-2015. Adapting Real-Dato's framework, we analyzed each case separately, producing monographs for comparing NPGH arenas. Analyzing both NPGH arenas for relational structures linking external resources to internal policy arena processes, we found five zones of interactions -including institutions, transgovernmental clubs, and connective forms. These interactions circulate ideas and soften arenas' boundaries. We argue that NPGH is characteristic of transnational governance of global health.

Governance for global health: the role of Nordic countries

“…Formulating policy/strategic direction Polycentric governance for global health requires adequate policy and strategy processes on the international, regional and national levels, and "the state has a critical role to play as a global health governor, beyond that as a global health financier." (Jones et al, 2020). Nordic states apply a great variety of identified tools to support this sub-function (Table 1: 1.1-1.9): national policies on global health; national strategies on specific health-related issues in international context and organization strategies for international organizations; multi-year strategic plans; policies, operational guidelines, training manuals, and protocols on different aspects of global health and related issues; targets-and priority-setting techniques.…”

“…For example, the strategy to combat antibiotic resistance set as one of the objectives Sweden's "leadership within the European Union (EU) and international cooperation", and contains a section about Sweden as a model for the containment of antibiotic resistance (Eriksen et al, 2021). The important consequence of such national strategic approach is that "states with national policies on global health arenas receive recognition as integral actors in the global health governance system, beyond institutional membership or donor status" (Jones et al, 2020).…”

“…This is explained by constantly emerging global health challenges and threats, the diversity of global health actors and the characteristics of the global health governance system (its resilience, complexity and innovative approaches) that make it interesting to other global governance systems. "Global health governance is a set of formal and informal processes, operating beyond state boundaries, through which actors participate in steering, coordinating, and financing collective action on health and disease in populations around the world" (Jones et al, 2020). In 2014, the Lancet Commission on Global Governance for Health identified the political origins of health inequity formulating five disfunctions of the global health governance system: (1) democratic deficit; (2) weak accountability mechanisms; (3) institutional stickiness; (4) inadequate policy space for health; (5) a total or near absence of international institutions (e.g.…”

“…Tools for governance of global health are developed and applied to achieve collective solutions for the maintenance and promotion of health as a common good, to ensure accountability and transparency, reconcile the interests of different groups on international and regional levels. Researchers have explored, among others, such important tools and mechanisms to govern as national global health policies (Jones et al, 2017(Jones et al, , 2020Steurs et al, 2018); public-private partnerships (Lee, 2010;Storeng and Puyvall ee, 2018); normative frameworks and international regulations (Gostin et al, 2019;Razavi et al, 2021); and metagovernance norms (Holzscheiter et al, 2016). Coronavirus disease 2019 (COVID-19) pandemic deepened inequities in global health in many aspects and raised questions about the effectiveness of some established tools and approaches (e.g.…”

How Will COVID-19 Impact on the Governance of Global Health in the 2030 Agenda Framework? The Opinion of Experts

“…The Agenda incorporates Global Health as one of its main objectives, (SDG 3), to “Guarantee healthy lives and promote well-being for all at all ages” [ 1 ]. However, by virtue of its transversal nature [ 3 ], Global Health is mentioned throughout the entire Agenda under the guiding principle that “no one should be left behind”.…”