Health Governance and 'Wicked Problems': Facing Complex Developmental Transitions Using a Rights-Based Approach

Abstract

This article discusses the question of 'good governance' in relation to the current debates about global development and health. It aims to clarify some of the conceptual confusion and problems surrounding the 'governance' idea, addressing governance issues in a direct and substantive way through a discussion of current global health reforms. The article responds to the theme of this issue of Irish Studies in International Affairs, 'The changing face of Africa', by taking the changing face of global health as the focal space and asking how this shapes the way we understand 'governance'. The discussion suggests that it is not the particular or exceptional situation of Africaner se that needs to be addressed but the complexity of development transitions, raising fundamental questions about equity, power, ideology, values and democratic choice. The article discusses the promises and shortfalls of the 'shared health governance' approach in Africa and suggests that a rights-based approach provides an alternative capable of addressing the 'wicked problems' of governance.