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Counter-contestation in global health governance: The WHO and its member states in emergency settings

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Villarreal,  Pedro A.
Max Planck Institute for Comparative Public Law and International Law, Max Planck Society;

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Citation

Lange, T., Villarreal, P. A., & Bärnighausen, T. (2023). Counter-contestation in global health governance: The WHO and its member states in emergency settings. Health policy, 131, 1-11. doi:10.1016/j.healthpol.2023.104756.


Cite as: https://hdl.handle.net/21.11116/0000-000F-B1D9-4
Abstract
Is the contestation of international institutions always a one-sided process that originates from nation-states? In research to date, there has been little discussion of the extent to which international institutions endure, or even form counter-reactions to national contestation strategies. This study examines the reasons for which WHO engages in counter-contestation vis-à-vis its member states.

The paper analyzes the evolution of global health governance by relating a principal-agent approach and contestation considerations. The WHO (agent) wants to reshape the principal-agent relationship with the member states (principals) in order to maximize its autonomy and eventually ensure stronger independence. The WHO pursues its efforts to become more independent on the basis of its own logic of action: To achieve this autonomy from member states, WHO on the one hand uses a strategy we call counter-contestation. On the other hand the member states want their interests to be represented by the WHO and ensure this goal through the logic of action known as contestation. Four international health crises are used to show how different the logics of action are and what effects they have. This study explores how and to what extent WHO actively engages in the political exchange of diplomatic moves and manoeuvres, creating contestation as a mutual game between states and International Organizations.