Rethinking Global Health Governance in a Changing World Order for Achieving Sustainable Development: The Role and Potential of the ‘Rising Powers’

Abstract

The idea of this paper is inspired by the dismal experience and lessons from the initially ineffective global (WHO-led) response to the 2014–2016 West African Ebola virus epidemic. It charts the evolution of global health policy and governance in the post-World War II international order to the current post-2015 UN Sustainable Development Goals era. In order to respond adequately existing and emerging health and development challenges across developing regions, the paper argues that global health governance and related structures and institutions must adapt to changing socio-economic circumstances at all levels of decision-making. Against the background of a changing world order characterised by the decline of US-led Western international liberalism and the rise of the emerging nations in the developing world, it identifies the ‘Rising Powers’ (RPs) among the emerging economies and their soft power diplomacy and international development cooperation strategy as important tools for responding to post-2015 global health challenges. Based on analysis of illustrative examples from the ‘BRICS’, a group of large emerging economies—Brazil, Russia, India, China and South Africa—the paper develops suggestions and recommendations for the RPs with respect to: (1) stimulating innovation in global health governance and (2) strengthening health systems and health security at country and regional levels. Observing that current deliberations on global health focus largely, but rather narrowly, on what resource inputs are needed to achieve the SDG health targets, this paper goes further and highlights the importance of the ‘how’ in terms of a leadership and driving role for the RPs: How can the RPs champion global governance reform and innovation aimed at producing strong, resilient and equitable global systems? How can the RPs use soft power diplomacy to enhance disease surveillance and detection capacities and to promote improved regional and international coordination in response to health threats? How can they provide incentives for investment in R&D and manufacturing of medicines to tackle neglected and poverty-related diseases in developing countries?