INSTITUTIONAL ANALYSIS
Until the 1990s, international health governance — also referred to as “the multilateral health regime” and “horizontal germ governance” — was relatively simple, with a small cast of actors and clearer lines of responsibility.
At first, the World Health Organization (WHO) coordinated worldwide efforts such as smallpox eradication with a limited set of partners; it also provided for international reporting and handling of disease outbreaks through the International Health Regulations (IHR).
The World Bank, which began operations in 1946, gradually evolved from having virtually no presence in global health to being the world’s largest financial contributor to health related projects superior resources have allowed it to displace the WHO as the main multilateral agenda-setter in health since the 1990s, especially in poor countries.
Disillusionment with WHO inefficiency and ineffectiveness has also arguably spurred engagement of non-state actors, driven by public-private partnerships, foundations, G8, and other non-UN/WHO entities has diminished the importance of WHO and health-related UN organizations in GHG.
