The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Expertise, Accountability, and the Depoliticisation of Global Health Governance
During his tenure as the Executive Director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (hereafter the Global Fund), Richard Feachem argued that the autonomous, multisectoral, and technically focused design of the Global Fund is ‘really insulated … from the political dynamic, which inevitably and appropriately permeates the UN. We are a very apolitical organization … we’ve been able to take principled and technical decisions … because we’re not subject to the political influences that would come to bear in the UN’ (Feachem, 2005). This is a notable quote, for it not only draws attention to the potential apolitical merits of the multisectoral Global Fund but also criticises the ‘politicisation’ of multilateral forms of global health governance. Charges of politicisation have been levelled at the UN throughout much of the organisation’s history, and there are two commonly cited examples from the arena of global health. First, it is common practice for wealthy nations to withhold financial contributions to bodies such as the WHO and UNICEF in order to manipulate policy priorities for their own interests (Brown et al., 2006; Godlee, 1994; Walt, 1993; Walt and Buse, 2006). Secondly, there is a history of competition and conflict between the multilateral health agencies over their relative authority, influence, and leadership in global health (Brown et al., 2006, pp. 67–68; Walt, 1993; Walt and Buse, 2006, pp. 661–664). Though a contested concept, the term ‘politicisation’ implies a pejorative influence of politics (Siddiqi, 1995, pp. 30–34) through which power and wealth has corrupted and colonised decision-making, thus leaving a multilateral system of governance that is unrepresentative of the global community; inefficient and ineffective in responding to collective action problems; and also lacking in both credibility and legitimacy (Brown, 2010; Ghebali, 1985).
KeywordsGlobal Health Global Fund Donor Country Collective Action Problem Global Health Initiative
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