The Global Health System: Actors, Norms, and Expectations in Transition

Nicole A Szlezák,Dean T Jamison,Barry R Bloom,Catherine M Michaud,Gerald T Keusch,William C Clark,Suerie Moon,Gill Walt

doi:10.1371/journal.pmed.1000183

Abstract

In the first in a series of four articles highlighting the changing nature of global health institutions, Nicole Szlezák and colleagues outline the origin and aim of the series.

Highlights

We present here a series of four papers on one dimension of the global health transition: its changing institutional arrangements
Actors may exercise power within the constraints of international institutions in hopes of achieving benefits and shared objectives [4]. Such a calculus helps to explain why actors are willing to fund multilateral initiatives such as World Health Organization (WHO), GFATM, Roll Back Malaria Partnership (RBM), and Stop TB, despite the fact that doing so entails relinquishing considerable control over what is done with their resources
As a case in point, despite widespread support for its overarching goals, there is considerable discussion, in some cases even unease and some tension, around the prominent role played by the Bill & Melinda Gates Foundation, whose spending on global health was Citation: Szlezak NA, Bloom BR, Jamison DT, Keusch GT, Michaud CM, et al (2010) The Global Health System: Actors, Norms, and Expectations in Transition

Summary

Policy Forum

As a case in point, despite widespread support for its overarching goals, there is considerable discussion, in some cases even unease and some tension, around the prominent role played by the Bill & Melinda Gates Foundation, whose spending on global health was Citation: Szlezak NA, Bloom BR, Jamison DT, Keusch GT, Michaud CM, et al (2010) The Global Health System: Actors, Norms, and Expectations in Transition. We define the global health system as the constellation of actors (individuals and/or organizations) ‘‘whose primary purpose is to promote, restore or maintain health’’ [19], and ‘‘the persistent and connected sets of rules (formal or informal), that prescribe behavioral roles, constrain activity, and shape expectations’’ [20] among them. N Learning lessons from the enormous variance in effectiveness and costs of various national and international health systems, from R&D to the delivery and monitoring and evaluation (M&E) of interventions in the field, to create improvements everywhere

Roadmap of the Series

Author Contributions