Research Article: The Global Health System: Actors, Norms, and Expectations in Transition

Date Published: January 5, 2010

Publisher: Public Library of Science

Author(s): Nicole A. Szlezák, Barry R. Bloom, Dean T. Jamison, Gerald T. Keusch, Catherine M. Michaud, Suerie Moon, William C. Clark, Gill Walt

Abstract: In the first in a series of four articles highlighting the changing nature of global health institutions, Nicole Szlezák and colleagues outline the origin and aim of the series.

Partial Text: The global health system that evolved through the latter half of the 20th century achieved extraordinary success in controlling infectious diseases and reducing child mortality. Life expectancy in low- and middle-income countries increased at a rate of about 5 years every decade for the past 40 years [1]. Today, however, that system is in a state of profound transition. The need has rarely been greater to rethink how we endeavor to meet global health needs.

In this series we undertook a study of the role of institutions in the global health system. The aims of the study were threefold: first, to advance current understanding of the interplay of actors in the system; second, to evaluate its performance; and third, to identify opportunities for improvement. The project was part of a larger program led by Harvard University’s John F. Kennedy School of Government to advance thinking on the challenges of linking research knowledge with timely and effective action in an increasingly globalized and diverse world [36],[37]. It drew together theoretical literature on global governance that has emerged from the field of international relations over the last half-century [20],[38],[39]; on empirical analysis of institutional design and performance in other sectors that, similar to public health, seek to mobilize scientific knowledge as a global public good (e.g., agriculture and environmental protection [40]–[42]); and on the engagement of several of the authors of this paper in contemporary policy debates on ways to improve the institutions that promote global health [43],[44].



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