Walker, Louise (Researcher in politics) (2012) Healing power : the global fund, disrupted multilateralism and mediated country ownership. PhD thesis, University of Warwick.

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Abstract

This thesis examines the changes in health governance at both global and country levels
brought by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), a
self-described public/private partnership intended as a financing mechanism to achieve
Millennium Development Goal (MDG) 6. Since the G8 announced the Global Fund's
creation in 2001, it has succeeded in mobilising over US$30 bn in commitments, primarily
from donor governments.
This thesis is rooted in the 'high politics' of International Relations (IR), and in particular
its literature on globalisation, governance and international institutions. Where this
literature has failures or gaps, it draws from the Development Studies and International
Political Economy (IPE) literatures. It also relies on key informant interviews undertaken
in Geneva, Lilongwe and Zomba with executives of international institutions, and those
involved in Malawi's HIV/AIDS response including government representatives and staff
from the National AIDS Commission, donors, NGOs and those working on the front line.
This thesis relies on a descriptive, single case study to create a 'thick' narrative. Rather
than deriving generalisations, it provides a basis for further research into the nature and
effects of systemic change in how health is governed that the Global Fund signals.
This thesis makes three contributions to knowledge: 1) It provides a basis to evolve the IR
literature on globalisation, governance and international institutions to consider the nature,
significance and effects of the Global Fund as a form of institutional innovation which is
disrupting the traditional multilateral order, particularly for international institutions
working in health; 2) It challenges the use of the term 'country ownership' to mean
'putting the country in the driver's seat', and instead notes the double deficit in external
accountability that arises when global politics and country evidence collide in a Global
Fund convened elite, mediated space for country ownership; and 3) It synthesises
observations from field work in Malawi on the exercise of the Global Fund's authority and
its dislocation from external accountability when failures occur. The IR literature is silent
on the rise of the Global Fund's authority. It fails to contend with the notion that country
ownership is as much about the burden of responsibility as it is about agenda setting. This
highlights the dislocation between the loci for authority and accountability despite the
Global Fund's growing authoritative territorial claims.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	J Political Science > JZ International relations R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Library of Congress Subject Headings (LCSH):	Public health -- International cooperation, Medical policy, World health, Global Fund to Fight AIDS, Tuberculosis, and Malaria
Official Date:	August 2012
Dates:	Date Event August 2012 Submitted
Institution:	University of Warwick
Theses Department:	Department of Politics and International Studies
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Stone, Diane, 1964- ; Lisk, Franklyn
Extent:	302 leaves
Language:	eng
URI:	http://wrap.warwick.ac.uk/id/eprint/51668

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