Beyond the ‘Global’ in Global Health Governance? Emerging Health Regionalism and Polycentric Order

Abstract

This paper aims to develop characteristics of a health regionalism and to find first indications of the extent to which regional organizations increasingly shaping international health policy. Since institutional tensions between nation-state interests and regional bodies often arise at the regional (supranational) level, this paper discusses the extent to which regional health governance is characterized by organized civil society as well as state actors. In addition, initial considerations are made as to the extent to which regional and interregional cooperation between state and civil society actors (bipartism) and, beyond that, cooperation with commercial enterprises/business (tripartism) characterize regional governance and thus deviate from state-led regionalism. The role of the WHO in this rise of regions thesis will also be discussed. On the one hand, the WHO's ability to develop a comprehensive impact as an institutional entrepreneur ends at its budget limits, which means that it only has the necessary resources to take the lead in a few policy areas. On the other hand, the WHO is in a position to act as a political entrepreneur, above all because it is heard as a mouthpiece in global health protection. With its effective instruments for proclaiming global health threats and praising or criticizing states, it is taken seriously and is thus given a power-political instrument to exert pressure on states and their health policies. This observation is of relevance to the question of how the WHO positions itself among rising regions.