Governing Global Health

The past few decades have seen a massive increase in the number of international organizations focusing on global health. Campaigns to eradicate or stem the spread of AIDS, SARS, malaria, and Ebola attest to the increasing importance of globally-oriented health organizations. These organizations may be national, regional, international, or even non-state organizations-like Medicins Sans Frontieres. One of the more important recent trends in global health governance,though, has been the rise of public-private partnerships (PPPs) where private non-governmental organizations, for-profit enterprises, and various other social entrepreneurs work hand-in-hand withgovernments to combat specific maladies. A primary driver for this development is the widespread belief that by joining together, PPPs will attack health problems and fund shared efforts more effectively than other systems. As Chelsea Clinton and Devi Sridhar show in Governing Global Health, these partnerships are not only important for combating infectious diseases; they also provide models for developing solutions to a host of other serious global healthchallenges and questions beyond health. But what do we actually know about the accountability and effectiveness of PPPs in relation to the traditional multilaterals? According to Clinton and Sridhar, we have knownvery little because scholars have not accumulated enough data or developed effective ways to assess them-until now. In their analysis, they uncovered both strength and weaknesses of the model. Using principal-agent theory in which governments are the principals directing international agents of various type, they take a closer look at two major PPPs-the Global Fund to Fight HIV/AIDS, TB and Malaria and the GAVI Alliance-and two major more traditional international organizations-the World HealthOrganization and the World Bank. An even-handed and thorough empirical analysis of one of the most pressing topics in world affairs, Governing Global Health will reshape ourunderstanding of how organizations can more effectively prevent the spread of communicable diseases like AIDS and reduce pervasive chronic health problems like malnutrition.

“"This is not only a timely and original book, but also a model of concise scholarship. After a quarter of a century working in the arena of global health, it wasn't until I read this book that I understood fully either the major institutions with which we so often work or the challenges before us now. Furthermore, Clinton and Sridhar have managed a minor miracle: they've made dry matters of governance interesting and even entertaining. This engaging study deserves a broad audience. Since the survival of tens of millions hang in the balance, as does the well-being of most on this planet, the stakes are greater than we know." - Paul Farmer MD, Partners In Health and Harvard Medical School "Who runs the world and why? Chelsea Clinton and Devi Sridhar ask this audacious question in this powerful and uncompromising book. They unmask the big four global health institutions of our era for the first time. Governing Global Health is a monumental achievement. Anyone seriously interested in the health of the world simply has to read it." - Lawrence O. Gostin, University Professor and Founding O'Neill Chair in Global Health Law, Georgetown Law School "The landscape of 'global health' is so fragmented, with so many agencies and private players in the picture, that it can be impossible to figure out who is in charge of everything from outbreaks to battling the tobacco industry. The adage, 'follow the money' too often leads to dead ends and bewildering arrays of public health players. Clinton and Sridhar have done a wonderful job of pulling the elusive pieces into focus, creating a must-read guide for students and practitioners of global health." - Laurie Garrett, Senior Fellow for Global Health, Council on Foreign Relations, and author of The Coming Plague "Clinton and Sridhar provide a unique insight in global health governance in a very rigorous and well documented analysis. A must for anybody working in global health, global governance and international affairs." - Peter Piot, Director & Handa Professor of Global Health, London School of Hygiene & Tropical Medicine”

"This is not only a timely and original book, but also a model of concise scholarship. After a quarter of a century working in the arena of global health, it wasn't until I read this book that I understood fully either the major institutions with which we so often work or the challenges before us now. Furthermore, Clinton and Sridhar have managed a minor miracle: they've made dry matters of governance interesting and even entertaining. This engaging study deserves a broad audience. Since the survival of tens of millions hang in the balance, as does the well-being of most on this planet, the stakes are greater than we know." - Paul Farmer MD, Partners In Health and Harvard Medical School"Who runs the world and why? Chelsea Clinton and Devi Sridhar ask this audacious question in this powerful and uncompromising book. They unmask the big four global health institutions of our era for the first time. Governing Global Health is a monumental achievement. Anyone seriously interested in the health of the world simply has to read it." - Lawrence O. Gostin, University Professor and Founding O'Neill Chair in Global Health Law, Georgetown Law School"The landscape of 'global health' is so fragmented, with so many agencies and private players in the picture, that it can be impossible to figure out who is in charge of everything from outbreaks to battling the tobacco industry. The adage, 'follow the money' too often leads to dead ends and bewildering arrays of public health players. Clinton and Sridhar have done a wonderful job of pulling the elusive pieces into focus, creating a must-read guide for students and practitioners of global health." - Laurie Garrett, Senior Fellow for Global Health, Council on Foreign Relations, and author of The Coming Plague "Clinton and Sridhar provide a unique insight in global health governance in a very rigorous and well documented analysis. A must for anybody working in global health, global governance and international affairs." - Peter Piot, Director & Handa Professor of Global Health, London School of Hygiene & Tropical Medicine

Chelsea Clinton is currently the Vice Chair of the Clinton Foundation and a Lecturer at the Mailman School of Public Health at Columbia. She completed her D.Phil in International Relations at Oxford University examining the first decade of the Global Fund to Fight HIV/AIDS, TB and Malaria. She is also the author of It's Your World: Get Informed, Get Inspired & Get Going!Devi Sridhar is Professor at the University of Edinburgh's Medical School and holds the Chair in Global Public Health. Previously, she was Senior Research Fellow at the Blavatnik School of Government and a Fellow of Wolfson College.

The past few decades have seen a massive increase in the number of international organizations focusing on global health. Campaigns to eradicate or stem the spread of AIDS, SARS, malaria, and Ebola attest to the increasing importance of globally-oriented health organizations. These organizations may be national, regional, international, or even non-state organizations-like Medicins Sans Frontieres. One of the more important recent trends in global health governance,though, has been the rise of public-private partnerships (PPPs) where private non-governmental organizations, for-profit enterprises, and various other social entrepreneurs work hand-in-hand with governments to combat specific maladies. A primary driver for this development is the widespread beliefthat by joining together, PPPs will attack health problems and fund shared efforts more effectively than other systems. As Chelsea Clinton and Devi Sridhar show in Governing Global Health, these partnerships are not only important for combating infectious diseases; they also provide models for developing solutions to a host of other serious global health challenges and questions beyond health. But what do we actually know about the accountability and effectiveness of PPPs in relation to the traditional multilaterals? According to Clinton and Sridhar, we have known very little because scholars have notaccumulated enough data or developed effective ways to assess them-until now. In their analysis, they uncovered both strength and weaknesses of the model. Using principal-agent theory in which governments are the principals directing international agents of various type, they take a closer look at two majorPPPs-the Global Fund to Fight HIV/AIDS, TB and Malaria and the GAVI Alliance-and two major more traditional international organizations-the World Health Organization and the World Bank. An even-handed and thorough empirical analysis of one of the most pressing topics in world affairs, Governing Global Health will reshape our understanding of how organizations can more effectively prevent the spread of communicable diseases like AIDS and reduce pervasive chronic health problems like malnutrition.

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