Optimal Allocation of Roles and Responsibilities
Allocating roles and responsibilities to actors best situated to realize health capabilities for all without unnecessary coercion
WHAT IS IT?
SHG allocates roles and responsibilities to those individuals and groups best situated by their positions, resources, and capabilities to fulfill them. "Best situated" is determined by effectiveness and efficiency: who is most capable of effectuating the health capabilities of all persons, and with the fewest resources possible. Allocations based on best functions are compatible with the Health Capability Paradigm (HCP) and Provincial Globalism (PG) principles, like the principle of shortfall equality. It takes the current level of resources, positions, and capabilities into account, according to which justice principles require us to distribute responsibilities. Functions also reflect health needs; those who lack essential goods and services must improve their own situations first before helping others. Role allocation must be voluntarily embraced, built upon actors' voluntary commitments to shared goals, public moral norms, and mutual collective accountability.
WHY IS IT IMPORTANT?
Optimal function-based allocation of roles and responsibilities is necessary because it contributes to the common goal of health capabilities for all while establishing an excellent system of health governance. The effective and efficient determination of functions ensures that we always keep our common goal in mind while minimizing the waste of resources. Compatibility with justice principles as well as the voluntary take-up of roles guarantees that actors willingly cooperate in SHG. Social experiments have found that unequal outcomes lead to negative reactions in games, such as emotional responses (e.g., anger, moral disgust), rejection of outcomes, and refusal to cooperate. Humans most likely evolved with a sense of justice and fairness, which facilitates cooperation, social reciprocity, conflict resolution, and shared endeavors. Without a reasonable, voluntary, function-based role assignment, we risk provoking negative emotions and unwillingness to cooperate amongst actors.
WHAT DOES IT LOOK LIKE?
Under optimal role allocation, each actor's relative position and absolute resources and capabilities determine their technical and political functions. Roles and responsibilities are then assigned according to what the effectuation of the health capability for all requires, and who can fulfill the requirement with the least resources. For example, given the authority and power of countries, they are best situated to develop and sustain just and functional health systems within their territory. Optimal role allocation is functional. However, SHG diverges from typical functionalism in its focus on equity and justice – it considers the needs of each actor in the assessment of capabilities (for example, domestic needs within a country) before allocating further roles at more expansive (for example, global) levels.
HOW DO WE DO IT?
Effectuating optimal role allocation starts with the collective acknowledgment of justice principles. Actors should understand and agree on justice principles in the Health Capability Paradigm (HCP) and Provincial Globalism (PG). The Global Health Constitution lays out general roles and responsibilities at the global level. The Global Institution of Health and Medicine and the Global Health Council govern the effectuation of general principles.