Global Health Governance and a Framework Convention on Global Health
Global Health Governance, Volume 9, No. 1, 2015
178 Pages Posted: 11 May 2018
Date Written: 2015
Global health governance continues to be a complex and challenging undertaking. A remarkably complicated patchwork of institutions at the international, national, and local levels contribute to global health outcomes. The formal, global-level international organizations and agencies that have traditionally taken prominent roles in global health governance — such as the United Nations, the World Health Organization (WHO), UNAIDS, the World Trade Organization, and the World Bank — now vie for funding and influence with non-governmental funders and non-governmental organizations like the Bill and Melinda Gates Foundation and Doctors Without Borders. National governments continue to have significant influence on health, but health must also compete with other national priorities. Numerous human rights treaties and national laws recognize some form of the right to health, yet operationalizing this right remains an elusive task.
This special issue of Global Health Governance examines in detail a proposal that seeks to address many of these global health governance shortcomings: a Framework Convention on Global Health (FCGH). The FCGH is an international legal framework — grounded in the international human right to health — that would support health at the local, national, and global levels. The concept of an FCGH has evolved substantially since it was first proposed by Lawrence O. Gostin in 2008. Initially designed as a structural mechanism that would pull together the multiplicity of actors in global health to help achieve the basic survival needs of the world’s least healthy people and address “intolerable” disparities in health outcomes, the FCGH proposal has — with transnational civil society input from the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)4 and its successor, the FCGH Platform — refocused on the primacy of the right to health in global health governance and the need for multilateral and multisectoral participation in determining the appropriate norms and goals for improving global health outcomes.
Creating a framework convention that would establish a set of global health norms and an infrastructure to implement these norms is an attractive idea in a world where such large disparities in health outcomes persist. An FCGH seeks to marshal existing resources for health, coordinate between disparate actors in global health governance, set standards and goals for health outcomes, and solidify the centrality of the right to health in law and policy. However, this ambitious idea will be hard to accomplish given the complexities of international politics, resource constraints, and competing priorities. While there is widespread consensus that the existing infrastructure and capacity of global health governance is insufficient to solve global health problems, whether a framework convention is the right approach to improve governance is a matter of debate.
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