Humanitarian governance and the consequences of the state-fragility discourse in the Democratic Republic of Congo's health sector.

Abstract

This paper examines how the discourse on state fragility affects the preferences of key actors in humanitarian governance for different types of health-sector interventions in the Democratic Republic of Congo. It argues that, instead of focusing on the actual meaning of state fragility, attention should be paid to interactive processes around the discourse among stakeholders in the health sector. The lack of consensus on state fragility influences humanitarian governance, especially the perceptions of and interactions between the host government, donors, and international non-governmental organisations. The latter have legitimised the persistence of vertical, emergency-based interventions by emphasising state fragility, whereas state officials have preferred to assert political statehood and a higher degree of control. Nevertheless, they agree that donors' financial contributions ensure the survival of the public health sector. Looking ahead, a policy coalition based on harmonised views about addressing fragility is necessary for effective engagement and the sustainability of interventions, but this is unlikely to happen any time soon.